Perceptions of Australia's e-cigarette regulations and recommendations for future reforms: a qualitative study of adolescents and adults

OBJECTIVE: To assess public perceptions of the effectiveness of e-cigarette regulations in minimising use among adolescents and those who have never smoked. Specifically, we explored (1) perceived effectiveness of current regulations relating to e-cigarettes and (2) ideas for further regulations that could reduce use. DESIGN AND PARTICIPANTS: Focus groups (n=16) were conducted with Australian adolescents (14-17 years), young adults (18-24 years) and adults (25-39 years). Groups were stratified by age, gender and e-cigarette use status. Data were analysed using reflexive thematic analysis. SETTING: Focus groups were conducted in-person in two major Australian cities. RESULTS: Groups lacked a comprehensive understanding of e-cigarette regulations in Australia. When informed of these regulations, half of the groups considered the prescription model for nicotine e-cigarette products to be effective when enforced appropriately. Almost all groups considered access to non-nicotine products problematic. All groups suggested a range of demand reduction regulations, including plain packaging, health warnings, flavour restrictions and increased vape-free areas. Most groups (predominantly those who had never vaped) also recommended supply reduction regulations such as banning all e-cigarettes. The need for supply reduction measures to include addiction and mental health supports was discussed. CONCLUSIONS: The regulations recommended by participants largely align with those that are to be introduced in Australia, indicating that these reforms are likely to be accepted by the public. Ensuring these reforms are complemented by formal supports for young people experiencing nicotine dependence and related mental health concerns is critical.