The New 'Cool'? A Qualitative Study of E-Cigarette Perceptions and Experience Among Irish Adolescents

E-cigarette use among young people has increased significantly in recent years, and their health impact is a concern. Countries are challenged to define an effective regulatory and public health response. In Ireland, information is limited in terms of access, knowledge, and the context in which e-cigarettes are used. The study aims to provide an in-depth understanding of these factors to help develop policies and interventions to combat e-cigarette use among young people.

Focus groups of children aged 15-16 years (n = 76) were conducted in three schools. A topic guide was utilised to facilitate discussion. Topics were introduced using a third person technique, asking participants to discuss them in terms of schoolchildren in general. Focus groups were recorded, transcribed, and thematically analysed.

E-cigarettes are popular, with the emergence of a sub-culture of young users. Risk awareness of nicotine, or the health effects of e-cigarettes was unclear. Few had seen e-cigarette warning labels. There was a lack of school education about e-cigarettes. E-cigarettes were used in locations where they can be concealed. There was an awareness of the e-cigarette flavours, with sweet and fruity flavours being popular. E-cigarettes were easy to access, particularly by using social media, with online buying and selling online between schoolchildren. Pop up adverts with discount codes were common plus social media was used to view videos of 'vape tricks'. Smoking, alcohol consumption, and use of e-cigarettes were interlinked; participants felt that those who smoked or vaped also consumed alcohol, which would often be consumed at the same time. Alcohol may influence the decision to experiment with e-cigarettes and other substances.

The study highlights the urgent need for further policy action, including better education for children and parents, regulating social venues and advertising, and restricting flavours and product placement of e-cigarettes.