Abstract
Background
E-cigarette use among 18-24 year olds has rapidly increased in Aotearoa New Zealand over the past 5 years. Current evidence suggests that e-cigarettes are appealing to young people. Currently, understanding of how and why young people use e-cigarettes is limited, including their experiences of vaping, what influences appeal, experience of harms, and the influence of both interpersonal and societal level social contexts. Tertiary education is a key setting, as it is located within literature as a time where substance use and experimentation increases among young people. Finally, several gendered aspects of men’s and women’s experiences using e-cigarettes have been identified in the existing literature, including device characteristics, motivations for use, and experiences of stigma. However, gendered aspects have yet to be explicitly explored, highlighting a key knowledge gap in the context of young peoples’ e-cigarette use.
The aim of this thesis is to explore female tertiary students’ experiences of initiation and maintenance of e-cigarette use, and the influence of both interpersonal and societal level social contexts on e-cigarette use behaviours.
Methods
This research took a qualitative approach, using friendship dyad style interviews where participants were two young women with an existing friendship. Participants were women aged between 18-24, who were currently enrolled in tertiary education, and had progressed from vaping fewer than four times a month to vaping daily. The social nature of the interviews aligned with the social contexts explored by the research and reflected the higher levels of self-disclosure among female same sex friendships. Interviews were conducted at the University of Canterbury campus and followed a semi-structured guide to explore key themes while maintaining flexibility for participant direction. The interviews were then transcribed and analysed following the thematic analysis process outlined by Braun and Clarke.
Results
Key themes identified included appeals of e-cigarettes and vaping, experiences of addiction and dependence, and interpersonal and societal social contexts. Flavours, device characteristics, mood management, and social connections heightened the appeal of e-cigarettes and vaping. Vaping for the first time was often facilitated by peers, and social settings with peers were perceived as an acceptable place to use e-cigarettes. The stereotype of who is an ‘addict’ conflicted with the self-identity of the young women. Further, the perception prior to using e-cigarettes was that nicotine addiction or dependence would not happen to them. Following development of addiction and dependence behaviours, several of the young women experienced negative impacts on physical, mental, or emotional health. Social contexts operated at the interpersonal level, where the young women experienced subtle peer pressure to engage in a shared behaviour. At the societal level, the theory of habitus highlighted how young women recognise settings in which vaping would be a normative behaviour, and settings where it would not.
Conclusion
This research goes beyond existing literature by exploring social contexts at both interpersonal and societal levels, offering unique perspectives of both and highlighting important gendered aspects of vaping by focussing on young women. The findings revealed that peers are a significant influence on initiation and ongoing use of e-cigarettes, young women identify both benefits and harms associated with vaping, and they recognise settings where e-cigarette use is normative or not and adjust their behaviour accordingly. These findings are evidence for the nuanced ways in which young women use e-cigarettes, and highlight the importance of understanding social contexts for future policy or practice interventions surrounding e-cigarettes.