Australian children's physical activity and screen time while in grandparental care.

OBJECTIVE: The objective of this study was to explore Australian children's engagement in physical activity and screen time while being cared for by their grandparents. METHOD: Grandparents (N = 1,190) providing ≥3 hours of weekly care to a grandchild aged 3-14 years completed an online survey assessing their grandchildren's movement behaviours while in their care. Descriptive statistics were computed for frequency of engagement in unstructured and structured physical activities, minutes spent playing outdoors, and minutes spent engaged in screen time. Regression analyses were conducted to assess socio-demographic predictors of movement behaviours. RESULTS: Playing in the yard was the most common form of physical activity in which grandchildren reportedly participated (77% 'usually' or 'always'), followed by playing with toys/equipment (62%). Few (14-36%) frequently engaged in active transport. Children spent an average of 181 minutes per week engaged in screen-based activities. CONCLUSIONS: There is an opportunity to improve children's movement behaviours while in grandparental care. Communicating to grandparents their importance in supporting an active lifestyle is warranted. IMPLICATIONS FOR PUBLIC HEALTH: Findings highlight the importance of creating environments that facilitate play-based, outdoor activities. Ensuring children have access to play equipment while in the care of grandparents and improving access to and quality of neighbourhood parks may assist with activity promotion.

The lasting impact of the Go for 2&5 campaign.

ISSUE ADDRESSED: Little is known about the executional techniques that are most likely to make healthy eating messages memorable over the longer term. The aim of this exploratory study was to identify factors contributing to the ongoing salience of the Go for 2&5 social marketing campaign among older audience members. METHODS: Interviews were conducted with 75 Western Australians aged 60+ years. A peer-interviewing method was used whereby eight older people recruited and interviewed members of their extended peer groups. The interview guide included questions about interviewees' recollections of healthy eating messages across their lifespans. RESULTS: Around one in five interviewees discussed the Go for 2&5 campaign that was on air in Western Australia between 2002 and 2011. These discussions focused on either specific advertisement features that were considered to be especially memorable (in particular, humour and the use of anthropomorphised depictions of produce) and/or their recollection of the number of daily servings of fruits and vegetables recommended in the campaign. Few were able to recall other healthy eating campaigns, and in some cases it was assumed that advertisements for specific food stores or products constituted health advice. CONCLUSIONS: Different campaign attributes may influence shorter-term attitudinal and behavioural responses versus longer-term recall. The characteristics of the Go for 2&5 campaign appear to have enabled it to achieve relatively high levels of recall among older people. SO WHAT?: The study results suggest that some advertising approaches that activate the peripheral route to persuasion may achieve recall over a longer period of time.

Perceptions of Australia's e-cigarette regulations and recommendations for future reforms: a qualitative study of adolescents and adults.

OBJECTIVE: To assess public perceptions of the effectiveness of e-cigarette regulations in minimising use among adolescents and those who have never smoked. Specifically, we explored (1) perceived effectiveness of current regulations relating to e-cigarettes and (2) ideas for further regulations that could reduce use. DESIGN AND PARTICIPANTS: Focus groups (n=16) were conducted with Australian adolescents (14-17 years), young adults (18-24 years) and adults (25-39 years). Groups were stratified by age, gender and e-cigarette use status. Data were analysed using reflexive thematic analysis. SETTING: Focus groups were conducted in-person in two major Australian cities. RESULTS: Groups lacked a comprehensive understanding of e-cigarette regulations in Australia. When informed of these regulations, half of the groups considered the prescription model for nicotine e-cigarette products to be effective when enforced appropriately. Almost all groups considered access to non-nicotine products problematic. All groups suggested a range of demand reduction regulations, including plain packaging, health warnings, flavour restrictions and increased vape-free areas. Most groups (predominantly those who had never vaped) also recommended supply reduction regulations such as banning all e-cigarettes. The need for supply reduction measures to include addiction and mental health supports was discussed. CONCLUSIONS: The regulations recommended by participants largely align with those that are to be introduced in Australia, indicating that these reforms are likely to be accepted by the public. Ensuring these reforms are complemented by formal supports for young people experiencing nicotine dependence and related mental health concerns is critical.

The Ability of Nutrition Warning Labels to Improve Understanding and Choice Outcomes Among Consumers Demonstrating Preferences for Unhealthy Foods.

