# Patient perceptions of the use of e-cigarettes in smoking treatment programs: a qualitative analysis

## TL;DR

This study explores how patients view e-cigarettes as a tool for quitting smoking, finding mixed feelings about their role in quitting and the need for clearer guidelines.

## Contribution

The study provides novel qualitative insights into patient perceptions of e-cigarettes in smoking treatment programs.

## Key findings

- Participants showed eagerness to try e-cigarettes but had concerns about what it means to 'quit' smoking.
- Many participants distinguished between short-term and long-term goals when using e-cigarettes.
- Clear guidelines are needed to integrate e-cigarettes into smoking cessation programs effectively.

## Abstract

E-cigarettes may serve as a safer alternative to combustible cigarettes and may be more effective than currently available nicotine replacement therapy (NRT). Little is known about the perceptions of using e-cigarettes as part of a smoking treatment program. The objective of this study was to gain insight into patient-level factors to consider when developing smoking treatment programs that incorporate e-cigarettes.

Qualitative analysis of in-depth interviews with 14 participants enrolled in the e-cigarette treatment arm of a tobacco treatment intervention pilot randomized trial comparing the impact of behavioral counseling paired with e-cigarettes or NRT on smoking outcomes. Participants were prompted to share their experiences with the products and the study overall. Transcripts were coded according to the principles of framework analysis for applied research. Codes were organized into themes using the principles of grounded theory.

Themes suggest that while there is an eagerness to try e-cigarettes as a new tool for smoking cessation, there is apprehension regarding what it means to “quit” if switching to e-cigarettes. Reflecting on the transitional purpose of e-cigarettes and potential health concerns associated with their use, many participants differentiated between the short-term goal to quit combustible cigarettes and the long-term goal to quit e-cigarettes.

Including e-cigarettes as an option in smoking treatment regimens may be an opportunity to re-engage people who smoke who have tried and failed to quit with other forms of treatment. Participants found it challenging to establish what it means to quit cigarettes with e-cigarettes due to addiction and other health concerns. Clear guidelines are needed for integrating e-cigarettes into smoking cessation programs.

ClinicalTrials.gov Identifier: NCT04465318.

The online version contains supplementary material available at 10.1186/s13722-025-00575-w.