GPs’ perspectives on assessing adolescent vaping among individuals without prior smoking history: a qualitative study within primary care

Background An increasing number of adolescents and young adults who have never smoked now use e-cigarettes. GPs must screen and counsel effectively: vaping is linked to nicotine addiction, respiratory symptoms, and cardiovascular effects. Limited long-term data compounds risk and uncertainty for chronic users. Evidence to guide GP counselling of adolescent and young adult vapers remains scarce in routine clinical practice. Aim To investigate GPs’ perspectives on tackling the vaping epidemic, their preparedness, challenges, and potential improvements at personal and national levels. Design & Setting Qualitative study using semi-structured interviews (SSIs) with British GPs. Method Invitations for SSIs were sent to Primary Care Networks (PCNs) nationwide. Participants were purposively sampled to reflect the national GP demographic. Interviews were conducted across the UK in April and May 2024, reaching data saturation at n =11. Interviews were transcribed verbatim, imported to NVivo10 and thematically analysed using the Gioia Method. Results Four aggregate dimensions, 11 second-order themes and 29 first-order concepts emerged. Drivers for change centred on rising concern about youth vaping; current practice was marked by limited knowledge and variable counselling; barriers included lack of guidance, services and time; recommendations emphasised improved education, digital tools and stakeholder engagement. Conclusion Our findings highlight the urgent need for interventions to address rising e-cigarette use among adolescent and young adult never-smokers. While some GPs are motivated to improve practice, others are uncertain given the limited and mixed evidence currently. Effective solutions must extend beyond primary care to involve other healthcare professionals and key stakeholders.