The family environment plays a crucial role in creating the health behaviours of children and youth. This study aimed to explore the attitudes of parents with children aged 7–12 who represent an influential environment for creating the eating behaviours of children. A qualitative study was conducted using focus-group interviews (FGI) involving 101 parents from various socioeconomic backgrounds. Three categories of parents were identified based on their level of involvement and awareness of nutrition: ‘aware’, ‘determined’, and ‘relaxed’. Among parents of 10–12-year-old students, an additional category, ‘distanced’ parents, was identified. The study revealed that parents require support in terms of providing compelling arguments and practical recommendations related to meals and reducing or eliminating their children’s consumption of sweets, snacks, fast food, and, in the case of older students, energy drinks. Parents reported that their children had a moderate understanding of the principles of proper nutrition. The majority of respondents viewed this knowledge as primarily theoretical and expressed a need for practical guidance and activities, which they believe should be offered by schools. To achieve positive outcomes in educational activities related to food and nutrition, it is essential to involve children, parents, guardians, teachers, and other school staff in these efforts. Dietary preferences change throughout life under the influence of biological, social, and environmental factors  and are The family has the greatest influence on children, especially in the first years of their lives, where many quantitative and qualitative changes in their dietary patterns occur, which is closely linked to the child’s development . During Children model their dietary behaviours, lifestyles, and attitudes related to food consumption and physical activity based on observations of their parents in everyday situations. Children’s behaviours are closer to the ideals of a health-promoting lifestyle the more often parents also exhibit these behaviours ,6,8,11. The mechanisms emphasizing the influence of the family environment on the health behaviours of children and youths are complex . The abiPrevious research has focused on quantitative studies of children’s and adults’ eating behaviours and attitudes. Qualitative research is needed for a more complex understanding of these issues, which will allow, among other things, a better understanding of the substrate of abnormal eating behaviour, which often already arises in childhood. This need is also pointed out by other authors ,21.Identifying parents’ concerns and expectations regarding the need for nutritional education is important to determine their level of nutritional awareness, which, in turn, will form the basis for developing the content of educational materials and other messages to support parents/legal guardians in adequately communicating nutritional knowledge to their children.The aim of the study was to identify the attitudes of parents of primary school students aged 7–12 years towards food and nutrition as an environment that is a source for the formation of children’s and young people’s dietary attitudes.This aim was accomplished using a qualitative approach because of the following reasons, (i) first, in FGIs, the informative source is a group; (ii) second, the heuristic value of this technique lies in the kind of interaction that emerges during the debate ; (iii) tQualitative research was carried out using the focus-group interview (FGI) technique in 16 groups in 10 locations across Poland, varying in size and thus taking into account different socioeconomic aspects. These included metropolitan cities with more than 500,000 inhabitants; cities with 100,000 to 500,000 inhabitants; small towns with up to 50,000 inhabitants; and villages . Each foFGI is a qualitative research technique involving in-depth group discussions, typically with 6–8 participants. Individuals are encouraged by a moderator to speak freely and engage in a discussion on specific topics according to a moderation scenario developed in advance and tested in a pilot study ,24,25,26The study was conducted by three moderators, with one person recording the interviews and taking notes. The interview was explained to the participants before the start. The main moderator initiated the group discussion by introducing the participants to each other. Introduced is the idea of the discussion and the rules governing group behaviour explained . Parents or legal guardians of primary school students aged 7–12 years who gave their agreement to participate in the study were included in the focus group. Among the criteria for exclusion from the focus group were parents of children with health problems . Participants were able to resign from the FGI at any stage of the study, without giving a reason, but there was no such situation. The issues addressed during the study concerned the problems and challenges parents meet in the context of children’s nutrition, assessing the level of engagement and awareness among parents regarding nutritional matters, and their approach to this area of education. The study also explored parents’ opinions on the current state of children’s nutritional education and the needs in this regard, as well as their ideas on how this education should be conducted.FGIs among parents were conducted by the specialist from Umbrella Agency Marketing Group. The duration of each group discussion was approximately 90 min. This article discusses topics related to child nutrition problems and the state of knowledge of children aged 7–12 years as perceived by parents.The group discussions were audio-recorded with the participants’ consent, preserving verbatim statements for the researchers to accurately assess content. Interview transcriptions and moderation notes were coded and initially analysed independently by two researchers. Correlations were examined to reach a consensus.In the analysis of the results, only the name of the research location was used alongside parents’ statements.Material from the in-depth group discussions was analysed using principles of grounded theory, focusing on uncovering recurring and prominent themes in participants’ discussions. Data analysis followed a seven-step process: becoming familiar with the data, applying thematic coding, identifying subthemes within the main framework, reviewing and revising the subthemes, defining and naming the subthemes, analyzing and interpreting patterns across the data, and linking the subthemes into dominant contextual domains . During All procedures involving human subjects received the approval of the Ethics Committee of the Institute of Human Nutrition Sciences of the Warsaw University of Life Sciences (No. 18/2022).Parents of primary school students aged 7–9 years.All parents of 7–9-year-olds participating in the FGI expressed the importance of the topic of good nutrition, diet, and nutritious foods, but also found it to be challenging and unpleasant. This is primarily due to the need for inconvenient, monotonous, and repetitive conversations with children about their food preferences, what they want to eat, and the importance of making healthy choices.According to some parents who participated in the FGI, children in the 7–9 age group often exhibit reluctance to try new flavours, and their list of favourite foods is relatively limited. Children at this age are still in the process of exploring new tastes, aromas, and textures of various foods, and their palates are not yet fully developed. Additionally, their food preferences may have been created by their experiences in kindergarten, as well as at home with family and grandparents, where different culinary habits, tastes, and food preparation methods may have prevailed. Consequently, children are still adapting to the new culinary habits at school and are just beginning to establish routines for meals away from home, such as having a second breakfast, snacks, or eating in the school