Abstract
INTRODUCTION: In 2022-2023, 30% of Australian adolescents aged 12-17 years had used electronic cigarettes (e-cigarettes). Adolescents are particularly vulnerable to the negative health impacts of e-cigarettes. Although sport and physical activity participation have been postulated as potential protective factors against e-cigarette use, evidence on their relationship is limited and no qualitative data are available. This study aims to qualitatively explore the relationship of e-cigarette use, sport participation and physical activity, among Australian adolescents aged 14-17 years. METHODS: A total of 96 participants aged 14-17 years completed 78 online single or paired semi-structured qualitative interviews, as part of the Generation Vape project, during February-May 2023. All discussion was unprompted. Reflexive thematic analysis was applied and inductive coding undertaken. RESULTS: Of the 96 participants, 52 (54%) volunteered data relating to this topic. Sport participation and athletic performance were perceived as key drivers of protective adolescent e-cigarette use behaviors including abstinence, cessation and 'responsible use'. Most current and former users reported experiencing health harms attributed to e-cigarettes - predominantly shortness of breath - during day-to-day physical activity such as walking or climbing the stairs and during sporting activities. Some users reported no difference in fitness attributable to e-cigarette use and former users reported improvements after quitting. CONCLUSIONS: Sport participation was considered important by adolescents and related it to e-cigarette patterns of use; and e-cigarette users described experiencing negative health effects in sport and fitness settings. E-cigarette use in adolescents may jeopardize the physical, mental and social benefits of engaging in sport and recreational physical activity. There is a need for greater regulation of e-cigarette industry sponsorship of sport to reduce adolescent exposure to e-cigarette marketing and promotion. E-cigarette prevention campaigns that highlight impacts on sport maybe an effective intervention to support overall adolescent wellbeing.