BACKGROUND: Given growing interest in warning labels as a form of front-of-pack nutrition label, it is important to better understand the mechanisms via which these labels may exert their effects, especially among those making suboptimal food choices. OBJECTIVE: The study aim was to assess the extent to which consumers with the weakest outcomes for objective understanding and choice in no-label conditions were able to improve their understanding and choices after exposure to warning labels on food product options. DESIGN: Post-hoc analyses of the cross-sectional FOP-ICE (Front-of-Pack International Comparative Experimental) study data generated from an online survey that included simulated food choice and nutritional quality ranking scenarios. PARTICIPANTS/SETTING: Participants included 3,680 adults from the following 18 countries: Argentina, Australia, Belgium, Bulgaria, Canada, Denmark, France, Germany, Italy, Mexico, Netherlands, Poland, Portugal, Singapore, Spain, Switzerland, United Kingdom, and United States. INTERVENTION: Survey respondents selected their preferred product options and ranked foods according to their healthiness before and after exposure to mock breakfast cereal, cake, and pizza products displaying warning labels. MAIN OUTCOME MEASURES: Objective understanding and food choice were measured. STATISTICAL ANALYSES PERFORMED: Within each product category, analyses were conducted on respondents who initially incorrectly identified the healthiest option and/or selected the unhealthiest option as their preferred choice. Significant differences between proportions selecting each understanding and choice response option were assessed using 2-sample z tests for proportions. RESULTS: Salience of the warning labels was low; 46% reported noticing the labels while completing the survey. Just over one-third of those aware of the presence of warning labels were able to identify the least healthy option in the post-exposure condition. Approximately one-half reselected the least healthy option post exposure and just over one-fourth switched to the healthiest option. CONCLUSIONS: The results indicated that warning labels can assist some consumers to improve their food quality assessments and choices. However, design improvements could enhance the salience and interpretability of this label format.

Motivators of e-cigarette use among Australian adolescents, young adults, and adults.

OBJECTIVE: There is limited research examining motivators of e-cigarette use among never smokers, a group for whom vaping has no benefits and many harms. To inform programs and policies that aim to prevent initiation and encourage cessation of e-cigarette use, this study investigated reasons for intended use, initiation, and continued use of e-cigarettes among various age and user groups in Australia. METHODS: An online survey was administered to 4617 respondents. Never users of e-cigarettes and never smokers who reported intending to try e-cigarettes (n = 348), current e-cigarette users and never smokers (n = 121), and current e-cigarette users and current smokers (n = 354) were of interest to this study. RESULTS: Among never smokers, curiosity was the most commonly reported reason for intended use and use initiation, whereas the taste of e-cigarettes and their appealing flavours were the most frequently reported motivators of current e-cigarette use. Among smokers, taste and flavourings were the most commonly reported motivators of current use, not smoking cessation. Adolescents and young adults in most user groups were more likely than adults to report using e-cigarettes out of curiosity and because they taste good, whereas adults were more likely to use for smoking cessation purposes and because they perceived e-cigarettes to be more acceptable and cheaper than tobacco cigarettes. CONCLUSIONS: Results suggest that (i) prohibiting flavourings and (ii) restricting advertising that highlights the pleasurable effects of e-cigarettes could constitute potential means of preventing e-cigarette initiation and encouraging cessation among never smokers, especially adolescents.

The lived experiences of hematology healthcare providers during and beyond the COVID-19 crisis: A qualitative study.

OBJECTIVE: Amid the COVID-19 pandemic, healthcare providers (HCPs) of hematology patients face unique challenges due to the vulnerability of their patients. This study explores the lived experiences of these providers during and beyond the crisis. METHODS: Twenty-one Australian HCPs caring for hematology patients completed semi-structured interviews exploring their experiences and needs during the COVID-19 pandemic, adequacy of support and information provided by healthcare organizations, impact on hematology patients, and the benefits and challenges of telehealth care. Data were analyzed using reflexive thematic analysis. RESULTS: Four themes were identified: (1) Managing an initial state of flux (unsettling uncertainty and fear, unique needs of hematology patients, getting on with the job together); (2) Concerns about care provision (questioning care efficacy, burden of compassion); (3) Disconnect between HCP needs and system-level responses (burnout, isolation, and poor work-life balance, broadcast fatigue, protecting mental health), and; (4) Reflecting on the future (ongoing challenges for hematology patients, higher staff turnover and heavier workloads, innovation in the healthcare field). CONCLUSION: This study sheds light on the challenges that hematology HCPs face during and beyond the COVID-19 crisis, impacting their wellbeing. Addressing these challenges is paramount for the healthcare system at large. Provider-led peer support programs may be beneficial for addressing moral distress and building resilience. Additionally, specific consideration for the ongoing vulnerability of hematology patients could have positive impacts on providers' professional satisfaction.

