'Maybe they should regulate them quite strictly until they know the true dangers': a focus group study exploring UK adolescents' views on e-cigarette regulation.

Heide Weishaar,Shona Hilton,Filippo Trevisan

doi:10.1111/add.13377

Abstract

Background and aimsRegulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age‐of‐sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents’ perceptions of existing, and opinions about potential e‐cigarette regulation.MethodsSixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed.ResultsParticipants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e‐cigarette regulation and endorsed restrictions on sales to minors, marketing and e‐cigarette use in public places. Concern about potential health harms of e‐cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation.ConclusionsIn focus group discussions, a sample of UK adolescents exposed to particular communications about e‐cigarettes supported strict regulation of e‐cigarettes, including banning sales to minors and use in indoor public areas.

Highlights

In the last few years the use of, and experimentation with, electronic cigarettes (e-cigarettes) has risen sharply among adolescents [1,2,3]
Participants acknowledged that the regulation of e-cigarettes required complex and ‘tricky’ decisions (17, male, non-smoker, ex/tried e-cigarette)
Our analysis shows that the adolescent participants in this study had a sophisticated understanding of the potential advantages and disadvantages of e-cigarette use and marketing, considered the existing evidence base critically and showed ample awareness of the difficulties of making regulatory decisions in view of inconsistent and inconclusive evidence of long-term harms

Summary

Introduction

In the last few years the use of, and experimentation with, electronic cigarettes (e-cigarettes) has risen sharply among adolescents [1,2,3]. A causal relationship remains unclear, research suggests that adolescents who use ecigarettes might be more likely to take up smoking [4,5,6]. These concerns have sparked regulatory actions (e.g. ageof-sales restrictions and regulation of advertising) by the European Union [7], English [8], Scottish [9] and Welsh [10] authorities. Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. Transcripts were imported into Nivivo 10, coded thematically and analysed

Methods

Results

Conclusion