Perceptions of FDA-authorized e-cigarettes and use interest among young adults who do not use tobacco

Kathryn La Capria; Kristen R Hamilton-Moseley; Lilianna Phan; Bambi Jewett; Kiana Hacker; Kelvin Choi; Julia Chen-Sankey

doi:10.18332/tpc/190582

Perceptions of FDA-authorized e-cigarettes and use interest among young adults who do not use tobacco

Tob Prev Cessat. 2024 Jul 29:10. doi: 10.18332/tpc/190582. eCollection 2024.

Authors

Kathryn La Capria¹, Kristen R Hamilton-Moseley², Lilianna Phan^{2

3}, Bambi Jewett², Kiana Hacker², Kelvin Choi², Julia Chen-Sankey^{1

4}

Affiliations

¹ Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, New Jersey, United States.
² National Institute of Minority Health and Health Disparities, Bethesda, Maryland, United States.
³ Drexel University, Dornsife School of Public Health and College of Nursing and Health Professions, Philadelphia, Pennsylvania, United States.
⁴ Rutgers School of Public Health, Piscataway, New Jersey, United States.

Abstract

Introduction: It is unclear how young adults who do not use tobacco perceive FDA-authorized e-cigarettes for market entry. This study explored the perceptions and use interests of FDA-authorized e-cigarettes among this population to inform policy decision-making.

Methods: We conducted in-depth interviews with young adults in the US, aged 18-29 years, who do not use tobacco (n=25). Participants viewed images of FDA-authorized e-cigarettes and discussed their perceptions and interest in using these products. We used reflexive thematic analysis to analyze interview data.

Results: Many participants stated that they were not interested in using FDA-authorized e-cigarettes because they had little interest in using e-cigarettes in general. Additionally, almost all participants found the tobacco flavor and product design of these products unappealing, which further added to their disinterest. Most reported high trust in the FDA and its authorization process for e-cigarette market entry and considered FDA-authorized e-cigarettes safe to use. Most considered FDA-authorized products less harmful than other (unauthorized) e-cigarettes they saw in daily life but were not more interested in using the authorized products. When given the hypothetical scenario where FDA-authorized products come with a variety of fruit and candy flavors, most participants still expressed little interest in using them, mainly due to the high perceived harm from using any e-cigarette products.

Conclusions: Although non-tobacco-using young adults in our study reported low interest in using FDA-authorized e-cigarettes for market entry and e-cigarettes in general, the FDA is recommended to continue to evaluate the impact of flavorings and packages on e-cigarette product appeal to reduce e-cigarette use among young people. The FDA should also examine strategies to effectively communicate the purpose of FDA authorization to the public and emphasize that it does not mean these products are 'approved' or safer than unauthorized products.

Keywords: FDA authorization; FDA-authorized e-cigarettes; e-cigarettes; in-depth interview; tobacco; young adults.

Grants and funding

FUNDING This work was supported by the National Institute on Minority Health and Health Disparities’ Intramural Research Program. L. Phan was supported by the NIH FIRST Program (U54CA267735), with funding support from the Office of Director (OD), NIH, and the Pathway to Independence Award in Tobacco Regulatory Research from NCI/FDA (R00CA272919). The content is solely the responsibility of the authors and does not necessarily represent the official views of the US Government, the National Institutes of Health, or the US Food and Drug Administration.