Constructing expert models of adolescent vaping behaviour: A mental models study

Research on vaping prevention messages has predominantly examined adolescents’ perceptions of and responses and the research exploring how experts’ perspectives is limited. Expert knowledge is crucial for conceptualising the risk phenomenon and its key causal mechanisms, uncertainties, and issues that are relevant to address in evidence-based communication strategies. This study therefore explored how professionals and experts conceptualise and understand adolescent vaping behaviour, including its perceived causes and drivers. Semi-structured interviews were conducted with a purposive sample of 12 experts from medical research, addiction science, public health prevention, and adolescent-oriented practice in Norway. Data collection and analysis were informed by the mental models approach to risk communication. The analysis identified an expert-derived mental model/influence diagram of adolescent vaping behaviour. Across expert domains, vaping was understood as a multifactorial phenomenon emerging from interacting biological, psychological, and social factors operating across multiple system levels. The first theme describes vaping initiation as a socially embedded and often intermittent practice shaped by identity development, peer belonging, and low perceived harm. The second theme captures how vaping is enabled, sustained, and legitimised through interacting drivers operating across social, structural, commercial, and regulatory contexts. The third theme focuses on reinforcement processes, whereby nicotine dependence and emotional coping mechanisms contribute to more sustained use. According to these expert accounts, adolescent vaping is sustained and legitimised through broader processes of normalisation operating across multiple societal levels. The expert perspectives identified in this study suggest that comparative risk framings of e-cigarettes as less harmful than cigarettes, and the social functions of vaping within adolescent peer cultures, may be important considerations in the development of risk communication targeting adolescents.