Access to E-Cigarettes Is Easy in a Regional Area in Australia: A Qualitative Study to Explore Young People's Views...

Working directly with young people to understand vaping use is necessary for developing meaningful strategies to support them to quit. We explored a range of aspects about the use of e-cigarettes among young people in regional Tasmania, Australia, to inform local approaches to mitigate vaping.

Tasmania is an island state with about two-thirds of its population living in inner-regional areas, and one-third in outer-regional, remote, or very remote areas. There are three regions: North, Northwest, and South.

Eighteen- to twenty-four-year-old Tasmanians who had tried vaping.

An exploratory qualitative study. Recruitment per region employed purposive snowball sampling. Data collection (2021-2022) included demographics, tobacco and e-cigarette usage, participants' knowledge, beliefs, and access to e-cigarettes. One-on-one interviews and group discussions were conducted using semi-structured questions. Analysis used a combination of summative and conventional content analysis approaches to develop themes.

Twenty-three qualitative interviews and group discussions were analysed, including 29 participants in the analysis sample, 13 females and 16 males (62% South, 24% North, and 14% Northwest). Six themes were developed: 'switch, not quit': smokers are not switching to e-cigarettes to quit nicotine; 'curiosity and social influence are key reasons why young people tried vaping'; 'vaping is convenient- easy to get, easy to use and easy to hide', 'short-term effects of vaping are experienced', 'knowledge about vaping is varied'; and 'suggestion for actions from young people to address the issue of vaping'. The acceptability of vaping was high, and it was seen as safe.

Our findings support the recently implemented vaping reforms for Australia and suggest that such reforms will be relevant in regional and rural areas. However, it is crucial to continue working with young people to ensure strategies are locally developed and meaningful.

Young people of Tasmania with lived experience were actively engaged throughout this research, to help us understand the underlying drivers of vaping in their communities. They have advised that if adults want to change the behaviour of young people, then we need to co-design solutions with young people. More co-design research is needed to incorporate the voices of young people and their ideas about prevention and cessation need to be considered alongside the implementation of regulatory changes.