The ambiguity of electronic cigarettes: reflections on boundary objects and biomedicalization

Abstract

This thesis investigates the perceptions of electronic cigarettes held by electronic cigarette users and stop smoking advisors in South East England between 2014 and 2015. This qualitative study draws on two thematically analysed datasets: 15 semi-structured interviews with electronic cigarette users and 13 semi-structured interviews with stop smoking advisors. The theoretical underpinnings of my empirical investigation are the Boundary Objects theory and Biomedicalization theory. I discuss how electronic cigarettes as boundary objects can function as both translational and facilitative objects between different actors, who construct different social meanings of electronic cigarettes. I clarify how the different social meanings attached to electronic cigarettes are impacted by the wider political, cultural and technological processes of biomedicalization. I also argue that biomedicalization processes are the outcome of divergent, but coexisting, perceptions and meanings. Electronic cigarettes bring both opportunities and threats, including the ways in which electronic cigarettes challenge contemporary social meanings of addiction and how such new innovations can prompt wider social and political changes. All my data exhibits a high level of ambiguity regarding electronic cigarettes’ status, efficacy and potential health and social risks. However, the research also shows different representations of electronic cigarettes that are related to a biomedical model of understanding and managing nicotine addiction, where individualisation and empowerment are at the core. Lastly, the data shows a potential for social change towards a socially acceptable recreational use of nicotine that mimics smoking, in spite of some electronic cigarette users’ concern about stigma potentially shifting from smokers to electronic cigarette users.