title: How and Why Do Smokers Start Using E-Cigarettes? Qualitative Study of Vapers in London, UK.
abstract: The aims of the study were to (1) describe how and why smokers start to vape and what products they use; (2) relate findings to the COM-B theory of behaviour change (three conditions are necessary for behaviour change (B): capability (C), opportunity (O), and motivation (M)); and (3) to consider implications for e-cigarette policy research. Semi-structured interviews (n = 30) were conducted in London, UK, with smokers or ex-smokers who were currently using or had used e-cigarettes. E-cigarette initiation (behaviour) was facilitated by: capability (physical capability to use an e-cigarette and psychological capability to understand that using e-cigarettes was less harmful than smoking); opportunity (physical opportunity to access e-cigarettes in shops, at a lower cost than cigarettes, and to vape in "smoke-free" environments, as well as social opportunity to vape with friends and family); and motivation (automatic motivation including curiosity, and reflective motivation, including self-conscious decision-making processes related to perceived health benefits). The application of the COM-B model identified multiple factors that may lead to e-cigarette initiation, including those that could be influenced by policy, such as price relative to cigarettes and use in smoke-free environments. The effects of these policies on initiation should be further investigated along with the possible moderating/mediating effects of social support.
authors.affiliation: National Addiction Centre, King's College London, 4 Windsor Walk, London SE5 8BB, UK. elle.wadsworth@kcl.ac.uk.
authors.forename: Elle
authors.initials: E
authors.lastname: Wadsworth
authors.affiliation: National Addiction Centre, King's College London, 4 Windsor Walk, London SE5 8BB, UK. joanne.neale@kcl.ac.uk.
authors.forename: Joanne
authors.initials: J
authors.lastname: Neale
authors.affiliation: National Addiction Centre, King's College London, 4 Windsor Walk, London SE5 8BB, UK. ann.mcneill@kcl.ac.uk.|UK Centre for Tobacco and Alcohol Studies, Nottingham NG5 1PB, UK. ann.mcneill@kcl.ac.uk.
authors.forename: Ann
authors.initials: A
authors.lastname: McNeill
authors.affiliation: National Addiction Centre, King's College London, 4 Windsor Walk, London SE5 8BB, UK. sara.hitchman@kcl.ac.uk.|UK Centre for Tobacco and Alcohol Studies, Nottingham NG5 1PB, UK. sara.hitchman@kcl.ac.uk.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Hitchman
mesh_terms: D000293:Adolescent; D000328:Adult; D066300:Electronic Nicotine Delivery Systems / Q000523:psychology*; D004644:Emotions; D005260:Female; D017144:Focus Groups; D006801:Humans; D007398:Interpersonal Relations; D008131:London; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D036301:Qualitative Research; D000072137:Vaping; D055815:Young Adult
keywords: COM-B model; behaviour change; cigarettes; electronic cigarettes; nicotine; smoking cessation