canteen. Parents (n = 47) shared during moderations their perceptions and concerns, as well as the daily problems and challenges they encounter in the realm of food and nutrition .It is evident that many of the issues identified are quite common among primary school students aged 7–9 years. What parents of children in this age group need most is inspiration and factual arguments to engage in conversations with their children. The majority of study participants expressed a desire for support and assistance in explaining why certain food groups are either healthy or unhealthy and how they affect their child’s health and proper development. Parents are clearly in need of not only motivation, energy, and patience but also accurate and substantial guidance to effectively implement nutritional education at home.Of particular concern, however, is the easy accessibility of products that are not recommended for children, not only in local stores but also in school shops. Parents emphasize the challenges in instilling healthy habits in children due to the virtually unlimited variety and availability of snacks and sweets in school shops. According to parents, school shops should inherently promote products recommended for children’s daily nutrition, supplement students’ dietary needs, and support the health-promoting efforts of school canteens. They acknowledge that efforts to promote health among children and adolescents have somewhat reduced access to unhealthy products in schools. However, they believe that school vending machines, present in most of the schools studied, still require monitoring.As children spend an increasing amount of time at school, the school environment becomes crucial for instilling and reinforcing health-promoting habits. From a young age, children gain a degree of financial independence, as they receive pocket money for their personal expenses. As a result, parents have no full control over their child’s food purchases on school premises and parents would like to trust the institution to ensure that children make health-conscious choices. This involves ensuring that products detrimental to their health are not available in these shops.Parents of 7–9-year-old primary school students also stressed that they face challenges in terms of good eating behaviours due to modern technology. Inappropriate dietary behaviours are created in children by the media and the internet . The ubiquitous and intrusive advertisements communicate that a biscuit or colourful cereal is a good choice for breakfast and that a fizzy drink is the best way to quench thirst. In such a situation, it is difficult to explain and convince children to eat, for example, plain oatmeal or nutritious sausage and vegetable sandwiches with water or fruit tea.‘Children seemingly realise that if they are at home, they will not get sweets before dinner. The condition is to eat dinner. At school it’s out of our hands if they don’t choose a chocolate bar first. A child with money can also buy whatever he or she wants in the grocery shop, and it doesn’t necessarily have to be a healthy product’.‘She’s at school and she sees someone, for example, eating something, and then she sees it in a shop. She often asks: will you buy it for me? And you have to come up with something to say no. And the questions arise: why can someone else and I can’t forever?’.‘I don’t understand why vending machines with products such as candy bars, fizzy drinks are so easily available in classes 0–3. For me it is incomprehensible’.Sample statements from parents of primary school children aged 7–9 years:they have a better understanding of good nutrition and have developed healthy eating habits;they enjoy trying new things and exploring different flavours, even with familiar products;they are often involved in shopping with their parents and have an influence on the shopping list and the contents of the basket;they travel to other countries, where they get to know the local products and dishes and, thus, reduce the level of neophobia;they are more open to a variety of food products and are willing to diversify their diets by trying new foods available in school canteens, shops, or at their friends’ homes;they are keen to talk to their peers about the subject, exchange cooking experiences, share products, and try things from each other;they are interested in what others bring to eat and compare it with the contents of their breakfast boxes, aiming to ensure that there are not too many differences, especially if they ‘aspire’ to be group leaders in this respect;they find the topic of nutrition interesting;enjoy spending time in the home kitchen, which is beginning to be attractive to them and is no longer just a place reserved only for adults and associated with urging/forcing them to eat;ask and talk to parents about products, how to prepare meals, and interesting and healthy recipes for different dishes;they discover the appeal of culinary at home;they help their parents or prepare interesting dishes/desserts with their own hands, inspired by the example of their peers from the Master Chef Junior programme;they often stay at home without parental supervision and are responsible for preparing a meal for themselves (reheating or even cooking simple food).become independent in the kitchen;The opinions on food and nutrition expressed by parents of primary school students aged 10–12 years (n = 54) are relatively similar to those presented by parents of younger students. They generally agreed that the topic of their children’s nutrition is important. The same as parents of younger children, they are involved in this area of parenting, passing on their knowledge and trying to create correct attitudes. The topic of nutrition education for parents of older children is less problematic, for the following reasons, expressed implicitly in their statements about the behaviour and nutritional knowledge of older children:The above circumstances influence the attitudes of children aged 10–12 towards nutrition. Parents participating in the study acknowledge that children at this age are less likely to be labelled as “picky eaters”. They are also less selective and more open to trying different foods, which makes their diet more diverse. In general, pupils are capable of defining their taste and culinary preferences. They can distinguish and describe flavours and understand what they do not like and why. In contrast, younger children often reject certain foods on principle, saying “no” simply because they are unfamiliar.According to the parents taking part in the research (n = 54), other problems arise with 10–12 year olds, more of a social and environmental nature, as primary school students become independent in their extracurricular life, have pocket money, and buy food products themselves. In addition, they spend a lot of time with peers outside the home, without constant parental control. Older children are more active on the internet and create social media accounts, and the internet plays an increasingly important role in their lives. They feel inspired and attempt to create themselves cooking suggestions like the ones they see from Instagram and TikTok influencers. Primary school students, especially those around the age of 12, are gradually entering maturation. Their appearance and physique start to hold greater significance for them. Consequently, it becomes easier to convey messages to them about the influence of nutrition on their bodies, particularly on their appearance, physical wellbeing, and overall behaviour. For example, messages like “fast food leads to obesity”, “diet impacts your skin condition”, or “missing lunch can hinder your performance during training” can be more effective in this age group. All of these factors make them more receptive to more sophisticated arguments compared to students in lower grades. They are also beginning to grasp the consequences of poor nutrition, which is why, according to parents who participated in in-depth group discussions, their children are at a