Journal of Addiction & Prevention
Review Article
‘I Think Smoking’s the Same, but the Toys Have Changed.’ Understanding Facilitators of E-Cigarette Use among Air Force Personnel
Little MA1*, Pebley K2, Porter K1, Talcott GW1,3 and Krukowski RA4
1University of Virginia, School of Medicine, Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA, USA 22903,
2University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN, USA, 38152
3Wilford Hall Ambulatory Surgical Center, 59 MDW/ 59 SGOWMP, 1100 Wilford Hall Loop, Bldg 4554, Joint Base Lackland AFB, TX, USA 78236
4Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN, USA 38163
*Address for Correspondence: Little MA, University of Virginia, School of Medicine, Department of Public
Health Sciences, 560 Ray C. Hunt Drive, Rm 2119 Charlottesville, VA, USA, 22903; E-mail: mal7uj@virginia.edu
Submission: July 24, 2020;
Accepted: August 28, 2020;
Published: August 31, 2020
Copyright: © 2020 Little MA. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The military has stringent anti-tobacco regulations for new recruits. While most tobacco products have declined in recent
years, e-cigarette use has tripled among this population. However, little is known about the factors facilitating this inverse relationship.
Objectives: Examine the facilitators of e-cigarette use during a
high risk period following initial enlistment among young adults.
Methods: Focus groups were conducted with Airmen, Military
Training Leaders (MTLs) and Technical Training Instructors (TTIs) to
qualitatively explore unique characteristics of e-cigarettes leading to
use in Technical Training.
Results: The most commonly used tobacco product across
participants was cigarettes (42.7%), followed by e-cigarettes (28.0%)
and smokeless tobacco (22.6%). Almost a third (28.7%) of participants
reported using more than one tobacco product. E-cigarette use was
much more common among Airmen (76.1%), compared to MTLs
(10.9%) and TTIs (13.0%).
Four main facilitators around e-cigarette use were identified
including: 1) There is no reason not to use e-cigarettes; 2) Using
e-cigarettes helps with emotion management; 3) Vaping is a way of
fitting in; and 4) Existing tobacco control policies don’t work for vaping.
E-cigarettes were not perceived as harmful to self and others, which
could explain why Airmen were much less likely to adhere to existing
tobacco control regulations. Subversion was viewed as the healthy
option compared to utilizing designated tobacco use areas due to
the potential exposure to traditional tobacco smoke. This coupled with
a lack of understanding about e-cigarette regulations and difficulties
with enforcement, promoted use among this young adult population.
Conclusion: Findings suggest that e-cigarettes are used for similar
reasons as traditional tobacco products, but their unique ability
to be concealed promotes their widespread use and circumvents
existing tobacco control policies. In order to see reductions in use,
environmental policies may need to be paired with behavioral
interventions at the personal and interpersonal level.