Knowledge and Beliefs About E-Cigarettes in Straight-to-Work Young Adults

Introduction: Young adults are a growing segment of electronic cigarette (e-cigarette) users. Young adults who go straight to work (STW) from high school make up a large portion of the young adult population, yet research to date has focused on college-educated young adults. This study explored STW young adult beliefs and knowledge about e-cigarettes. Methods: Semistructured individual interviews were used to elicit in-depth information from STW young adults ages 19-31 from a state in the southwest United States. Thirty interviews were conducted focusing on beliefs about e-cigarettes, current knowledge, and information-seeking practices. Interviews were recorded, transcribed, and analyzed using NVivo. Results: Nine themes were identified falling into three categories: (1) beliefs about e-cigarettes, (2) knowledge about e-cigarettes, and (3) personal rules about e-cigarettes. STW young adults held positive beliefs about the health and safety of e-cigarettes for themselves, others, and the environment. They reported their social networks and the Internet as reliable sources of information about e-cigarettes, but they reported parents as the best source for advice. Participants had rules about e-cigarettes that contradicted some of their beliefs such as using e-cigarettes around children indicating that their beliefs were not as strongly held as they initially reported. Conclusions: Industry marketing and contradictory information may contribute to STW young adult knowledge and beliefs about e-cigarettes. Lack of credible public health information may also contribute to this issue. Ensuring that what is known about the benefits and harms of e-cigarettes is conveyed through multichannel communication and continued monitoring of marketing practices of the e-cigarette industry in light of the soon to be implemented regulations should be top priorities for public health. Implications: Beliefs and knowledge of STW young adults have not been explored even though they are heavily targeted by the e-cigarette industry. This group holds strong positive beliefs about the health and safety of e-cigarettes, despite having little credible knowledge about them. This study indicates a need for efforts focused on educating STW young adults on the potential risks and benefits of e-cigarettes and the communication of credible information or at minimum the acknowledgment of the uncertainty regarding the long-term health effects of e-cigarettes. It also indicates a need for continued monitoring and advocacy related to marketing practices of the e-cigarette industry.