critical age in terms of nutritional education needs. This is the period during which it is still possible to influence and make changes to previously, often unhealthy eating habits. It is also an opportune time to stimulate their interest in food and nutritional issues within the context of public health and the environment and to establish healthy habits that are fundamental for healthcare, as well as for the effectiveness of the learning process, individual wellbeing, and societal wellbeing. Parents of 10–12-year-old students, just like parents of younger children, require strong arguments that effectively communicate to their children why certain groups of products are ‘healthy’ or not. This is because students are increasingly spending time alone, coming home from school without supervision and waiting for other family members to return. Simultaneously, this is the age when they begin to socialize more with their peers. All of this means that parents no longer have strict control over their children’s food choices and decisions. Parents have also emphasized that the availability of snacks in school vending machines poses a challenge to proper nutritional education. In many locations, it is still possible to purchase sweets on school premises.‘Legal regulations will not help when the range of vending machines is not controlled. This is where the problem is, vending machines should not have been in schools since 2015, and there is a vending machine full of sweets in our school’.‘The school should be teaching good habits, but it’s not educating about healthy alternatives. Instead of chips, there should be nuts. Even snacks like dried plums and sultanas are considered sweets’.Sample statements from parents of students aged 10–12:For older students, the assortment in school shops matters less. The greater concern, compared to younger students, is posed by off-campus shops offering a wide range of products not recommended for children, such as snacks and sweets. Parents emphasize that it is challenging to instill healthy habits in children with such a vast variety and easy access to different types of products.From an early age, children are spending more and more time away from home, often returning from school on their own, and passing numerous grocery shops, even in small towns. Therefore, parents are aware that education at school and at home must be consistent, setting the same standards and goals, which is a significant problem and challenge.‘The children go home by themselves, and there’s a shop on the way. A small amount of money is enough to buy something sweet’.‘I liked it when there were previous restrictions on sweets and chips in the school shop. Now, everything can be bought again, and as parents, we don’t quite have control. At home, we try to ensure the child eats reasonably healthy. The children have pocket money, and we know they’ll go to the shop and buy whatever they want’.‘For example, my son generally doesn’t eat chips at home, but I know he eats them at school because they’re in the shop. Some products are known to be in the shop, like sandwiches when a child forgets their lunch, but sweet rolls shouldn’t be available’.‘They are aware that they shouldn’t eat this, but it’s difficult to resist their will. There are so many appealing, colorful sweets in the shops’.Examples of parents of pupils 10–12 years old statements:It is also worth noting that students of this age are beginning to take an interest in energy drinks, especially boys. In the opinion of many parents, regardless of their place of residence, this is a significant issue and a challenge. This is even more concerning because influential figures, such as internet developers and online gamers, consume these types of drinks. Children lack knowledge and awareness of the potential effects of consuming energy drinks. According to parents, this topic is closely linked to a proper eating style; if children consumed the right number of balanced meals, they would not need stimulant and concentration-enhancing drinks.‘Selling energy drinks to children should be banned, because children don’t know what they are doing and consequently become addicted. Then there are health problems from excess caffeine’.‘There is a problem with the energisers. I don’t know if this problem is raised in school. There shouldn’t be such easy access to them at all. A lot of children of an age like my son, around 12, and even younger already try these drinks. And that’s what’s dangerous, because the body of such young people reacts differently. I try to make my child aware that it’s not like water, and drinking energy drinks is a health hazard’.Sample statements from parents of 10–12-year-old pupils:Within the study’s participants, a differential typology can be established based on the level of engagement and awareness of nutrition-related issues, as well as their approach to this aspect of parenting and education. Among parents of primary school children, three profiles were identified: “aware”, “determined”, and “relaxed”. In the case of 10–12-year-old students, an additional profile of “distanced” parents was recognized. Their characteristics are presented in Parents representing the ‘aware’ profile (n = 16) constitute the smallest group and are more likely to be women residing in a city and in larger rural areas near major urban centres.‘I know what I eat’ and ‘you are what you eat’.Parents who fall into the “aware” profile exhibit distinctive characteristics in their approach to food and nutrition. They pay close attention to and are concerned about the dietary habits of the entire family, not just their children. They take pleasure in and have a genuine interest in topics related to nutrition and its impact on health and the body. They adhere to the mantras Their concern for what they consume arises from the satisfaction and pleasure it brings them, along with the clear positive effects on their wellbeing, physical and mental health, and overall health. Some of them have maintained a proper diet throughout their lives, while, for others, the change was triggered by specific events, such as illness, unfavourable test results, obesity, declining health, or the sudden loss of a loved one. They are well-informed about the alternative market options and can find high-quality, local products with a “clean label” even in popular discount stores and supermarkets. Despite their strict dietary preferences and eating habits, this comes naturally to them, as they feel comfortable maintaining a healthy dietary routine.It is evident that children of parents in this profile encounter fewer challenges regarding nutrition and adhering to dietary restrictions. The children are accustomed to consuming vegetables, fruits, legumes, fish, and whole grain products, which form the foundation of their diet.Parents belonging to the “aware” profile often engage their children in discussions about nutrition and take an interest in this area of knowledge. In their households, it is a significant and engaging subject. The children’s nutritional education naturally unfolds during grocery shopping and meal preparation. Good eating habits are passed down from parents to children. The entire family follows consistent dietary guidelines and is well-informed about proper nutrition. They often hold views such as plant-based milk being superior to cow’s milk and the belief that organic certification is the sole indicator of quality, among other things.‘As the child grows older, awareness grows, but from a young age it is necessary to instil proper dietary rules. Teach children how to follow the rules of proper nutrition’.‘Good arguments are needed. You want to live longer, eat healthy. You want to be pretty eat healthy. You want to have nice skin, eat healthy. These are the kind of arguments I try to pass on to my child all the time’.Sample statements from parents of pupils 7–9 years old:‘My child is exposed to healthy products from a young age. For him, eating vegetables is something natural’.