Knowledge, perceived harms and reasons for use of disposable electronic cigarettes among youth: a qualitative study in Switzerland.

Background: Disposable electronic cigarettes (DECs) have rapidly gained popularity among adolescents and young adults (AYAs), raising public health concerns related to nicotine dependence, exposure to potentially harmful substances and environmental burden. While motivations for e-cigarette use have been explored, little is known about how AYAs perceive and use DECs, in particular within a changing regulatory context such as Switzerland. Objectives: This qualitative study explored AYA's knowledge, perceived harms and reasons for DEC use through a developmental lens, to better understand vulnerabilities specific to this age and inform prevention strategies targeting this population. Methods: Eight focus groups were conducted via videoconference between October and December 2022 with 51 participants aged 14-25 years living in the Swiss cantons of Vaud and Valais. Discussions were transcribed, anonymised and analysed using a thematic analysis approach. Results: While DECs were largely known and consumed, participants had limited and often imprecise knowledge regarding product composition and nicotine content. Perception of harm was heterogeneous and influenced by packaging and insufficient product information. DEC use was primarily described as driven by experimentation, transgression, peer dynamics and identity construction rather than by nicotine effects, although nicotine addiction was sometimes described as a consequence of use. DECs were often described as interchangeable with conventional cigarettes. Accessibility and marketing features such as flavours, design and social media visibility were central to product appeal. Differences in cantonal legislation did not seem to clearly influence perceptions or reported behaviours. Conclusions: DEC use among AYAs reflects both developmental vulnerabilities and the influence of targeted marketing strategies. Alongside age restrictions, effective prevention should address product design, marketing and packaging practices, as well as information transparency. Further research on vaping-related harms is needed to inform healthcare professionals, and surveillance of DEC and other tobacco-derived product use following legislative changes will be essential to guide future regulations.