Factors associated with susceptibility to e-cigarette use among Australian adolescents.

BACKGROUND: Preventing uptake of e-cigarette use among adolescents is critical to minimizing vaping-related harms. To inform the development of effective prevention programs and policies, this study explored potential determinants of susceptibility to e-cigarette use among young Australians. METHODS: A cross-sectional online survey was administered to 12- to 17-year-old Australians who had never smoked nor vaped (N = 973; 53 % women). The survey assessed susceptibility to e-cigarette use (curiosity about use, willingness to use, and intentions to use) and a comprehensive range of potential correlates that included individual, social, and environmental factors. Regression analyses were conducted to identify factors significantly correlated with each of the dependent variables. RESULTS: Susceptibility to e-cigarette use was observed in 45 % of respondents. Individual factors associated with susceptibility included respondents' (i) overall opinion of e-cigarettes, (ii) attitudes toward e-cigarettes, (iii) affect regulation expectancies, and (iv) quitting perceptions. Significant social factors included both descriptive and injunctive norms, specifically: perceiving that use is ok for people of one's age, approval from important others to use, and having at least one family member or close friend who vapes. CONCLUSION: Susceptibility to vaping was observed in a substantial proportion of adolescents who have never smoked. Shifting attitudes and social norms around e-cigarette use appears critical to reducing susceptibility. Recommended prevention efforts include the development of communications addressing misperceptions about the benefits of vaping on affect regulation and stricter regulations on e-cigarette advertising to reduce young Australians' exposure to claims that may result in favourable attitudes to e-cigarette use.

Dimensions of the diet-exercise relationship in later life: A qualitative study.

OBJECTIVE: Diet and physical activity are two lifestyle behaviours that are critical for healthy ageing. The aim of this study was to explore how older adults negotiate dietary and physical activity decisions to identify areas of intersection between these two behaviours and inform health promotion interventions targeting both diet and exercise. METHODS: This exploratory study utilised a novel data collection approach that involved lay interviewers recruiting their peers to (i) participate in two interviews over a period of six months and (ii) make notes on their thoughts relating to diet and physical activity. Participants were 75 adults aged 60+ years in Western Australia (n = 64 females). RESULTS: Three primary themes were identified: (i) the importance but difficulty of achieving energy balance; (ii) issues relating to managing food intake before, during, and after physical activity; and (iii) reciprocal opportunities for eating and physical activity. CONCLUSIONS: Diet and physical activity are linked in complex ways, highlighting the need for multi-factorial interventions. IMPLICATIONS FOR PUBLIC HEALTH: When developing communications strategies designed to encourage older people to both improve their diets and increase their physical activity, consideration could be given to leveraging existing perceived alignments between healthy eating and being active.

Testing campaign slogans designed to motivate older people to be more physically active.

Objectives and importance of study: Being physically active is critical for healthy ageing, yet many older people do not meet physical activity guidelines. The aim of this study was to test the relative effectiveness of five previously identified campaign slogans designed to encourage older people to be more physically active: 'Be active 30-60 minutes a day to stay fit and well'; 'Move more, live longer'; 'Stay fit to stay functional'; 'This is your time - enjoy being strong and active'; and 'Use it or lose it'. STUDY TYPE: Online experiment Methods: A total of 1200 Australians aged 50 years and older (50% female, mean age 65 years) were recruited to complete an online survey, with respondents randomised to answer a series of questions on a video featuring one of the five slogan conditions. One-way ANOVAs with Tukey's post-hoc tests were used to identify differences in outcomes between slogans. RESULTS: Overall, the slogans were assessed favourably, suggesting older adults may be receptive to messages about increasing their physical activity. 'Use it or lose it 'performed best across the outcome measures of internal and external motivation, perceived effectiveness, liking, believability, and personal relevance. CONCLUSION: Efforts to encourage physical activity among older Australians could use the slogan 'Use it or lose it' as an evidence-based tagline.

Perceptions of a prescription model for accessing nicotine vaping products: an examination of submissions made by self-reported e-cigarette users to an Australian consultation.