‘It’s just that if we eat wholemeal pasta, we all do. My child doesn’t know any different and he doesn’t have a choice’.Sample statements from parents of pupils 10–12 years old:This group of parents, who have children in both the 7–9 (n = 30) and 10–12 (n = 25) age groups, is the most numerous . In the These parents make a concerted effort to instil healthy eating habits in their children, but, at the same time, they find it challenging. They are aware of the importance of being role models in this regard, although it is not always easy to achieve. They care about and recognize the value of promoting good eating behaviours within their households, particularly among their children.Parents of younger children struggle to maintain specific restrictions and healthy habits, even though they desire to do so. They employ various methods to encourage a healthy eating style at home, often resorting to directives  and prohibitions  as a means of education. They occasionally seek out recipes for “healthy” dishes on their own initiative or modify their favourite meals to make them both delicious and beneficial to their health . However, in their daily lives, they may feel uncertain about diversifying and planning their meals. They typically shop for groceries based on a standard list and may struggle to identify valuable products. Still, if they come across recommendations or someone suggests healthier options, they are willing to try and make changes.Parents of 7–9 year olds with a “determined” profile devote a significant amount of time and attention to nutrition principles. However, it is essential to highlight that parents are often more interested in the topic than their children. Their primary goal is to engage their children in learning about and following proper nutrition principles, which can be challenging. These parents may lack nutritional knowledge but are reluctant to admit it.Parents of 10–12 year olds differ from parents of 7–9 year olds in having a more relaxed approach to the topic of nutrition. Parents of younger children tend to feel more tension and stress regarding nutrition. Nevertheless, both groups are equally committed to ensuring their children adopt healthy eating habits and strive to meet these expectations.Children aged 7–9 were continuously supervised by parents, grandparents, or caregivers at school or daycare, who determined meal times and types. In contrast, 10–12 year olds are entering a stage of independence and responsibility for their actions and food choices. They decide what to eat when they are home alone after school, and if they do not like their school lunch, they may choose not to eat it and may even spend their pocket money on snacks or sweets. As a result, parents of older “determined” students are aware that they can no longer control all their children’s behaviours.Some parents in this group of older students are deeply concerned that their children understand the consequences of their dietary choices, including the positive and negative effects on their bodies, health, behaviour, and emotions. They believe this is the last chance to instil the right attitudes towards food and nutrition, which will ultimately lead to changes in their habits and bear fruit in the future.‘When shopping ‘on the go’ I don’t read labels. I take what is on the shelf. I don’t have time to read the label’.‘We try to make sure we eat healthy and stay healthy. We try, but unfortunately there is resistance from some of the household members, so it doesn’t always work out, but we try’.‘The food pyramid alone is not enough, because children know what the nutrition basis is. It’s all explained in grade 1 or 2, but experiential learning is important. Talking about what problems a person has when they are obese, i.e., that they have heart disease, high blood pressure or diabetes, can make children more aware of the scale of the problem’.‘My children watched the film ‘Super Size Me’ about a man who ate at McDonalds for 30 days. It made an electrifying impression on them’.‘They know that what is unhealthy, but they don’t know what it can be, what the consequences and harm can be. For example, diabetes, but they don’t know what the disease entails. Children think that food cannot be harmful’.Examples of parents’ statements:‘food is necessary for life, so you have to eat something’, ‘everything is for people after all’.Parents falling into the ‘relaxed’ profile (n = 22), whether with younger or older primary school students, are often men residing in smaller towns or rural areas. They recognize the importance of proper nutrition but feel it is a luxury that only those with ample free time can afford. They argue that, given the numerous responsibilities parents and children have today, maintaining a healthy diet is challenging. They contend that children are generally active, both at school and during play, which they believe compensates for any shortcomings in their diet. These parents admit to having limited nutritional knowledge. They are familiar with the basics, but they do not see the need to expand their knowledge on the subject. In their view, schools should be responsible for providing children with the most critical nutritional information. Some believe that rational nutrition should not be a heavily emphasized subject. They adhere to the principles: nothing by force’ principle. This group of parents generally lacks adequate nutritional knowledge. Among the parents who participated in the study, they are the most likely to overlook issues like excessive sweets consumption and a shortage of vegetables in their children’s diet, among other things.For parents within this profile, it is important to maintain a minimum level of nutrition for their children. This includes ensuring that the child has lunch during the day, preferably at school, prepares a sandwich for a second breakfast, consumes vegetables and fruit several times a week, and limits sweets, though without strict boundaries. Parents with a “relaxed” profile are the least informed and reluctant to discuss dietary guidelines with their children. They tend to be quite apathetic about the subject, sometimes even following the ‘‘You cannot eliminate sweets 100 percent. You can only introduce moderation. I am of the opinion not to overdo it in the other direction’.‘I for one am not in favour of us not giving sweets to children because it is a pleasure for them. At our house we have a rule ‘eat the fruit first then you will get some sweets’. I can’t completely deprive children of, for example, chocolate, they can probably have a bit of pleasure’.‘On a day-to-day basis, the biggest problem I have when it comes to feeding my child is with time. I just don’t, I have time to deal with this subject’.‘At my home sweets are generally available, my son takes when he wants’.‘We all like it. When I buy chocolate, there are four of us, everyone has their own. In the same way, everyone has their bottle of cola’.‘Sometimes a person is only human and has a craving for something unhealthy. Everything is for people’.Sample statements from parents:The ‘distanced’ parent profile (n = 8) is specific to parents of primary school students aged 10–12. As these primary school students have a more extensive curriculum and start learning various new subjects, such as biology, mathematics, and history, grades and knowledge become increasingly important. Consequently, some parents of older pupils no longer consider the acquisition of nutritional knowledge as a priority. This group is more likely to consist mainly of women from large cities who are specialists in their respective fields, prioritizing their busy careers. They believe that children at school should primarily focus on acquiring scientific knowledge to ensure a good education. In their perception, nutritional education is not knowledge but rather a matter of habits and customs that can be easily acquired.‘You simply have to eat. However, there are more important things, such as learning’.