Beliefs about E-cigarettes: A Focus Group Study with College Students.

Objectives: In this study, we consider how best to prevent recreational uptake of e-cigarettes among tobacco nonusers; it is important to investigate the underlying beliefs that young adults have about e-cigarettes and package elements. Methods: Using the focus group method of belief elicitation, we explore underlying belief structures that undergraduate students at a large Midwestern public university have about e-cigarettes. Beliefs are analyzed using the constant-comparative approach and categorized using the theory of planned behavior. Results: Participants describe a dual view, wherein e-cigarettes are a cool and causal item to use at a party, while holding a negative stigma toward everyday use. They acknowledged confusion over nicotine and focused on the flavors and smoke tricks as attractions to the product. In response to package elements, participants describe the flavors and modified risk statement as undermining the health warning. Conclusions: Findings suggest it may be useful to supplement the required warning labels with a public education campaign that improves understanding of nicotine and to regulate the amount of nicotine permissible in e-cigarettes in order to prevent addiction in recreational users, while at the same time supporting use of the product for smoking cessation.