Removing or returning freedom? Views on a nicotine-free generation policy held by young people from aotearoa who use electronic nicotine delivery systems (ENDS).

Abstract

Introduction: International interest in a smokefree generation policy has grown as more local authorities and governments move to introduce this policy. Young people strongly support this measure, but we know less about how they view a nicotine-free generation policy that includes electronic nicotine delivery systems (ENDS). We addressed this gap by probing adolescents' views on a birth-year policy that included all nicotine products.

Methods: We undertook in-depth interviews with 20 adolescents aged 16-18 who self-assessed as moderately or severely addicted to vaping and lived in Aotearoa New Zealand. In semistructured interviews, we explored participants' views on a nicotine-free generation, its rationale, implementation and likely impact. We interpreted the data using a reflexive thematic analysis approach.

Results: Most participants supported a nicotine-free generation, rejected arguments that ENDS use was a 'choice', and called for government leadership to protect them and future generations; a small minority saw the measure as unwarranted interference. Several participants thought compliance would be low, given their experiences of lax age verification practices and the widespread social supply of ENDS, but suggested measures to improve compliance.

Conclusions: Although participants thought a nicotine-free generation could impose personal hardship, most privileged the freedom they thought it could bring over the illusory 'choice' they currently had. Policy-makers should consider looking beyond a smokefree generation to a nicotine-free generation; alongside this measure, they should implement strong enforcement and provide comprehensive support so young people addicted to nicotine can be empowered to stop using ENDS.