‘It is only important that food choices are not random’.Sample statements from parents of pupils 10–12 years old:The majority of parents (n = 91) assess their children’s nutritional knowledge as reasonably good, even though they perceive it as being too theoretical and not practical enough. Parents believe that their children primarily receive information about food and nutrition at school and, before that, in kindergarten. According to parents, their children understand why they should avoid consuming products from certain food groups, but they are less aware of the risks these products pose to their health. In cases where they do recognize the risks, they typically identify only the basic ones, such as the risk of obesity associated with excessive sugar consumption. Another significant aspect is the lack of awareness regarding potential long-term side effects resulting from an unsuitable diet. The same applies to the food pyramid, which serves as the foundation of the curriculum and marks the beginning of children’s nutritional education. However, children tend to be more familiar with its theoretical dimension than its practical application.Knowledge about food products and food production methods is rated slightly lower by parents. They believe that these areas receive less emphasis in the curriculum. Parents residing in large cities emphasize the importance of their children acquiring this knowledge to dispel the misconception that supermarkets are the primary source of food. In our study, practical knowledge in this regard is more likely to be gained by 7–9-year-old students from smaller towns or rural areas who have direct exposure to vegetable gardens, agricultural fields, or animal husbandry for meat production.Healthy Eating Day, Red Vegetable Day, Yellow Fruit Day, etc., have a positive impact on their children. In some of the schools participating in project JEŻ (Junior-Edu-Żywienie), e.g., Nowy Sącz, Warszawa, and Czachówek, the school organized practical activities consisting of preparing meals together, e.g., salads, fruit smoothies, or even breakfast, although such activities are, in their opinion, too rare. On the other hand, permanent campaigns organised by teachers, such as ‘you get points for a vegetable in your breakfast tray’, carried out, for example in Brańszczyk or Ostrowiec Świętokrzyski, are not recognised by parents as promoting healthy eating habits. This is because children are rewarded if they have brought in, but not necessarily eaten, healthy products.Parents participating in the study note that the various activities organised by the school to promote healthy eating, e.g., ‘It’s nicely packaged. It says eat me. The adverts about sweets, crisps and all that kind of snacking, that’s what the child fights for. He sees it and that’s what he wants afterwards’.(Nowy Sącz)Sample statements from parents of 7–9-year-old pupils:During FGIs, parents of 10–12-year-old primary school students, like younger students, rate their children’s knowledge of the principles of good nutrition highly, although, again, they consider this knowledge to be theoretical. Older children regard nutrition education—e.g., in biology—as knowledge to be learnt and passed for marks. They lack the ability to translate what they have learned into practice, which may be a recommendation for teachers to introduce a more practical thread to these lessons.In the opinion of the participating parents, there is a need for activities that make pupils aware of the purpose of learning a rational diet from the early years of school and even kindergarten.‘You are told in such vague terms what is healthy, this has this vitamin and that has another vitamin. This is good for you and this is bad for you. Just theorising is of little use. It’s more like if you eat this product, you’ll have a lot of energy. If you eat this product, you won’t have energy. We adults already know that if we eat a tuna sandwich with, for example, lettuce, we’ll feel great, and if we eat a bowl of pop-corn, we won’t feel good’.‘It seems that a practical approach to the subject is important. Only theoretical knowledge will not be effective’.‘Myself, I think drastic examples would work, what happens when you consume products that are not recommended and what happens when they are recommended. What effect it has on appearance, illnesses. Fear is a strong stimulus’.Sample statements from parents of students aged 10–12:Based on group interviews, it can be concluded that, as in the case of pupils aged 7–9, older children also lack an idea of the consequences of poor nutrition far into the future. Parents during the study shared examples that their children constantly reproduce patterns and incorrect habits. They are unable to find solutions on their own, despite having sufficient knowledge.‘When my daughter comes back from training and is tired, she doesn’t want to eat and after an hour she starts to get a headache. Even though I explain to her: you come back, you absolutely have to eat, only then can you do other things. And this happens once, then a second time and again. The third time she comes to me and says: I did it again, I have a headache, I won’t do it again. Children have to practice bad and good behaviour with themselves. Experience it for themselves. To see what it really means’ .Here is what one mother of a student 10–12 year old said about the lack of nutritional recovery after exercise and too long of breaks between meals: ‘How it’s made’ or ‘Galileo’. Therefore, it seems that this age is appropriate for making students aware of the processes involved in food production. There is a good chance that they will remember this knowledge well and, more importantly, apply it in practical situations, such as when shopping on their own.According to parents of 10–12-year-old students, children lack knowledge about food production. These topics appear particularly unfamiliar and distant in large cities. However, students are genuinely interested in learning how various products are manufactured. They eagerly watch programs like Parents (n = 47) participating in the focus group interviews pointed out that, for children aged 7–9 years, a limitation to the introduction of an appropriate eating behaviour is the fact that they prefer, for taste reasons, a limited number of foods and are consequently characterised by a selective choice of foods in a diet that is not varied. In contrast, pupils aged 10–12 are already more aware that nutrition plays an important role in maintaining health. However, the emerging influence of the peer environment, as well as traditional and social media, results in the consumption of products that are not recommended and categorised as junk food, as well as those not allowed to be consumed at this age, such as energy drinks. These behaviours depend on the nutritional awareness of parents, who have a huge influence on children and adolescents at this age. The social influence on children aged 7–9 manifests itself in imitation and automatic acceptance of the behavioural reactions of those around them, as well as in obedience to the authority of parents. Adolescents aged 10–12, on the other hand, are more influenced by the peer group with which they identify and emulate.As research has shown, parents need support in this area, understanding the role of proper nutrition in maintaining health. Indeed, proper nutrition is an essential factor for the harmonious development of the young organism and the attainment of high health potential, as well as shaping appropriate eating patterns in adulthood. Early modifications of eating habits, especially in childhood, can promote health and reduce the risk of developing diseases in later life.Eating regular main meals and refraining from snacking between them, particularly on foods with low nutritional value, plays a crucial role in the proper utilization of nutrients provided by food. Snacking on such items increases the risk of being overweight and obese. Conversely, skipping main meals can lead to nutritional deficiencies, which can be a contributing factor to various