Psychological distress and e-cigarette use among young Australians: An exploratory, qualitative study

Introduction Emerging research suggests an association between psychological distress and e-cigarette use. However, our understanding of young adults’ experiences of this relationship is limited. We explored young adults’ experiences of psychological distress and e-cigarette use. Methods We conducted semi-structured interviews with 18- to 24-year-old university students (n=13; 77% female; mean age=21.5 years) based in Victoria, Australia. Interviews were conducted May–June 2023. Data were subject to reflexive thematic analysis. Results Individuals reported that they or their friends had initiated e-cigarette use to manage their psychological distress (e.g. low mood, social isolation, stress). Immediate stress reduction following use and subsequent nicotine dependence appeared to maintain use. Conclusions A reciprocal relationship likely exists between psychological distress and e-cigarette use whereby psychological distress contributes to use initiation and use maintains distress. Public campaigns and health services should provide: 1) education on adaptive coping/stress management strategies and the signs of nicotine dependence, and 2) support to manage nicotine dependence and the psychological distress that can arise from addiction.