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Peer-reviewedCC BY-NC-ND 4.0Substance Abuse Treatment, Prevention, and Policy

Initiation, appeal, and dependence: a qualitative exploration of e-cigarette use in Chile

  • Constanza Silva-Gallardo1,2
  • Gabriel Astudillo3,4
  • Francisca Concha5
  • Teresita Rocha-Jiménez6,7
7 affiliations
  1. 1Department of Psychology, Faculty of Psychology and Humanities, Universidad San Sebastián, Santiago, Chile
  2. 2Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago, Chile
  3. 3Facultad College, Pontificia Universidad Católica de Chile, Santiago, Chile
  4. 4Escuela de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
  5. 5Departamento de Antropología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
  6. 6Society and Health Research Center, Escuela de Gobierno y Administración Pública, Universidad Mayor, Santiago, Chile
  7. 7SENTINET: Surveillance, Epidemiology, and New Technologies for Infectious Emerging (CIN250062), Santiago, Chile
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Abstract

Background: E-cigarette use has increased in Chile, where products remain widely accessible through diverse sales channels, including informal markets. Lifetime prevalence is 15.1%, with 3.6% reporting past-year use. Use is highest among young adults (19–25 years) and lowest among older groups. Despite Chile’s historically high smoking prevalence among women, national data show no sex differences in past-year e-cigarette use. Although nicotine-containing devices are classified as pharmaceutical products, no brand has obtained formal authorization for sale. This study aims to examine how adults engage with e-cigarettes in the Chilean regulatory context, focusing on patterns of initiation, product selection, and sustained use.

Methods: Eighteen semi-structured in-depth interviews were conducted between May 2024 and 2025 with adult e-cigarette users (including one informal seller) in the Metropolitan Region of Santiago, Chile, in a convenience sample. Participants were recruited through snowball sampling and outreach across social and digital platforms. Data were transcribed, anonymized, and thematically analyzed using an inductive approach to capture participants’ experiences.

Results: Participants were primarily young adults (aged 18–45), with a predominance of women (77.8%). Four interrelated themes emerged: (1) initiation often took place in social and recreational settings, where peer sharing and informal access were common; (2) users frequently prioritized design, flavor, and ease of use over nicotine content, framing e-cigarettes as lifestyle products; (3) occasional use sometimes progressed to routine consumption, facilitated by convenience and environmental factors; and (4) signs of dependence and reported strategies to moderate their use.

Conclusions: E-cigarette use was closely tied to social settings, aesthetic appeal, and daily routines. Product engagement was shaped more by usability and context than by nicotine content or health motivations. These findings highlight the need for policies that address informal sales channels, improve product transparency, and consider the social and sensory drivers of e-cigarette use in underregulated contexts.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13011-026-00757-y.

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Cite

BibTeXRIS
BibTeX
@article{silvagallardo2026initiation,
  title = {{Initiation, appeal, and dependence: a qualitative exploration of e-cigarette use in Chile}},
  author = {Constanza Silva-Gallardo and Gabriel Astudillo and Francisca Concha and Teresita Rocha-Jiménez},
  journal = {Substance Abuse Treatment, Prevention, and Policy},
  year = {2026},
  month = jul,
  doi = {10.1186/s13011-026-00757-y},
  url = {https://doi.org/10.1186/s13011-026-00757-y},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Initiation, appeal, and dependence: a qualitative exploration of e-cigarette use in Chile
AU  - Constanza Silva-Gallardo
AU  - Gabriel Astudillo
AU  - Francisca Concha
AU  - Teresita Rocha-Jiménez
PY  - 2026
DA  - 2026/07/01
JO  - Substance Abuse Treatment, Prevention, and Policy
DO  - 10.1186/s13011-026-00757-y
UR  - https://doi.org/10.1186/s13011-026-00757-y
AB  - Background: E-cigarette use has increased in Chile, where products remain widely accessible through diverse sales channels, including informal markets. Lifetime prevalence is 15.1%, with 3.6% reporting past-year use. Use is highest among young adults (19–25 years) and lowest among older groups. Despite Chile’s historically high smoking prevalence among women, national data show no sex differences in past-year e-cigarette use. Although nicotine-containing devices are classified as pharmaceutical products, no brand has obtained formal authorization for sale. This study aims to examine how adults engage with e-cigarettes in the Chilean regulatory context, focusing on patterns of initiation, product selection, and sustained use.  Methods: Eighteen semi-structured in-depth interviews were conducted between May 2024 and 2025 with adult e-cigarette users (including one informal seller) in the Metropolitan Region of Santiago, Chile, in a convenience sample. Participants were recruited through snowball sampling and outreach across social and digital platforms. Data were transcribed, anonymized, and thematically analyzed using an inductive approach to capture participants’ experiences.  Results: Participants were primarily young adults (aged 18–45), with a predominance of women (77.8%). Four interrelated themes emerged: (1) initiation often took place in social and recreational settings, where peer sharing and informal access were common; (2) users frequently prioritized design, flavor, and ease of use over nicotine content, framing e-cigarettes as lifestyle products; (3) occasional use sometimes progressed to routine consumption, facilitated by convenience and environmental factors; and (4) signs of dependence and reported strategies to moderate their use.  Conclusions: E-cigarette use was closely tied to social settings, aesthetic appeal, and daily routines. Product engagement was shaped more by usability and context than by nicotine content or health motivations. These findings highlight the need for policies that address informal sales channels, improve product transparency, and consider the social and sensory drivers of e-cigarette use in underregulated contexts.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13011-026-00757-y.
SN  - 1747-597X
ER  -