{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:58:34Z","timestamp":1790179114593,"version":"4.1.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["19\/641"],"award-info":[{"award-number":["19\/641"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Royal Society Marsden Fund"},{"name":"Te K\u0101hui Matepukupuku O Aotearoa"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Despite policies setting a minimum legal sales age, youth continue to access electronic cigarettes (ECs). Evidence of rising youth vaping prevalence in many countries suggests existing measures have serious loopholes and raise important questions about how youth source vaping products.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>We explored how youth source ECs using in-depth interviews with 30 adolescents aged 16\u201317 who vaped at least once a month and lived in Aotearoa New Zealand. Our semistructured interview guide probed participants\u2019 vaping experiences and how they developed and used social, quasi-commercial, and commercial supply routes to access ECs. We used an inductive reflexive thematic analysis approach to interpret the data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nearly all participants shared ECs with peers and sharing was the sole access route for some. Many used proxies, often older relatives or people they knew socially, to purchase ECs on their behalf; however, others recruited proxies by approaching previously unknown people they identified on social media. Participants also sourced ECs via quasi-commercial networks that existed within schools and on social media, and some purchased in their own right, usually from smaller retail outlets that did not ask for ID.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Disrupting social supply will be challenging, though reducing ECs\u2019 availability, appeal, and affordability could make social supply, including sharing and proxy purchasing, more difficult. Reports that youth purchase ECs from commercial retailers known to waive age verification suggest stronger monitoring and enforcement, along with escalating retailer penalties, are required.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>Vaping access routes sit on a continuum from informal, spontaneous sharing to carefully planned commercial purchases. While supply via friends, siblings and other social contacts is an important means of access, nicotine dependence drives some to use riskier access routes, including approaching unknown people to act as proxy purchasers. Evidence young people identify noncompliant retailers suggests policy makers should monitor and enforce existing measures more stringently and consider additional penalties for recidivist underage suppliers. A more comprehensive response that reduces the appeal, addictiveness, affordability, and availability of vaping products would address factors fostering and maintaining youth vaping.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntae096","type":"journal-article","created":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T00:04:37Z","timestamp":1713657877000},"page":"1370-1376","source":"Crossref","is-referenced-by-count":7,"title":["A Qualitative Analysis of How Underage Adolescents Access Nicotine Vaping Products in Aotearoa New Zealand"],"prefix":"10.1093","volume":"26","author":[{"given":"Katie","family":"Frost","sequence":"first","affiliation":[{"name":"Otago School of Medicine, University of Otago , Dunedin , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-3269","authenticated-orcid":false,"given":"Anna","family":"Graham-DeMello","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, University of Otago , Dunedin , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4717-5495","authenticated-orcid":false,"given":"Jude","family":"Ball","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Otago , Wellington , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Pettie (Ng\u0101ti P\u016bkenga)","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Otago , Wellington , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-1539","authenticated-orcid":false,"given":"Janet","family":"Hoek","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Otago , Wellington , New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,20]]},"reference":[{"issue":"6","key":"2024092305551571100_CIT0001","first-page":"546","article-title":"New Zealand Youth 19 survey: vaping has wider appeal than smoking in secondary school students, and most use nicotine-containing e-cigarettes","volume":"45","author":"Ball","year":"2021","journal-title":"ANZJPH."