Qualitative Study Explores Why People Start Using E-Cigarettes in Iran

A qualitative study exploring electronic cigarette use in Golestan Province, Iran, found that initiation is primarily driven by convenience, social appeal, curiosity, and widespread beliefs of reduced harm compared to conventional cigarettes. Investigating Electronic Nicotine Delivery Systems has become an important public health priority in Iran, where understanding why individuals take up vaping and how they evaluate health risks is considered essential for designing effective interventions. The researchers determined that while user uptake is shaped by accessibility, aesthetic appeal, and peer dynamics, misconceptions regarding the safety and addictiveness of these devices remain prevalent among users.

To capture user perspectives, the research team recruited twenty-two e-cigarette users aged 15 to 42 years from the urban locations of Gorgan and Aqqala. The investigators utilized purposive and snowball sampling strategies to identify and enroll participants across this age range. Data collection relied on in-depth semi-structured interviews designed to explore personal motivations and risk evaluations in detail. To ensure the credibility and trustworthiness of the findings, the study applied Guba and Lincoln’s evaluative criteria and incorporated investigator triangulation during both data collection and qualitative content analysis.

Through qualitative content analysis, the authors established two overarching themes divided into seven main categories and eleven subcategories. The first primary theme focused on the reasons participants began using e-cigarettes. Participants cited accessibility and ease of use as central elements facilitating their initiation. In addition, aesthetic appeal and trendiness served as major attractions, with users viewing the devices as modern and socially appealing. Other participants reported adopting e-cigarettes as a direct substitution for conventional cigarettes, while personal curiosity and direct peer pressure were also identified as key catalysts driving initial experimentation.

The second overarching theme addressed participants’ perceptions of risk, identifying marked contrasts in how health consequences and dependency were viewed. Although most participants perceived e-cigarettes to be less harmful than traditional combustible cigarettes, this belief did not indicate a total denial of risk. In fact, all twenty-two participants explicitly acknowledged that e-cigarette use carries potential health hazards. Conversely, recognition of the potential for addiction was far less common; perceived addictiveness was reported by only three individuals among the twenty-two users interviewed, demonstrating that addictiveness was largely unacknowledged across the cohort.

In light of these findings, the study authors emphasized the necessity of targeted measures to curb uptake and rectify widespread misconceptions. Because e-cigarette adoption among the participants was heavily shaped by convenience, social appeal, curiosity, and reduced-harm perceptions, public health strategies must directly respond to these motivating factors. The authors concluded that educational interventions are needed to inform communities and resolve common misunderstandings surrounding the devices. Furthermore, they emphasized that stronger regulation of social media marketing is critical to prevent initial uptake and systematically address user misconceptions about e-cigarette safety and addictiveness.

Subject of Research: E-cigarette initiation motivations and perceived health risks in Iran

Article Title: Reasons for electronic cigarette initiation and perceived risks in Golestan Province, Iran: a qualitative study

Article References: Foroughi, A., & Charkazi, A. (2026). Reasons for electronic cigarette initiation and perceived risks in Golestan Province, Iran: a qualitative study. BMC Public Health. https://doi.org/10.1186/s12889-026-30313-z

Image Credits: AI Generated

DOI: 10.1186/s12889-026-30313-z

Keywords: electronic cigarettes, e-cigarettes, public health, smoking initiation, risk perception, qualitative research, Iran, nicotine delivery systems, Reasons, electronic, cigarette, initiation