In all, 18 focus groups were conducted which consisted of 92 individual participants (Table 2).
[INSERT TABLE 2 HERE]
Three overarching themes were generated from the analysis (Figure 1): i) attitudes about own children vaping; ii) boundaries for vaping; and iii) conversations. Supporting quotes for each theme are given in Table 3.
[INSERT FIGURE 1 HERE]
Theme 1: Attitudes about own children vaping – “I just wish vaping wasn’t a thing”
Specific concerns about vaping were raised by participants, with most focused on the potential health harms to the lungs, and a few also noting risks to brain development during adolescence. Participants recognised that long-term impacts are unknown, which was also a source of concern. Some talked about the specific concerns regarding nicotine in vapes and subsequent vulnerability to addiction. Parents with a smoking history likened their unease by drawing from their own experiences and would commonly express the regret they have for taking up a “bad habit”.
Most participants agreed that they did not want their child to vape. There were layers to this sentiment however, with some expressing strong feelings about this, for example one participant commenting “I don’t agree, it’s never acceptable”. However, some were open to the idea and others recognised the likely harms but had accepted that vaping was inevitable for young people.
Resignation that vaping is a part of their world
Participant attitudes towards their children vaping was nuanced, as they discussed what is ideal versus what is reality. While they did not want their children to vape, there was recognition that adolescence is a period of curiosity and temptation, and participants reflected on their own similar behaviours of trying cigarettes when younger. Given this, some talked about accepting the inevitability of their child vaping or trying a vape. This sign of resignation was also displayed when some participants reasoned that discouraging vapes would make them more attractive for their child and would ultimately encourage uptake.
Vaping is a less of a concern compared to other things
Some expressed the view that compared to other behaviours, such as smoking or alcohol, vaping was a “vice” they were more comfortable with. As one participant said, vaping is the “lesser of two evils. Or 15 evils.”
There were rare instances where participants shared having offered their child a vape to try, with the belief they were “going to do it at some stage”. Albeit expressed in a small few, the rationale was that it would be safer to try vaping with a parent present.
Vaping to help with mental health was raised in a small number of participants. Here, vapes were seen as comparatively benign and as such were talked about in a way that offered relief for their child’s anxiety or stress.
Vaping is their child’s decision to make
Some participants spoke about leaving the decision to vape or not entirely to their child. Here, this was discussed this in terms of their perceived maturity to make informed choices, but participants also tended to emphasise having an open, trusting relationship with their child. Allowing this freedom was expressed more in participants with older adolescent children (i.e., 16-17 years old). Some also talked about giving their children autonomy about vaping once they started earning their own money, with one participants stating “it’s their money, I’m not paying for it”.
Theme 2: Boundaries for vaping – “I think it depends”
There was a mixture of attitudes regarding the boundaries for vaping and what that might look like in the home environment. For many participants, however, this was discussed in hypothetical terms as they had yet to encounter this scenario with their children.
Social versus habitual vaping
The idea of being open to their children experimenting or occasionally vaping was discussed by some. Allowing their children the opportunity to try and then make their own decisions (or the “right” choice) was perceived as serving a greater effect than simply being told not to do it. However, in this vein, these participants clearly made distinctions that while trying was acceptable, regular or addictive vaping was not and would be problematic.
Vaping at home is not allowed
Most indicated that they would not allow their child or their friends to vape while at home. For many, the rule was straightforward and “non-negotiable”. Some explained that by allowing this would be to condone the behaviour. A few referred to the laws, acknowledging that individuals need to be an adult (aged 18 or older) to vape.
For those who previously tried to dissuade their children from vaping, there was concession that they cannot stop them, and now expressed a changed preference for their child not vaping around them instead.
Vaping at home is allowed and used as a monitoring strategy
Those who felt comfortable with their child vaping at home, tended to indicate a preference to this as they considered it safer to do in their presence (as raised in the “Vaping is a less of a concern compared to other things” sub-theme) but also because they did not want vaping to be hidden from them.