diet-related diseases .A meta-analysis of 57 studies involving 203,706 participants revealed that shared family meals have a significant impact on children’s eating behaviour . The intThe benefits of family meals extend into adolescence and early adulthood. Young adults who had daily meals with their families during adolescence consumed more fruits and vegetables compared to their peers who did not have this practice at home . Among tBreakfast is considered the most important meal of the day . HoweverParental practices exert a significant influence on children’s nutrition, affecting both food choices and meal regularity. When parents follow a restricted diet, certain foods may be absent from the family table, potentially contributing to neophobia among children and adolescents, particularly towards healthier but unfamiliar food alternatives .To shape children’s food preferences and behaviours, parents employ a range of methods that combine effective and ineffective forms of influence, including overt and covert control strategies ,55. OverIt is important to note that the use of restrictive dietary practices by parents can be counterproductive and lead to increased consumption of restricted foods, potentially increasing the risk of excessive weight gain ,56. Howeeverything is for the people’ prevails. Some parents (n = 32) in our study also argue that it is not feasible to eliminate sweets from their children’s diets, as prohibiting them may only make the children desire these items more. Furthermore, they believe that it is impossible to protect children from sweets, as they are bound to receive them as gifts from grandparents, friends, or during peer birthday parties sooner or later.Another parental practice involves using foods as rewards, particularly those that are high in fat and sugar. Numerous studies have demonstrated that repeatedly offering snacks or sweets as rewards can lead to an increased preference for such foods  while deParents consider family meals as an opportunity to enhance interaction with their children and convey their values regarding food and nutrition. However, the act of watching television during family meals seems to negate the associated benefits . This isAt the age of 10–12 years, in preadolescence, there are tendencies to manifest one’s independence, which manifests itself in rebellion against parents and other authority figures, while, at the same time, the need for acceptance by peers emerges. The peer group plays a key role during this period ,68. YounIn the present study, parents indicated a problem with the consumption of snacks, fast food, sweetened drinks, or energy drinks (n = 95). In this respect, they expect support from the school, which does not always create positive role models by locating vending machines with inadvisable sweets or drinks on school premises. At the same time, they themselves, as also pointed out by other authors , give moNutrition knowledge is widely acknowledged as an integral component of healthy eating behaviour . ParentsThe accelerating pace of life, insufficient financial resources, long working hours, and at times, a lack of motivation, mean that some parents do not have the time, opportunity, or inclination to prioritize the quality of their children’s diet. This leads to irregular eating patterns, frequent snacking between meals, and the consumption of non-nutritious foods and meals, all of which have a negative impact on health. Inadequate education regarding the principles of healthy eating and limited access to nutritious food options to replace high-calorie snacks consumed between meals contribute to the proliferation and persistence of unhealthy eating preferences and behaviours.The consistent lack of time among parents results in a transfer of responsibility for educating their children about health and nutrition to the school. All parents who participated in the TGI expressed a need for nutritional education for their children at school, along with educational materials designed for them.Appropriate nutrition education for both children and their parents/legal guardians and teachers can support the formation of eating habits in a health-promoting direction . It appeThe eating behaviours of children and adolescents are a product of the influence of two social environments: the home/family environment and the school environment. Many authors emphasise the need for multilevel education from kindergarten through school, involving children and teachers, the media, and parents, and up to medical personnel ,81.A high level of knowledge of children and adolescents about healthy eating is a factor in shaping health-promoting eating behaviours. Many authors ,78 find During their time in school facilities, children are exposed to various influences related to values and opinions, including those concerning food and nutrition. Through the provision of nutritional knowledge in the classroom and the meals served in the school cafeteria, the eating behaviours of school children and adolescents can be moulded. The goal of nutrition education is to instil an understanding of the principles of proper nutrition and cultivate the skills, beliefs, and attitudes necessary to maintain and enhance one’s own health and that of others ,83,84. TTo sum up, the qualitative research was conducted using the FGI method among parents of students in grades 1–6; it should be noted that there is a necessary synergy of interactions between parents and teachers in shaping the nutritional attitudes of their children. In order to convey common educational content, during regular meetings between educators and parents of students attending these classes, we should talk about proper nutrition and its role in achieving students’ physical fitness and cognitive function, as well as in the prevention of diet-related diseases. It is also worth proposing joint practical activities involving games and gamification, in which not only teachers but also students could be encouraged to participate.The implementation of these recommended activities will also be supported by educational materials developed as part of the “JEŻ” project, especially a book containing rebuses, comics, and crosswords that can be solved by students with their parents, as well as a cookbook with suggested recipes for dishes that can also be made by children.Based on the research findings, it has been determined that parents require support in addressing food and nutrition issues, including providing sound arguments and practical recommendations to help instil healthy habits and attitudes in their children. The goal is to empower children to make informed and health-conscious food choices. Parents of children aged 7–9 years often struggle with convincing their children to consume a variety of foods regularly and to reduce their consumption of sweets. Parents of 10–12 year olds frequently face challenges related to restricting their children’s intake of sweets, snacks, fast food, and energy drinks.Addressing the behaviour of school-age children necessitates the development of intervention proposals that consider the complexity of their attitudes and behaviours regarding food and nutrition, as well as their emotional and nutritional requirements. Understanding the perceptions and significance of good nutrition among school-age children can inform strategies aimed at making nutritious foods more accessible, attractive, and normalized within their peer groups. Furthermore, it is apparent that parents may lack creativity in diversifying meals, emphasizing the need to create and promote simple recipes for preparing various meals at home with both parents and children, as well as with peers.Effective food and nutrition education initiatives should engage children, adolescents, parents or legal guardians, teachers, and other school staff, as only multilevel approaches can produce positive effects.


