Publish date: Jul 2017

Paper under discussion

'Maybe they should regulate them quite strictly until they know the true dangers': A focus group study exploring UK adolescents’ views on e-cigarette regulation

Heide Weishaar, Filippo Trevisan & Shona Hilton. Addiction, 111(9), pp. 1637-1645. doi:10.1111/add.13377

 

In the July Qualitative Methods Journal Club, members discussed the above titled paper which was published in Addiction. The paper explored adolescents’ views of regulation of e-cigarette sale, promotion and use. We were joined by researchers from King’s College London’s Nicotine Research Group, including Dr Sara Hitchman, a lecturer in the Addictions Department who has previously conducted qualitative research into e-cigarette use.

When discussing the paper, we considered some of the issues around conducting focus groups. Members considered the following as strengths of the paper:

The title identifies that the paper reports a qualitative study by stating that it is a focus group study and by using a quotation from a focus group participant. Members liked how the quotation clearly captures the study finding around the support for strong e-cigarette regulation.

The introduction is very concise. It focusses on the current policy situation in relation to e-cigarette regulation in the United Kingdom and positions the international relevance of this. We particularly liked how the authors explain why the study is needed and why adolescents are the target group – consultations on e-cigarette regulation have neglected the views of this group. At the end of the introduction, the authors link this justification to the aim of the paper and state the originality of their study.

The methods provide detailed information on the setting, sampling procedures, and data collection. The authors include information on ethical approval at the end of the methods.

The sample of 16 focus groups with 83 participants aged between 14 and 17 was substantial, although members noted that the paper does not justify how the number of focus groups was decided upon. We liked how the authors used purposive sampling with the help of local youth organisations to recruit a diverse sample of adolescents in terms of gender, socio-economic background, smoking status and e-cigarette use. The use of a short questionnaire was a suitable and helpful way to obtain standard information on all participants and monitor diversity within the sample.

QJC members particularly liked the section on the conduct of the focus groups as the authors include information on the issues they considered when collecting the data e.g. how they tried to avoid participants feeling pressured to agree with their peers in the focus groups and how they used images of e-cigarettes as conversation starters.

We thought the process of data management was clear, however we noted that there was no information on the analytical approach taken or on how the analysis identified themes from the data.
Various opinions were raised during our discussions on the section on the sample. For example, some members suggested that it was unusual to report qualitative information using quantitative terms such as ‘skew’ and ‘distributed equally.’

The findings are broken down into 3 areas. They are easy to read and link to the aim of the study as they report participants’ opinions and perceptions about e-cigarette regulation. In addition, the findings explain the reasons why participants were (or were not) in supportive of regulation and identify any similarities and differences between current and former smokers/ vapers.

The authors highlight their findings with various quotations from focus group participants. We liked how the authors provide the age, gender, and smoking status (cigarettes and e-cigarettes) for each quoted participant, as this 1) protects participants from being identified, 2) helps the reader to understand more about participants, and 3) indicates the range of participants who have been quoted. For example, readers see that the participant quoted in the title is a 17-year-old male with no history of smoking or e-cigarette use. Club members also liked that the quotations are produced word for word, including the dialect of the participant. The authors have considered the readership of Addiction as they explain any participant words or phrases which international readers may find difficult to understand.

The discussion reminds the reader of the focus of study, outlines the relevance and implications of the findings to the UK policy setting, and draws on wider research to discuss the policy and practice implications of the findings. There is a section on the study limitations which considers the geographical remit of the study and cautions against generalising beyond this setting. The discussion closes with a summary based on the key findings, that adolescents will strongly support the regulation and age-of-sale restriction of e-cigarettes.

 

Dr Charlotte Tompkins, Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London. charlotte.tompkins@kcl.ac.uk

 

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Barbour, R. & Kitzinger, J. (1999) Developing Focus Group Research: Politics, Theory and Practice. Sage.

Neale, J., Miller, P. & West, R. (2014) Reporting quantitative information in qualitative research: guidance for authors and reviewers. Addiction, 109: 175-176.

Wadsworth, E., Neale, J., McNeill A. & Hitchman S.C. (2016) How and Why Do Smokers Start Using E-Cigarettes? Qualitative Study of Vapers in London, UK? International Journal of Environmental and Public Health Research, 13(7). 

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The opinions expressed in this commentary reflect the views of the author(s) and do not necessarily represent the opinions or official positions of the Society for the Study of Addiction.