Abstract
The aims of the study were to (1) describe how and why smokers start to vape and what products they use; (2) relate findings to the COM-B theory of behaviour change (three conditions are necessary for behaviour change (B): capability (C), opportunity (O), and motivation (M)); and (3) to consider implications for e-cigarette policy research. Semi-structured interviews (n = 30) were conducted in London, UK, with smokers or ex-smokers who were currently using or had used e-cigarettes. E-cigarette initiation (behaviour) was facilitated by: capability (physical capability to use an e-cigarette and psychological capability to understand that using e-cigarettes was less harmful than smoking); opportunity (physical opportunity to access e-cigarettes in shops, at a lower cost than cigarettes, and to vape in “smoke-free” environments, as well as social opportunity to vape with friends and family); and motivation (automatic motivation including curiosity, and reflective motivation, including self-conscious decision-making processes related to perceived health benefits). The application of the COM-B model identified multiple factors that may lead to e-cigarette initiation, including those that could be influenced by policy, such as price relative to cigarettes and use in smoke-free environments. The effects of these policies on initiation should be further investigated along with the possible moderating/mediating effects of social support.
Highlights
E-cigarettes are electronic devices that use a battery powered heating element to disperse liquid, usually a solution of glycerine and/or propylene glycol containing nicotine, into an aerosol that can be inhaled [1]
This paper, has the following three aims: (i) to describe how and why smokers start to vape, and what products they choose to initiate; (ii) to relate the findings to an established theory of behaviour change, the COM-B model [16]; and (iii) to consider the implications of the findings for policy research
Relating data on how and why smokers start to vape to the six core components of the COM-B model (i) physical capability; (ii) psychological capability; (iii) physical opportunity; (iv) social opportunity; (v) automatic motivation; and (vi) reflective motivation) should, provide useful insights into how the initiation of e-cigarettes might be better facilitated and prevented [18]
Summary
E-cigarettes are electronic devices that use a battery powered heating element to disperse liquid, usually a solution of glycerine and/or propylene glycol containing nicotine, into an aerosol that can be inhaled [1]. Models that are designed to be refilled with liquid by the user (tanks) [2]; and third generation models that contain a higher capacity battery and are modified (mods). A Cochrane review found that e-cigarettes containing nicotine were better at helping smokers to stop smoking compared with placebo e-cigarettes [4]
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