In response to rapid and substantial increases in rates of e-cigarette use among young people, Australia's Therapeutic Goods Administration (TGA) made changes to the regulations governing nicotine vaping products. As part of the regulatory change process, Australians were invited to comment on the proposed regulations, which featured the introduction of a prescription model for nicotine vaping products. To inform strategies to enhance compliance with the tightened regulations, this study examined submissions made by self-reported e-cigarette users to the TGA's public consultation (n = 1405). A content analysis was conducted to identify and quantify key arguments. Claims about possible negative consequences associated with the regulations (e.g. people will return to smoking, inconvenience) featured in most submissions (84%). Around half (55%) of submissions mentioned perceived benefits of e-cigarettes, including favourable health outcomes (e.g. improved breathing) and enhanced tobacco cessation. Around half (52%) featured concerns about inconsistency in treatment and the argument that e-cigarettes should not be restricted when more harmful tobacco products are readily available. Alternative approaches to a prescription model were offered in nearly one-third (31%) of submissions. One-quarter (26%) included text provided by an industry-led astroturfing campaign. The arguments made in the analysed submissions suggest a lack of appreciation of (i) the negative health outcomes associated with e-cigarette use and (ii) evidence linking these devices to smoking relapse. Results highlight the need for targeted health campaigns that address (i) gaps in consumers' knowledge and (ii) vaping-related misinformation being promulgated by the industry and its allies.

The Influence of Grandparents on Children's Dietary Health: A Narrative Review.

PURPOSE OF REVIEW: To examine and synthesise recent evidence on the role of grandparents in shaping children's dietary health. RECENT FINDINGS: The influence of grandparents on children's dietary health was evident across studies. Grandparents frequently provide their grandchildren with meals and snacks, and engage in many of the same feeding practices used by parents. Although grandparents report providing their grandchildren with healthy foods, the provision of treat foods high in sugar or fat was a common finding. This provision led to family conflict, with the indulgent behaviours of grandparents seen by parents as a barrier to healthy eating. Grandparents are exerting significant influence on child dietary health. Efforts are needed to ensure these care providers are considered key stakeholders in the promotion of healthy eating and are targeted in policies and programs addressing children's diets. Research that determines how to best support grandparents to foster healthy behaviours in children is critical.

Perceptions of e-cigarettes among Australian adolescents, young adults, and adults.

Increases in e-cigarette use are of concern to public health authorities given the harms associated with vaping. Understanding people's perceptions of the risks and benefits of e-cigarette use has the potential to assist with prevention efforts. However, research assessing the perceptions of Australian adolescents and any differences in perceptions between adolescents, young adults, and adults is limited. Additionally, research exploring perceptions of various types of e-cigarettes is lacking. To inform the development of prevention and intervention programs and policies, this study aimed to explore Australians' perceptions of the risks and benefits associated with e-cigarette use and whether perceptions differ by age and user status. A sample of 4,617 Australians aged 12 + years completed an online survey that assessed (i) smoking and e-cigarette user status, (ii) e-cigarette risk perceptions, (iii) beliefs about e-cigarettes as a smoking cessation tool, and (iv) positive e-cigarette outcome expectancies. Across all age groups, respondents perceived non-nicotine and flavoured e-cigarettes as less harmful than nicotine e-cigarettes. Significantly more adolescents and young adults than adults held positive outcome expectancies, and a substantial minority of non-users and never users in all age groups believed that using e-cigarettes confers social and mental health benefits. Given the potential benefits they perceived to be associated with e-cigarette use, a substantial proportion of adolescent and young adult never users may be vulnerable to initiation. These findings highlight the importance of (i) adequately communicating the risks associated with non-nicotine e-cigarette use and (ii) addressing misperceptions about use, especially among youth.

Factors associated with changes in healthy lifestyle behaviors among hematological cancer patients during the COVID-19 pandemic.

Background: There is a paucity of research examining the effects of the COVID-19 pandemic on the healthy lifestyle behaviors of hematological cancer patients. We examined changes in healthy lifestyle behaviors since the pandemic and identified factors associated with these changes among members of this high-risk population. Methods: Hematological cancer patients (n = 394) completed a self-report online survey from July to August 2020. The survey assessed pandemic-related changes in exercise, alcohol consumption, and consumption of fruit, vegetables, and wholegrains. Information relating to several demographic, clinical, and psychological factors was also collected. Factors associated with changes in healthy lifestyle behaviors were analyzed using logistic regression. Results: Just 14% of patients surveyed reported exercising more during the pandemic (39% exercised less). Only a quarter (24%) improved their diet, while nearly half (45%) reported eating less fruit, vegetables, and wholegrains. Just over a quarter (28%) consumed less alcohol (17% consumed more alcohol). Fear of contracting COVID-19 and psychological distress were significantly associated with reduced exercise. Younger age was significantly associated with both increased alcohol consumption and increased exercise. Being a woman was significantly associated with unfavorable changes in diet and being married was significantly associated with decreased alcohol consumption. Conclusion: A substantial proportion of hematological cancer patients reported unfavorable changes in healthy lifestyle behaviors during the pandemic. Results highlight the importance of supporting healthy lifestyle practices among this particularly vulnerable group to ensure health is optimized while undergoing treatment and when in remission, particularly during crisis times like the COVID-19 pandemic.

