Rituals comprise specific artefacts, scripted behaviours, roles, and audiences that support uniquely personal practices while also featuring common actions that support social connections. Addressing these questions could provide important insights into how ENDS use evolves, and the role (if any) that smoked tobacco continues to play.Ĭonsumer ritual theory presents a novel framework to explore how ENDS users construct or recreate practices that replace smoking. 20, 21 Yet while studies have documented ENDS use among existing smokers, 22 identified determinants of uptake 23–25 and examined reported smoking cessation outcomes, 26–28 few have explored the psychosocial benefits ENDS users seek. These options offer users many personalising opportunities by allowing them to select from multiple flavour options, determine the nicotine content of their e-liquid, and customise the aerosol produced to create diverse consumption experiences.
18, 19 Third generation devices, or ‘mods’, are typically larger, more technically complex and sophisticated. 16, 17ĮNDS have evolved rapidly from cigarette replicas, or ‘cigalikes’, which look similar to traditional smoked cigarettes and are more standardised, to second generation options including highly patterned and sleekly designed vape pens. 6–12 Debate continues over whether ENDS offer a gateway to smoked tobacco, 13, 14 renormalise smoking, 6, 15 or reduce cessation among smokers. 1–5 Yet despite these potentially appealing attributes, concerns exist over ENDS' wider population effects, particularly given brand proliferation, extensive product marketing and rapid uptake among young people. Global initiatives to reduce smoking prevalence have stimulated interest in electronic nicotine delivery systems (ENDS), which reduce smokers' exposure to toxicants in smoked tobacco and may provide safer alternatives for those who have repeatedly tried but failed to quit.
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