Mixed-Methods Study Exploring Motivation to Vape and Perception of Vaping Risk.

Abstract

Background: Electronic cigarette (e-cigarette) use has surged globally, particularly among young adults and parents of young children. Though often perceived as a safer alternative to traditional cigarettes, concerns have grown regarding secondhand exposure, especially for children. Misconceptions about the safety of vaping may influence parental decisions to use e-cigarettes around their children.

Objectives: To explore parental motivations for e-cigarette use and perceptions of the risks associated with vaping around children, using a mixed-methods approach.

Methods: This explanatory sequential mixed-methods observational study combined quantitative survey data and qualitative focus group findings. Participants were daily e-cigarette users who were parents of children aged 4-12 years and lived in the same household. Participants completed self-report questionnaires assessing sociodemographic characteristics, motivations to vape, and perceived harms. Psychological dependence was assessed using the E-cigarette Dependence Scale (EDS). A subset participated in virtual focus groups, guided by a semistructured interview protocol. Quantitative data were analyzed using SPSS version 26; qualitative data were coded inductively and deductively using MAXQDA and analyzed thematically.

Results: Survey participants were predominantly Black, single, low-income mothers with a mean age of 38 years and moderate to high nicotine dependence. Most participants reported initiating e-cigarette use as a smoking cessation strategy and believed vaping posed little to no health risks. Three qualitative themes emerged: (1) vaping as a means to stop smoking, (2) perceived belief that vaping is better than cigarette smoking, and (3) the power of addiction. Despite awareness of potential harms, participants described compulsive use and limited understanding of secondhand exposure risks to children.

Discussion: Parental e-cigarette use is influenced by beliefs about harm reduction, smoking cessation goals, and nicotine dependence. Misconceptions about secondhand aerosol risks underscore the need for targeted health education. Interventions must consider both the psychological dependence and the socioeconomic context influencing parental vaping behaviors.