},{"issue":"8","key":"2024092305551571100_CIT0002","doi-asserted-by":"crossref","first-page":"e18943","DOI":"10.2196\/18943","article-title":"Tactics for drawing youth to vaping: content analysis of electronic cigarette advertisements","volume":"22","author":"Struik","year":"2020","journal-title":"J Med Internet Res."},{"issue":"3","key":"2024092305551571100_CIT0003","doi-asserted-by":"crossref","first-page":"e231799","DOI":"10.1001\/jamanetworkopen.2023.1799","article-title":"Association of fully branded and standardized E-cigarette packaging with interest in trying products among youths and adults in great Britain","volume":"6","author":"Taylor","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"6","key":"2024092305551571100_CIT0004","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1080\/10408444.2020.1794443","article-title":"A review of toxic effects of electronic cigarettes\/vaping in adolescents and young adults","volume":"50","author":"Overbeek","year":"2020","journal-title":"Crit Rev Toxicol."},{"key":"2024092305551571100_CIT0005","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2147\/VHRM.S175970","article-title":"Electronic cigarettes and cardiovascular health: what do we know so far","volume":"15","author":"Macdonald","year":"2019","journal-title":"Vasc Health Risk Manag. 2019"},{"issue":"3","key":"2024092305551571100_CIT0006","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/MOP.0000000000000896","article-title":"Vaping in adolescents: epidemiology and respiratory harm","volume":"32","author":"Hamberger","year":"2020","journal-title":"Curr Opin Pediatr."},{"issue":"1","key":"2024092305551571100_CIT0007","first-page":"17","article-title":"Respiratory impact of electronic cigarettes and low-risk tobacco","volume":"71","author":"Thirion-Romero","year":"2019","journal-title":"Rev de Investig Clinica"},{"issue":"3","key":"2024092305551571100_CIT0008","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1093\/ntr\/ntaa171","article-title":"Systematic review of electronic cigarette use (vaping) and mental health comorbidity among adolescents and young adults","volume":"23","author":"Becker","year":"2021","journal-title":"Nicotine Tob Res."},{"issue":"6","key":"2024092305551571100_CIT0009","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/tobaccocontrol-2018-054446","article-title":"Examining the relationship of vaping to smoking initiation among US youth and young adults: a reality check","volume":"28","author":"Levy","year":"2019","journal-title":"Tob Control."},{"issue":"2","key":"2024092305551571100_CIT0010","doi-asserted-by":"crossref","first-page":"e2020025122","DOI":"10.1542\/peds.2020-025122","article-title":"Use of E-cigarettes and other tobacco products and progression to daily cigarette smoking","volume":"147","author":"Pierce","year":"2021","journal-title":"Pediatrics."},{"issue":"43","key":"2024092305551571100_CIT0011","doi-asserted-by":"crossref","first-page":"E1328","DOI":"10.1503\/cmaj.161002","article-title":"Electronic cigarette use and smoking initiation among youth: a longitudinal cohort study","volume":"189","author":"Hammond","year":"2017","journal-title":"CMAJ."},{"key":"2024092305551571100_CIT0012","author":"Health Canada","year":"2023"},{"issue":"6","key":"2024092305551571100_CIT0013","doi-asserted-by":"crossref","first-page":"e2112464","DOI":"10.1001\/jamanetworkopen.2021.12464","article-title":"The decline in e-cigarette use among youth in the United States\u2014an encouraging trend but an ongoing public health challenge","volume":"4","author":"Choi","year":"2021","journal-title":"JAMA Netw. Open"},{"issue":"4","key":"2024092305551571100_CIT0014","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s40429-020-00332-w","article-title":"A literature review on international E-cigarette regulatory policies","volume":"7","author":"Klein","year":"2020","journal-title":"Curr Addict Rep"},{"key":"2024092305551571100_CIT0015","author":"Australian Government, Dept. of Health and Aged Care: Therapeutic Goods Administration","year":"2022"},{"issue":"8","key":"2024092305551571100_CIT0016","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1001\/jamapediatrics.2020.0901","article-title":"Changes in prevalence of vaping among youths in the United States, Canada, and England from 2017 to 2019","volume":"174","author":"Hammond","year":"2020","journal-title":"JAMA Pediatr"},{"issue":"18","key":"2024092305551571100_CIT0017","doi-asserted-by":"crossref","first-page":"11570","DOI":"10.3390\/ijerph191811570","article-title":"An International systematic review of prevalence, risk, and protective factors associated with young people\u2019s E-cigarette use","volume":"19","author":"Kim","year":"2022","journal-title":"Int J Environ Res Public Health."