Teenage perceptions of electronic cigarettes in Scottish tobacco-education school interventions: co-production and innovative engagement through a pop-up radio project

Abstract

Aims: This article thematically analyses spontaneous responses of teenagers and explores their perceptions of electronic cigarettes (e-cigarettes) with a focus on smoking cessation from data collected for research exploring Scottish secondary school students' recall of key messages from tobacco-education interventions and any influence on perceptions and behaviours. Methods: E-cigarettes were not included in the research design as they did not feature in interventions. However, in discussions in all participating schools, e-cigarettes were raised by students unprompted by researchers. Seven of 19 publicly funded schools in the region opted to participate. Groups of 13- to 16-year-olds were purposely selected to include a range of aptitudes, non-smokers, smokers, males and females. A total of 182 pupils took part. Data were generated through three co-produced classroom radio tasks with pupils (radio quiz, sitcom, factual interviewing), delivered by a researcher and professional broadcast team. All pupils were briefly interviewed by a researcher. Activities were recorded and transcribed verbatim and the researcher discussed emerging findings with the broadcast team. Data were analysed using NVivo and transcripts making reference to e-cigarettes examined further using inductive thematic analysis. Results: Key themes of their impressions of e-cigarettes were easy availability and price; advertising; the products being safer or healthier, addiction and nicotine; acceptability and experiences of use; and variety of flavours. Conclusions: This was a qualitative study in one region, and perception of e-cigarettes was not an a priori topic. However, it provides insights into youth perceptions of e-cigarettes. How they discerned e-cigarettes reflects their marketing environment. The relative harmlessness of nicotine, affordability of e-cigarettes, coolness of vaping, absence of second-hand harms and availability of innovative products are all key marketing features. Conflicting messages on safety, efficacy, potential ‘gateway' to smoking and nicotine may be contributing to teenagers' confusion. The allure of ‘youthful cool' to vaping offers no public health gain, so children should be protected from misleading promotion. Consistent tobacco-education initiatives need to account for this popular trend.