Rules are complicated
It was discussed how house rules become “grey” as their children and friends become older. As younger teenagers (e.g., 14-15 years), it was seen as easier to enforce a no vape rule at home, however as they neared legal age participants felt it become more complicated.
Additional nuances were expressed by participants who currently vape or smoke themselves. That is, applying a consistent rule for the household, with the same rules for parents and children alike.
Theme 3: Conversations – “I express my concerns, and that is that we don’t know exactly…”
Many participants indicated that they have had at least one conversation with their child about vaping. Of the few yet to do so, this was commonly because they felt their child had no interest in vaping and was not “big issue” for their household.
Typically, conversations around vaping seemed to be initiated by the child (rather than the parents) and prompted by either specific incidents that happened at school such as other students being “busted” for vaping or “collapsing” because of vaping, or sharing the measures their schools are taking to deter use. Vaping was also raised casually by participants’ children when talking about who in their peer groups vape or not. In the scenarios where parents initiated the discussions, this tended to be more opportunistic, commonly after they had caught their children vaping. However, general communications from schools, for example newsletters or notification of vaping education sessions, were also noted to prompt parents to have conversations with their children.
Content of conversations
Many participants acknowledged that conversations with their children were generally about the possible harms of vaping, as well as the largely unknown risks given it is a more recent product on the market. Participants talked about comparing it to smoking, where initially the harms were unknown, but have since become well established and common knowledge.
Participants commented that they would use these conversations as an opportunity for information-seeking about what is happening in their child’s world. For example, participants noted curiosity about exploring what their child’s attitudes were about vapes, whether they had tried vapes and about what is happening at their school or peer groups in relation to vaping.
Approach to conversations
Participants spoke about the different approaches they had used to have discussions about vaping. Trying to make it relevant to their child, by linking in with their health and fitness or current activities was a common tact, particularly to highlight how vaping will be a detriment.
Using personal stories was another approach, most commonly by participants with a smoking history. Here, discussions would focus on experiences with addiction, cessation challenges and health impacts due to smoking. This was presented as personal warnings, as one participant said, “[to] learn from my mistakes”.
Barriers to conversations
Challenges to conversations were also commonly expressed by participants who vape or smoke, and described feeling “hypocritical” for discouraging a behaviour they themselves do.
However, broadly across participants, there was recognition that feeling uninformed about vapes made conversations difficult as well. This was in relation to various aspects, such as not knowing the long-term impacts, the ingredients or chemicals contained in vapes and levels of nicotine, and general facts or statistics. Some also raised that current information is “vague” or “conflicting” which adds to their confusion.
Facilitators to conversations
Participants mentioned a variety of enablers that helped facilitate conversations with their child. For some, it was the mood or tone of the conversation that created a “safe” space to talk openly. Others commented that sharing facts, videos or images that they have found online demonstrating the ill-effects of vaping was helpful. Having such resources helped make the issue “real” for their children and to “make them understand”. Conversely, a few felt that the limited facts and unknown details itself helped highlight the “scary parts” about vaping. Vaping education seminars run by schools was also noted as a facilitator, acting as a conversation starter between parent and child about the session content.
When asked what would help support conversations with their child, participants largely agreed that resources that provide facts or statistics would be helpful. While some understood that long-term data is not available, knowing short-term or immediate harms to individuals would give participants some “back-up” to validate their views against vaping during discussions. Some participants suggested that public health campaigns, similar to those for tobacco control, that provide real-life stories relevant to young people (e.g., focus on teenagers, use of uncomplicated language or free of jargon) of the risks of vaping would create impact and resonate, as well as provide a conversation starter. As one participant commented, showing that vaping is “not a glamourous thing to do”, is needed to reduce social acceptability. A small number also talked about highlighting the role of the tobacco industry.
[INSERT TABLE 3 HERE]