The unique contribution of e-cigarettes for avoiding relapse to smoking – consumer experiences of quitting, switching, dual using, and ‘permissive lapse’ on the path to maintaining abstinence

Aims: Although many smokers manage to quit, in the general population more than 90% of quit attempts result in eventual relapse (Etter & Stapleton, 2006). Most current e-cigarette users state that they use e-cigarettes for smoking cessation or to cut down from smoking (McNeill et al, 2015). We know very little about people in the general population who quit smoking using an e-cigarette and their eventual relapse status. Methods: Qualitative data from an ongoing study. In-depth interviews with 40 participants, complemented by innovative photo elicitation techniques to specifically examine the social contexts and meaning of e cigarette use in the daily lives of consumers. Data are iteratively analysed using thematic coding, also incorporating a discursive approach. Results: Variable aspects of e cigarettes offer the ex-smoker a unique experience beyond other nicotine replacement therapies. Ex-smokers can choose a substitute ‘smoking-like’ experience, preferable for some, or a move away from smoking towards a new vaping identity, attractive to others. Importantly, our sample of vapers demonstrate how smoking lapse may be perceived qualitatively differently than for other ex-smokers, as a ‘permissive lapse’. Having the alternative of vaping means that full relapse to smoking is not perceived as inevitable following a lapse, as it may have been previously. Conclusions: Our work aligns closely with everyday concerns, motivations, and experiences of different profiles of e-cigarette users, providing much needed qualitative evidence on e-cigarette use in relation to maintaining smoking abstinence. This will be important in informing future development of e-cigarette based smoking relapse prevention interventions.