“It’s a bunch goop that you're putting in your lungs”: A Qualitative Study of E-Cigarette Perceptions Among Young Adults Who Do Not Vape

INTRODUCTION: E-cigarettes (ECs) are the most used tobacco product among adolescents and young adults. While most research investigates initiation, few studies focus on protective factors that discourage vaping. METHODS: To examine protective factors against e-cigarette use, participants (N = 48) aged 18-25 who had never used e-cigarettes completed a virtual individual interview lasting up to 15 minutes. The interviews explored three key areas: (1) perceptions of EC health risks, (2) exposure to and influence of EC-related media (social media and marketing), and (3) perspectives on why others use ECs. An inductive thematic analysis of the transcripts identified themes and patterns within the three topic areas. All transcripts were coded by two independent coders (NVivo) and cross-checked by a third researcher to resolve discrepancies. RESULTS: On average, participants (N=48) were 20.5 years old (SD = 1.92 years). A large proportion of participants identified as White = 41.6%, Female (81.2%), and non-Latinx/Hispanic/Latino (81.25%). Participants (83%) cited harm to physical health, to mental health (35%), and addiction (27%) as primary concerns of EC-use. Participants (44%) cited exposure to content in the media and online anti-tobacco campaigns (65%). Participants perceived others' EC use as driven by social appeal (50%), appealing product characteristics (75%, primarily citing flavors), and coping (33%). CONCLUSIONS: Findings suggest that negative risk perceptions and exposure to anti-EC content may deter EC use initiation. Findings from this and similar studies can inform prevention campaigns by emphasizing the values, beliefs, and social factors that motivate young people to avoid EC use.