},{"key":"2024092305551571100_CIT0018","author":"UK Government, Office for Health Improvement and Disparities","year":"2022"},{"key":"2024092305551571100_CIT0019","author":"Alcohol and Drug Foundation (ADF)","year":"2022"},{"issue":"2","key":"2024092305551571100_CIT0020","first-page":"100035","article-title":"E-cigarette attitudes and use in a sample of Australians aged 15\u201330 years","volume":"47","author":"Pettigrew","year":"2023","journal-title":"ANZJPH"},{"key":"2024092305551571100_CIT0021","author":"Ministry of Health NZ"},{"key":"2024092305551571100_CIT0022","author":"ASH-Action for Smokefree 2025","year":"2022"},{"issue":"3","key":"2024092305551571100_CIT0023","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1177\/0890117118790366","article-title":"How do adolescents get their E-cigarettes and other electronic vaping devices","volume":"33","author":"Pepper","year":"2019","journal-title":"Am J Health Promot."},{"issue":"13","key":"2024092305551571100_CIT0024","doi-asserted-by":"crossref","first-page":"6784","DOI":"10.3390\/ijerph18136784","article-title":"The influence of friends on teen vaping: a mixed-methods approach","volume":"18","author":"Groom","year":"2021","journal-title":"IJERPH"},{"issue":"6","key":"2024092305551571100_CIT0025","doi-asserted-by":"crossref","first-page":"e2111336","DOI":"10.1001\/jamanetworkopen.2021.11336","article-title":"Characteristics of e-cigarette use behaviors among US youth, 2020","volume":"4","author":"Wang","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"2024092305551571100_CIT0026","doi-asserted-by":"crossref","first-page":"106345","DOI":"10.1016\/j.addbeh.2020.106345","article-title":"How are adolescents getting their vaping products? Findings from the International Tobacco Control (ITC) Youth Tobacco and Vaping Survey","volume":"105","author":"Braak","year":"2020","journal-title":"Addict Behav."},{"issue":"1","key":"2024092305551571100_CIT0027","doi-asserted-by":"crossref","first-page":"e193912","DOI":"10.1001\/jamapediatrics.2019.3912","article-title":"Association of Canada\u2019s provincial bans on electronic cigarette sales to minors with electronic cigarette use among youths","volume":"174","author":"Nguyen","year":"2020","journal-title":"JAMA Pediatr"},{"key":"2024092305551571100_CIT0028","first-page":"814","article-title":"Vaping product access and use among 14\u201317-year-olds in New South Wales: a cross-sectional study","author":"Watts","year":"2022","journal-title":"ANZJPH"},{"issue":"1","key":"2024092305551571100_CIT0029","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/s12889-023-15142-8","article-title":"E-cigarette product preferences of Australian adolescent and adult users: a 2022 study","volume":"23","author":"Jongenelis","year":"2023","journal-title":"BMC Public Health"},{"issue":"2","key":"2024092305551571100_CIT0030","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.3390\/ijerph20021399","article-title":"Underage youth continue to obtain E-cigarettes from retail sources in 2022: evidence from the Truth Continuous Tracking Survey","volume":"20","author":"Do","year":"2023","journal-title":"Int J Environ Res Public Health."},{"key":"2024092305551571100_CIT0031","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.pmedr.2018.11.011","article-title":"Youth who use e-cigarettes regularly: a qualitative study of behavior, attitudes, and familial norms","volume":"13","author":"Alexander","year":"2019","journal-title":"Prev Med Rep"},{"issue":"9","key":"2024092305551571100_CIT0032","doi-asserted-by":"crossref","first-page":"4843","DOI":"10.3390\/ijerph18094843","article-title":"Adolescent use and perceptions of JUUL and other pod-style e-cigarettes: a qualitative study to inform prevention","volume":"18","author":"Wagoner","year":"2021","journal-title":"IJERPH"},{"issue":"2","key":"2024092305551571100_CIT0033","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1136\/tobaccocontrol-2019-055417","article-title":"E-cigarette and cigarette purchasing among young adults before and after implementation of California\u2019s tobacco 21 policy","volume":"30","author":"Schiff","year":"2021","journal-title":"Tob Control."},{"issue":"1","key":"2024092305551571100_CIT0034","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/1524839920963691","article-title":"Local and state policy action taken in the United States to address the emergence of e-cigarettes and vaping: a scoping review of literature","volume":"23","author":"O\u2019Connell","year":"2022","journal-title":"Health Promot Pract."