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ForwardWMJ Vol 123 Issue 2: Perspectives on Electronic Nicotine Delivery System Use Cessation Among Adults in Rural Areas: Implications for Future Studies
ABSTRACT
Introduction: More young adults (age 18-24 years) in rural areas versus urban areas use electronic nicotine delivery systems (ENDS) – also known as e-cigarettes. Little is known about young adults’ perceptions toward ENDS use and cessation. The objective of this study was to examine barriers and facilitators to ENDS use cessation among young adults living in rural areas, as well as their perceptions about ENDS use and cessation and to determine implications for future cessation studies.
Methods: We administered cross-sectional online surveys to young adults living in rural Midwestern counties. A total of 100 individuals responded to the surveys. Descriptive statistics were used to report their perceptions of ENDS use as well as barriers and facilitators to ENDS use cessation. The content analysis method was used to analyze the answers to an open-ended question regarding perceptions about the ENDS use cessation in the context of rural areas.
Results: Barriers to ENDS use cessation included perceived advantages to ENDS use, high nicotine dependence, and the perception that ENDS use was less harmful cigarettes. Facilitators to ENDS use cessation included cost of ENDS use, perceived harm, and high confidence in ability to quit. Participants’ perceptions about ENDS use cessation in the context of rural areas were conceptualized under the themes of (1) exposure to and initiation of ENDS use, (2) continuation of ENDS use, and (3) prevention and cessation of ENDS use.
Conclusions: Health care providers, tobacco control researchers, and public health advocates should be aware of barriers and facilitators to ENDS use cessation among young adults for future cessation intervention studies relevant specifically to rural areas.
Intended Audience
The intended audience for this continuing education activity is healthcare professionals caring for the people of Wisconsin and beyond.
Learning Objectives
As a result of this journal-based activity, learners as members of the healthcare team will be able to:
- Summarize evidence regarding electronic nicotine delivery systems (ENDS) use reviewed in this article.
- Explain results of a cross-sectional online survey study exploring perceptions of ENDS use and barriers and facilitators to ENDS use cessation among young adults living in rural areas.
- Discuss how the study results apply to the learner’s healthcare team and their patients who use ENDS.
FACULTY DISCLOSURE
It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.
For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.
| Name of Individual | Individual's Role in Activity | Financial Relationship Disclosure | Discussion of |
| Marianna Shershneva, MD, PhD | Accreditation Specialist | No relevant relationships with ineligible companies to disclose | No |
| Seok Hyun Gwon, PhD, RN | Author | No relevant relationships with ineligible companies to disclose | No |
| Vipavee Thongpriwan, PhD, RN | Author | No relevant relationships with ineligible companies to disclose | No |
| Yourim Kim, MS | Author | No relevant relationships with ineligible companies to disclose | No |
| Imteyaz El Jarrah, MSN, RN | Author | No relevant relationships with ineligible companies to disclose | No |
| Amani Mobarki, MSN, RN | Author | No relevant relationships with ineligible companies to disclose | No |
| Young Ik Cho, PhD | Author | No relevant relationships with ineligible companies to disclose | No |
| Han Joo Lee, PhD | Author | No relevant relationships with ineligible companies to disclose | No |
| Alex Nelson | Author | No relevant relationships with ineligible companies to disclose | No |
| Devon Noonan, PhD, MPH, FNP-BC | Author | No relevant relationships with ineligible companies to disclose | No |
| Matthew Dellinger, PhD | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Fahad Aziz, MD | Reviewer, Editor | No relevant relationships with ineligible companies to disclose | No |
| Jennifer Esch, PharmD, MBA, BCPS | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Cassie Meffert, PA-C, MPH | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Roberta Pawlak, PhD, RN, NEA-BC | Reviewer | No relevant relationships with ineligible companies to disclose | No |
*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.
The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.
Accreditation
Accreditation Statement
 | In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. |
Credit Designation Statements
American Medical Association (AMA)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Nurses Credentialing Center (ANCC)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.
Accreditation Council for Pharmacy Education (ACPE)
The University of Wisconsin–Madison ICEP designates this knowledge-based activity for 1.0 hours or 0.1 CEUs. Credit can be earned by successfully completing the activity. Credit will be provided to NABP CPE Monitor within 60 days after the activity completion. UAN: JA0000358-9999-24-066-H01-P
American Academy of Physician Assistants (AAPA)
 | The University of Wisconsin–Madison ICEP has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until 08/07/2025. PAs should only claim credit commensurate with the extent of their participation. |
Continuing Education Units
The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.
Available Credit
- 1.00 AAPA Category 1 CME
- 1.00 ACPE Contact Hours - Pharmacist
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC Contact Hours
- 1.00 University of Wisconsin–Madison Continuing Education Hours
- 1.00 Approved for AMA PRA Category 1 Credit™
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