To further understand the behavior of Chinese young adults in relation to their perception of e-cigarettes as a “snack”, the study developed a social context framework (crossroads model) and psychological judgment model to explain how youth e-cigarette users’ perception of “controlled addiction and ready cessation” arises. These models can be used to assess the effectiveness of e-cigarette policy.The potential health value and pitfalls of e-cigarettes are currently under dispute in the scientific community. Exploring young adult e-cigarette users’ perceptions would assist in adding a public dimension of understanding to the literature and in scientific public health decision making. Therefore, in this study, we collected and analyzed data from interviews with young adult ( In recent years, e-cigarettes have gradually become popular in various countries. These devices, which produce aerosols by heating a liquid containing a variety of chemicals such as nicotine, additives, and flavorings, have become increasingly popular among young people, with the number of e-cigarette users in this demographic having grown rapidly in recent times.The Sixth Conference of the Parties to the World Health Organization Framework Convention on Tobacco Control report detailed that the global expenditure on e-cigarettes was USD 3 billion in 2013. Without considering trends towards banning them, e-cigarette sales are expected to increase by 17 times by 2030 .Early e-cigarette products were marketed as smoking cessation products and were supported by some tobacco control organizations because they followed the global political trend of tobacco control . Thus, tIn the context of the parallel emphasis on e-cigarettes’ alternative role in smoking cessation and the scientific knowledge regarding their taste risks and potential health dangers, how exactly do many youth consumers perceive e-cigarettes as a substance? Is the public ignorant of the risks of e-cigarettes, blindly following the hype surrounding these devices, and if so, will this ignorance evolve for many users into the addictive dependence that is so worrisome to academics? This study took young adult e-cigarette users as its research group and focused on “how users understand ‘e-cigarettes’ and their behavior.” Firstly, we assessed young adults’ understanding of e-cigarettes, and then explored how this publicized cognition is formed from the comprehensive perspective of the social environment and psychological judgment. Next, we returned from public knowledge to scientific knowledge, theorizing and logically establishing a model and framework for understanding the research group’s behavior and empirical cognition in order to facilitate public health policy and support organizations that assess individual e-cigarette use behavior.One of the main differences between e-cigarettes and tobacco lies in their safety of use. How are e-cigarettes a safer alternative to smoking? Their safety is demonstrated firstly in their inhibition and reduction of combustion, which studies have proven to be one of the leading causes of tobacco-related morbidity and mortality ,22, and Another difference is that e-cigarettes function as an alternative to tobacco during smoking cessation. The relatively low risk of e-cigarettes makes them an essential aid in quitting smoking. They are the most popular method of quitting in the United Kingdom and the United States . The heaHowever, the alternative effects of e-cigarettes are still worthy of deeper investigation. Studies have found secondary effects, such as smoking relapse, dual use, and priming effects in e-cigarette users ,32. MeanAs a new tobacco and recreational product, e-cigarettes have revolutionized traditional smoking behavior with their unlit, portable, and flavorful features. The use of e-cigarettes is rich in connotations, both as a form of smoking cessation and as a new form of smoking behavior, which stems from the cross-cutting attribute of e-cigarettes’ being understood as both “cigarettes” and different from “traditional tobacco.” As the number of e-cigarette users increases globally, the social implications of e-cigarette use must be taken into account. From an e-cigarette user’s perspective, how are e-cigarettes viewed, and do they have alternative uses, dual uses, and introductory effects? How do e-cigarette users understand e-cigarette behavior in their daily lives? This study will reveal how e-cigarettes are defined, used, and narrated in real social life.As individuals enter adolescence, along with experiencing the awakening and strengthening of self-awareness, they can become susceptible to the influence of peers, popular culture, and fashion discourse, and can develop health-hazardous behaviors, such as e-cigarette use . A totalResearch on youth e-cigarette use behavior has first focused on the causal factors leading to e-cigarette use, specifically the peer effect ,20, sociSecond, the influences of the technology, taste and decorative features of e-cigarettes can be explained from a developmental and objective perspective. E-cigarette technology has evolved through four generations to achieve more powerful features and to feature adaptive flavors. The current fourth generation of e-cigarettes, the pod-style e-cigarette (pod system), has gained new highs in the number of young users due to, among other factors, its portability due to its low weight, improved oil leakage, and lower manufacturing costs and prices (USD 43−46 in the Chinese market) . The adaTherefore, researchers have grown concerned that e-cigarettes can trigger more complex negative effects than traditional cigarettes. First, adolescents and young adults do not have a clear understanding of the hazards of e-cigarettes and only perceive them to be less harmful than traditional cigarettes , which cTherefore, our study will add to the complex debates surrounding and scientific understanding of users’ perceptions of e-cigarettes, particularly their understanding (or misunderstanding) of the addictive nature of the substances involved, in order to bring individual awareness and perceptions into scientific consideration and reflection. In this study, Chinese young adults were selected as the subgroup of the study group in order to step outside of the bilateral family and school relationships that underage groups are limited to  and to fThe study mainly used a mixed method that combined questionnaires and interviews. Initially, in December 2021 and from January to June 2022, we advertised the questionnaire primarily online, and eligible youth within the age restriction (17–35 years old) were invited to take the initiative to fill in the questionnaire. During this period, we conducted three recruitment campaigns , in whicWe then recruited interview participants, and a total of 30 e-cigarette users accepted the interview invitation.Starting in May 2022, we conducted interviews with the voluntary participants. The interviews were divided into initial interviews, in-depth interviews, and post-return supplements. The initial interviews were conducted from March to June and focused on e-cigarette use habits and storytelling experiences. The in-depth interviews were conducted from the beginning to the end of June. Based on the initial interviews, 14 respondents were selected for the in-depth interviews based on the richness of their e-cigarette use habits, the depth of their practices, and the variability of their experiences, with the in-depth interview times ranging from 20−40 min. In early July, after primary and secondary coding of existing interview materials . The effects of gender, income, education, and age differences within the group were insignificant (limited by the sample size), and all respondents showed signs of use. Additionally, and more noteworthy regarding the correlation analysis, is why these youth e-cigarette users still exhibited use behaviors and expressed perceptions of e-cigarettes being manageable, healthy, and safe when they knew about their adverse effects.Further, in several in-depth interviews with young users, in addition to describing e-cigarettes as addictive and stress-relieving psychoactive comfort products, the interviewees suggested that e-cigarettes hardly played a role of releasing stress and served more as a snack in their daily lives. The term “Snack” is used to describe e-cigarettes because snack food has specific temptation characteristics but is also relatively controlled and safe.The interviewees described e-cigarettes as similar to spiritual comfort items, with this being mainly closely related to their initial individual e-cigarette use intentions. Among the respondents, the first use of some users was primarily to cope with stressful events in their daily life, including, but not limited to, love disappointments, exam stress (such as gaokao ), and co“October 2019, I remember this day, I failed to confess my love, and then my friend was vaping, so I borrowed it and vaped it, until now.”