},{"issue":"1","key":"2024092305551571100_CIT0035","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1002\/capr.12360","article-title":"Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches","volume":"21","author":"Braun","year":"2021","journal-title":"Couns and Psychother Res"},{"issue":"3","key":"2024092305551571100_CIT0036","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s11135-021-01182-y","article-title":"A worked example of Braun and Clarke\u2019s approach to reflexive thematic analysis","volume":"56","author":"Byrne","year":"2022","journal-title":"Qual Quant"},{"key":"2024092305551571100_CIT0037"},{"key":"2024092305551571100_CIT0038","first-page":"100232","article-title":"Sources of youth access to JUUL vaping products in the United States","volume":"10","author":"McKeganey","year":"2019","journal-title":"Addict Behav Rep."},{"issue":"12","key":"2024092305551571100_CIT0039","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1093\/ntr\/nty238","article-title":"Youth access to tobacco products in the United States: findings from wave 1 (2013-2014) of the population Assessment of Tobacco and Health Study","volume":"21","author":"Tanski","year":"2019","journal-title":"Nicotine Tob Res."},{"issue":"1","key":"2024092305551571100_CIT0040","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1186\/s12889-023-16755-9","article-title":"How do underage youth access e-cigarettes in settings with minimum age sales restriction laws? A scoping review","volume":"23","author":"Graham-DeMello","year":"2023","journal-title":"BMC Public Health"},{"issue":"2","key":"2024092305551571100_CIT0041","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1136\/jech.2005.038281","article-title":"Bonding versus bridging social capital and their associations with self-rated health: a multilevel analysis of 40 US communities","volume":"60","author":"Kim","year":"2006","journal-title":"J Epidemiol Community Health."},{"issue":"1","key":"2024092305551571100_CIT0042","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13011-022-00451-9","article-title":"Tobacco use, smoking identities and pathways into and out of smoking among young adults: a meta-ethnography","volume":"17","author":"Poole","year":"2022","journal-title":"Subst Abuse Treat Prev Policy."},{"key":"2024092305551571100_CIT0043","author":"Hon Dr. Ayesha Verrall, Health Minister","year":"2023"},{"issue":"6","key":"2024092305551571100_CIT0044","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1080\/10826084.2023.2188555","article-title":"E-cigarette device type, source, and use behaviors of youth and young adults: findings from the truth longitudinal cohort (2020\u20132021)","volume":"58","author":"Do","year":"2023","journal-title":"Subst Use Misuse."},{"issue":"3","key":"2024092305551571100_CIT0045","doi-asserted-by":"crossref","first-page":"e068466","DOI":"10.1136\/bmjopen-2022-068466","article-title":"Youth\u2019s engagement and perceptions of disposable e-cigarettes: a UK focus group study","volume":"13","author":"Smith","year":"2023","journal-title":"BMJ Open"},{"key":"2024092305551571100_CIT0046","author":"Smith","year":"2023"},{"issue":"3","key":"2024092305551571100_CIT0047","first-page":"tobaccocontrol-2022-057348","article-title":"Tobacco promotion restriction policies on social media","volume":"33","author":"Kong","year":"2022","journal-title":"Tob Control."},{"key":"2024092305551571100_CIT0048","article-title":"Online marketing activity following New Zealand\u2019s vaping legislation","author":"Cochran","journal-title":"Tob Control"},{"issue":"1","key":"2024092305551571100_CIT0049","first-page":"10","article-title":"White privilege and cultural racism","volume":"28","author":"Addy","year":"2008","journal-title":"NZAC"},{"key":"2024092305551571100_CIT0050","author":"ASH (Action for Smokefree 2025)","year":"2022"}],"container-title":["Nicotine and Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntae096\/57405205\/ntae096.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/26\/10\/1370\/59124180\/ntae096.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/26\/10\/1370\/59124180\/ntae096.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T05:55:34Z","timestamp":1727070934000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/26\/10\/1370\/7655500"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,20]]},"references-count":50,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,4,20]]},"published-print":{"date-parts":[[2024,9,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntae096","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,4,20]]}}}