Initiation, appeal, and dependence: a qualitative exploration of e-cigarette use in Chile

Résumé fourni par la source

E-cigarette use has increased in Chile, where products remain widely accessible through diverse sales channels, including informal markets. Lifetime prevalence is 15.1%, with 3.6% reporting past-year use. Use is highest among young adults (19–25 years) and lowest among older groups. Despite Chile’s historically high smoking prevalence among women, national data show no sex differences in past-year e-cigarette use. Although nicotine-containing devices are classified as pharmaceutical products, no brand has obtained formal authorization for sale. This study aims to examine how adults engage with e-cigarettes in the Chilean regulatory context, focusing on patterns of initiation, product selection, and sustained use. Eighteen semi-structured in-depth interviews were conducted between May 2024 and 2025 with adult e-cigarette users (including one informal seller) in the Metropolitan Region of Santiago, Chile, in a convenience sample. Participants were recruited through snowball sampling and outreach across social and digital platforms. Data were transcribed, anonymized, and thematically analyzed using an inductive approach to capture participants’ experiences. Participants were primarily young adults (aged 18–45), with a predominance of women (77.8%). Four interrelated themes emerged: (1) initiation often took place in social and recreational settings, where peer sharing and informal access were common; (2) users frequently prioritized design, flavor, and ease of use over nicotine content, framing e-cigarettes as lifestyle products; (3) occasional use sometimes progressed to routine consumption, facilitated by convenience and environmental factors; and (4) signs of dependence and reported strategies to moderate their use. E-cigarette use was closely tied to social settings, aesthetic appeal, and daily routines. Product engagement was shaped more by usability and context than by nicotine content or health motivations. These findings highlight the need for policies that address informal sales channels, improve product transparency, and consider the social and sensory drivers of e-cigarette use in underregulated contexts. As one of the first qualitative studies of adult e-cigarette use in Chile, this research provides insight into users’ experiences in an evolving regulatory environment. The study highlights behavioral patterns, such as peer-driven initiation, flavor-oriented preferences, and habitual use, that may inform public health approaches in Chile and other countries navigating similar market and public health conditions.

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