Exploring the cultural factors affecting E-cigarette use among young adults in China: Utilizing the PEN-3 cultural model.

Abstract

Cultural identity shapes individuals' health priorities and decision-making processes. This study aimed to explore cultural factors affecting e-cigarette use and related behaviors among young adults. This study employed descriptive phenomenological approach using semi-structured interviews with 43 young adlut vapers in China. Thematic analysis of the interview data, guided by the PEN-3 cultural model, explored participants' personal experiences and culturally relevant beliefs regarding e-cigarette use. Nine sub-themes were organized within the domains of the PEN-3 cultural model matrix. These sub-themes coalesced into three key themes: 1) perceptions: beliefs, knowledge, and values about e-cigarette use, 2) enablers: social impacts and regulations on e-cigarette use, and 3) nurturers: social network resources for e-cigarette users. Each key theme demonstrated positive, existential, and negative factors influencing young adults' vaping behaviors. Factors promoting young adult vaping included perceived benefits, social acceptability, accessibility, and peer/friend motivation. Conversely, inhibiting factors encompassed perceived barriers, control policies, and family norms. Existential factors-consideration of future consequences, materialism, ritualism, and self-construction-were identified as less mutable influences. All factors exhibited variation between single and dual users. This research advances understanding of culturally situated young adult vaping. Distinctions between user groups offer an actionable foundation for targeted interventions-informing distinct strategies for single-users and dual-users based on their unique cultural contexts and risk profiles.