Lived experiences of stigma and altered self-perceptions among young people who are addicted to ENDS: a qualitative study from Aotearoa New Zealand
Bibliographic record
Abstract
INTRODUCTION: Rising use of electronic nicotine delivery system (ENDS) among young people, especially those who have never smoked, has received considerable attention from the health community. However, fewer studies have examined the mental health impacts of ENDS use. We addressed this gap by exploring the stigma, altered self-perceptions and negative affect experienced by adolescents who assessed themselves as addicted to using ENDS. METHODS: We interviewed 20 adolescents aged 16-18 who lived in Aotearoa New Zealand and assessed themselves as moderately or highly addicted to ENDS use. Using in-depth, semistructured qualitative interviews, we explored participants' experiences of addiction and its effects on their well-being. We interpreted the data using an inductive reflexive thematic analysis approach. RESULTS: We identified four key themes. First, addiction to ENDS use adversely affected participants' physical and mental health. Second, addiction greatly diminished the pleasurable effects ENDS use first provided and participants who initially enjoyed using ENDS now felt unable to stop. Third, participants felt judged, stigmatised and belittled by others who did not understand their struggle with addiction. Fourth, they experienced several negative emotions, including self-blame, regret, disappointment and embarrassment that diminished how they saw themselves. CONCLUSIONS: We extend earlier studies by probing the mental health burden ENDS use imposes on young people, offer new insights into how they experience addiction and outline potential policy responses. Measures reducing young people's access to ENDS are urgently needed alongside empathetic, youth-oriented cessation support.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".