Educators' perceptions of e-cigarettes in Australian secondary schools.

INTRODUCTION: Secondary schools are a setting in which e-cigarette use among students has increased significantly, resulting in an urgent need for educators to develop and implement strategies to curb youth vaping. Research assessing school-based vaping prevention efforts is limited and largely confined to the US. This study assessed Australian secondary school staff members' experiences with e-cigarettes and explored (i) the presence of e-cigarette policies and educational programs, (ii) barriers to policy development and implementation, and (iii) desired support. METHODS: Public, Catholic, and Independent secondary schools across Australia were sent an invitation to participate in this study, which involved completion of an online survey. A total of 218 school staff members (55% women) participated. Respondents included school principals, teachers, and other staff members. Data collection occurred May to September 2022. Both quantitative and qualitative data were collected. RESULTS: Nearly half (46%) of all school staff members surveyed reported finding a student with an e-cigarette on campus at least monthly, and one-third (36%) of principals reported suspending or expelling students at least monthly for e-cigarette possession or use. The vast majority of those surveyed agreed that e-cigarette use is increasingly becoming a problem in secondary schools (93%) and reported being concerned about e-cigarette use by students (94%). Only half (51%) reported that their school had an e-cigarette policy in place. The discreet appearance of e-cigarettes (83%) and difficulties pinpointing from where the vapor/scent is coming (73%) were the most frequently reported barriers to policy enforcement. CONCLUSIONS: The results of this study suggest that e-cigarettes present a threat to secondary school environments. There is an urgent need to develop, implement, and enforce both school- and government-level e-cigarette policies to prevent and reduce youth vaping in Australian secondary schools.

E-cigarette product preferences of Australian adolescent and adult users: a 2022 study.

BACKGROUND: Research that comprehensively documents preferences for different types of novel nicotine products in Australia is lacking, making it difficult for policymakers to determine where public health efforts should be focused. This study thus sought to explore Australian adolescent and adult e-cigarette users' preferences for different types of e-cigarettes and e-liquids. Purchasing behaviours and sources of e-liquid were also examined. METHODS: An online survey was administered to 4,617 Australians aged 12 + years, 636 of whom had used an e-cigarette in the last 30 days and were the focus of this study. Among users, 45% also smoked tobacco cigarettes, 41% were non-smokers, and 14% had never smoked. RESULTS: The majority (82%) of e-cigarette users surveyed reported using nicotine-containing e-liquid in their devices. Fewer (60%) reported using non-nicotine e-liquid. The preference for nicotine over non-nicotine e-liquid was observed among all age and smoking groups. Most users (89%) reported using flavoured e-liquids, with adolescents (96%) significantly more likely than young adults (90%) and adults aged 25 + years (85%) to report using such e-liquids. Fruit flavours were the most popular among all subgroups. In terms of device type, disposable e-cigarettes were the most common product used among almost all groups; the exception being adults aged 25 + years who preferred systems with refillable tanks. Friends and tobacco retailers were the most frequently nominated sources of nicotine e-liquid among adolescents and young adults. Among adults aged 25 + years, tobacco retailers and the Internet were the most frequently nominated sources of these products. CONCLUSION: Disposable e-cigarettes with flavoured, nicotine-containing e-liquid are popular among users of the devices, including adolescents. Measures that restrict the accessibility and availability of flavoured e-liquids and disposable e-cigarettes, and greater enforcement of laws regarding the sale and importation of nicotine e-liquids, are urgently needed to protect youth and never smokers from these products.

The ability of five different front-of-pack labels to assist Australian consumers to identify healthy versus unhealthy foods.

