Uncertainty around the role of vaping in smoking cessation services: Insights from Scotland
Year: 2026
Type: article
Abstract: Background To understand the persisting sources of contention around the role of vapes in smoking cessation, existing research has investigated diverging evidence-based positions across regulatory contexts. While the empirical foundations of differing perspectives have been widely explored, less is known about how non-epistemic factors influence approaches to vaping in practice, particularly within specialist smoking cessation services (SCSs). Methods A qualitative case study was undertaken with Scottish tobacco control and SCS professionals. Both semi-structured qualitative interviews (n = 25) and policy document analysis (n = 26) were performed. The dataset was analysed thematically, with this paper focusing on the relationship between evidence mobilisation and experiences of metaphysical uncertainty around vapes in Scottish SCS policy and practice. Results Four themes categorise the findings: conceptualisations of smoking cessation and SCSs, experiences of uncertainty around vaping products, experiences of uncertainty around the role of vapes in SCSs and approaches to managing uncertainty. Evidence mobilisation and experiences of metaphysical uncertainty were shaped by contextual and normative factors. While product-based uncertainty was acknowledged across interviews and documents, practice-related forms appeared almost exclusively among SCS delivery professionals and contributed to their ‘under-confidence’ toward the role of vapes in SCSs. Strategies for managing uncertainty included mobilisation of locally-produced SCS guidance and deference for standardised medically licensed cessation products. Conclusion This paper is one of the first to explore how Scottish SCS professionals navigate engaging with vapes in practice. The findings emphasise how contextual and normative factors shape approaches to evidence mobilisation, experiences of metaphysical uncertainty and tactics for managing uncertainty around the role of vapes in SCS policy and practice. Key messages • Evidence mobilisation, experiences of metaphysical uncertainty and strategies for managing uncertainty around vapes are contextually shaped and differ in policy and practice. • Metaphysical uncertainty around vapes reflects product-based concerns around their consumer nature and practice-based concerns around ambiguous guidance for specialist smoking cessation services.
Author: KM Kim
Institution: University of Edinburgh
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7223671449