Real world experiences of using e-cigarettes to avoid smoking relapse: findings from an ongoing qualitative study

First published: 30 March 2019 | Last updated: 20 May 2019


Dr Caitlin Notley

Caitlin Notley

Dr Notley is an SSA Post-Doctoral Fellow, undertaking a programme of work focused on tobacco smoking relapse prevention. She is an expert in qualitative research methods. In recent years she has led a qualitative study of self-help and relapse prevention in smoking. This study collected qualitative process evaluation data alongside an HTA funded trial of a self-help relapse prevention intervention. She also led a systematic review synthesising barriers and facilitators to postpartum smoking relapse prevention. Currently she is leading a study with funding from Cancer Research UK on electronic cigarettes for relapse prevention, and also has recently secured funding from the Medical Research Council to develop an intervention to support women who stop smoking in pregnancy to stay stopped postpartum.

Aims: Tobacco smoking remains the leading preventable cause of death worldwide (WHO, 2013). Although many smokers manage to quit, in the general population more than 90% of quit attempts result in eventual relapse to smoking (Etter & Stapleton, 2006). Since first appearing on the market in the UK in around 2005, use of e-cigarettes has increased exponentially  (Dockrell et al, 2013) with estimates suggesting that 2.6 million adults in Great Britain currently use electronic cigarettes (Ash, 2015). Encouragingly, most current e-cigarette users state that they use e-cigarettes for smoking cessation or to cut down from smoking, with an eventual aim of quitting smoking completely (McNeill et al, 2015). However, we know very little about people in the general population who quit smoking using an e-cigarette and their eventual relapse status.

Methods: This presentation presents preliminary qualitative data offering in-depth participant perspectives on patterns of e-cigarette use over time in the context of smoking cessation or relapse. Data is drawn from an ongoing interview based study iteratively analysing data according to Grounded theory principles.

Results: We suggest that important unique aspects of e cigarettes such as the range and type of devices used, the range and variety of e liquid flavourings and strengths, and the social context of use that can mimic ‘smoking-like’ behaviours, offer the ex-smoker a unique substitute experience beyond what is offered by other nicotine replacement therapies. Aspects related to the devices, their use in social situations, and the interplay between e cigarette use and social identity are important from a participant perspective.

Conclusions: The data presented provides much needed qualitative research evidence on e-cigarette use in relation to smoking relapse which will be of importance in informing future development of e-cigarette based smoking relapse prevention interventions, aligning closely with the everyday concerns, motivations, and experiences of different profiles of e-cigarette users.


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Dr Caitlin Notley