OBJECTIVE: The aim of this study was to assess the relative ability of different interpretive front-of-pack food labels to alert consumers to both healthier and unhealthier options to inform their food choices. METHODS: One thousand Australians completed an online experiment where they rated the nutritional quality of sets of fictional products pre- and post-randomisation to one of five front-of-pack labels: Health Star Rating, Multiple Traffic Lights, Nutri-Score, Reference Intakes and Warning Label. Two sample z-tests were used to assess the ability of each label to facilitate the correct identification of the least and most healthy product options. RESULTS: The Nutri-Score was superior in assisting respondents to identify both the healthiest and unhealthiest options. The Health Star Rating ranked second for both outcomes, followed by the Multiple Traffic Lights. CONCLUSIONS: Results reinforce the role of interpretive front-of-pack labels in assisting consumers to understand the nutritional quality of food products and suggest spectrum labels may provide superior utility in assisting consumers to identify both the most and least nutritious products from among available product options. IMPLICATIONS FOR PUBLIC HEALTH: The strongest performance of a highly interpretive front-of-pack label (Nutri-Score) featuring colour in a summary indicator suggests potential strategies for enhancing the performance of the Health Star Rating.

Exploring grandparents' receptivity to and preferences for a grandchild nutrition-focused intervention: A qualitative study.

OBJECTIVE: Interventions promoting healthy eating in children typically overlook the critical role of grandparent caregivers. Utilising a co-design approach, this study (i) assessed the receptiveness of grandparents to a nutrition-focused resource aimed at promoting healthy eating in their grandchildren and (ii) explored grandparents' preferences for resource delivery and dissemination. METHODS: Seventy-nine grandparents (58% female; mean age=69.37 years) who were secondary carers to a grandchild aged 3-12 years participated in one of 10 focus groups. Focus group transcripts were imported into NVivo for coding and semantic thematic analysis. RESULTS: The vast majority of focus groups (n=9) were receptive to receiving a nutrition-focused resource. Participants indicated that such a resource should contain strategies that help grandparents promote healthy eating in their grandchildren rather than outline what grandchildren should be fed. A range of delivery (pamphlets, seminars and fridge magnets) and dissemination (online, email) methods were suggested. CONCLUSIONS: A nutrition resource that equips grandparents with the strategies they need to promote healthy eating in their grandchildren would likely be welcomed. IMPLICATIONS FOR PUBLIC HEALTH: Results provide program developers with the preliminary information required to tailor childhood lifestyle interventions to the needs of grandparents, thus helping increase acceptability and uptake.

Development and validation of the Alcohol Message Perceived Effectiveness Scale.

To assist intervention developers assess the likely effectiveness of messages designed to encourage greater use of protective behavioral strategies, this study developed and tested the Alcohol Message Perceived Effectiveness Scale (AMPES). Recommendations from the message effectiveness literature were used to guide AMPES development. The resulting scale was administered in online surveys at two time points to Australian drinkers aged 18-70 years (3001 at Time 1 and 1749 at Time 2). An exploratory factor analysis identified the presence of two factors ('effect perceptions' and 'message perceptions') that accounted for 71% of the variance in scores. Internal consistency of scores was good for the overall scale (ω = 0.83) and 'effect perceptions' factor (ω = 0.85), but suboptimal for the 'message perceptions' factor (α = 0.60). Scores on both factors significantly predicted enactment of protective behavioral strategies. The AMPES appears to be an appropriate tool to assess perceived message effectiveness and assist in the development of public health messages designed to reduce alcohol consumption.

Challenges and opportunities associated with e-cigarettes in Australia: A qualitative study.

OBJECTIVE: The use of e-cigarettes in Australia has increased significantly in recent years. To assist with identifying policy and practice priorities, this study sought to provide a greater understanding of the population-level challenges and opportunities associated with these products. METHODS: Semi-structured interviews were conducted with 34 public health experts working in tobacco- and/or nicotine-related policy, practice and research. Interview transcripts were subject to reflexive thematic analysis. RESULTS: Several challenges associated with e-cigarettes were identified, with uptake of use among youth, the potential for use to lead to smoking and industry interference the most frequently mentioned. Recommended means of addressing these challenges included improved regulation and increased enforcement of existing laws. Most interviewees acknowledged some potential for e-cigarettes to assist with smoking cessation. CONCLUSIONS: Despite strong restrictions on e-cigarettes in Australia, experts working in this field reported that these products, and the companies behind them, present several challenges to public health. IMPLICATIONS FOR PUBLIC HEALTH: Tighter regulation and increased enforcement are needed to address the challenges posed by e-cigarettes. Controlled access to liquid nicotine under a pharmaceutical model offers an opportunity for smokers to access the behavioural support that may help them to quit while also restricting e-cigarette availability.