(Xiaoyu 20220617)“Because of the pressure before the examination, (I) smoked the traditional cigarette first, and then feel tabacoo uncomfortable, choose the e-cigarettes. Also, e-cigarettes is the fashion.”(Aman 20220614)“Parents quarrel, I am no way to cope, so always avoidance (and) hiding. I just found this (e-cigarettes) to try., I’ve been vaping, maybe want my parents to focus on me.”(Wasi 20220618)The interviewees noted that they chose to use e-cigarettes because the low nicotine content in e-cigarettes can play a role in relieving stress and eliminating pain. In addition to their reasons for initial use, the interviewees generally discussed the status of their e-cigarette addiction, suggesting that their behavior meets some of the characteristics of substance addiction. For example, they described craving and having a strong desire to use e-cigarettes and using larger doses than they expected or using them for more extended periods. Further, they judged e-cigarettes to be a product that has some mental impact, that is, a psychoactive comfort product.“Addiction definitely, I’m addicted. I put it in my hand when I write, and I will use it a lot if I don’t pay attention and keep vaping. ”(Xiaoyu 20220617)“Vaping, I have not been denying this inhaled, having nicotine, it is harmful to the body.”(Hetian 20220602)“I also recently a week I inhaled very often, I did not figure out why. Recently, I had to know where it was, and then I had to keep it on hand, so I didn’t know when I wanted to take a sip.”(Maimai 20220302)However, the respondents also repeatedly referred to e-cigarettes as “snacks” and described how they found the variety of flavors they offer appealing. Although they emphasized the addictive nature of their e-cigarette use, they stated that this was not a symptomatic behavior of substance addiction disorder but rather a snacking behavior. This snacking use was characterized by the following features: “Habitual craving for use but accompanied by intermittent interruptions,” “Ready adjustment of dose and duration of use,” and “Awareness of health risks and occasional quitting.”“Habitual craving for use but accompanied by intermittent interruptions” refers to how the interview participants described stockpiling some e-cigarettes and developing a habit of e-cigarette use because of daily use. Specifically, they reported using e-cigarettes at a fixed time after writing, eating meals, or exercising (this behavior is similar to eating popcorn while watching a movie). After using e-cigarettes for a long time or over a high-frequency period, the interviewees reported developing a sense of disgust for the taste of e-cigarettes and their oral odor and consciously controlled their use.“Vaping has to relieve hunger well, a little bit like eating bubble gum.”(Ajing 20220620)“ When e-cigarettes are vaped too much, you will be a little dizzy and nauseous, too much nicotine intake. The e-cigarette is very easy to cause this situation because of no unpleasantness (tar feeling), you do not know how much to vape...”(Hetian 20220602)“The e-cigarette with the kind of flavor, after vaping more, will make you feel a little nauseous, chemical feeling is powerful.”(Aman 20220614)The second feature was “Ready adjustment of dose and duration of use.” In addition to occasional dose control due to taste aversion, the participants reported adjusting their quantity of e-cigarette use due to their current social situations or goals, such as college entrance exams, intimate relationship maintenance, pregnancy preparation, weight loss, etc.“I was able to control it... vaping has a big effect on your body, and if you’re thinking about pregnancy, you definitely need to quit e-cigarettes, so I tried to quit and then I found it fairly easy.”(Aman 20220614)“My ex-boyfriend didn’t care if I smoked or not, and then I would use his e-cigarettes. Now my boyfriend doesn’t let me vape, and I’m getting older so start to quit.”(Xiaoyu 20220617)“Awareness of health risks and occasional quitting” was also commonly mentioned in the interviews. The participants, especially those who reported more than two years of e-cigarette use, all indicated that they could perceive the health risks associated with e-cigarettes.“If I vape more, I feel a little uncomfortable, dizzy, a little sick to my stomach, always not very good for the body.”(Wasi 20220618)“ I felt it was firm to the stomach that irritation, plus my digestion was not very good during that time. After vaping feel bloated and very uncomfortable, so that period, I thought, do not vape.”(Xiaoqi 20220531)Some participants reported having already quit; some even had stopped for three months and did not desire to intentionally use e-cigarettes again. Interestingly, their quitting e-cigarettes was described as similar to not eating snacks, as the participants related using e-cigarettes (snacks) when offered in a particular setting but that it did not trigger addictive use again.“Surely addiction but having tried to quit. Just deliberately not bringing it with you, or not allowing the device to be in front of you, naturally don’t think about using it, and it’s not particularly hard.”(Aman 20220614)“You sometimes go out with other people and see other people there vaping. But because I put that cigarette stick in school and didn’t get it back, I control myself.”(Tongtong 20220607)The snacking attribute of e-cigarettes was more prominent in the participants who also reported using traditional cigarettes. The participants who used tobacco stated that e-cigarettes only make up for the inconvenience of being in no-smoking places. Further, they described how their low nicotine content and elimination of tar reduce the pleasure of smoking, and thus they will still choose traditional cigarettes when the occasion allows for their use. They therefore evaluated e-cigarettes as a “better than nothing” snack.“For the smokers who use traditional cigarettes themselves, e-cigarettes are considered to be a bit useful in terms of portability, smoking ban places can be comforted by electronic cigarettes, it (e-cigarettes) nicotine content is not enough, the taste is too sweet, there will be a sense of plastic, strictly speaking, I do not like, but special circumstances mouth greedy words is also better than nothing.”(Alee 20220620)This narrative of youth perceptions reveals that e-cigarettes do not have a single material identity at the cognitive level. Their psychoactive comfort goods attribute relates to the medical definition of e-cigarettes and the addictive properties of the substances within them themselves. However, e-cigarettes’ snacking attribute shows that beyond materiality, and considering e-cigarettes’ mutuality and relationship shaping regarding the user, e-cigarettes are social products with realistic, expressive, diffuse and cultural symbols. As Shérazade and colleagues pointed out, the “Reasons for using e-cigarettes in young adults are varied and are not limited to stopping smoking.”  In the pIn the previously described results, why were two perceptions reported, especially the perception of e-cigarettes’ snacking properties, which differ from the mainstream medical and scientific view? The cognitive differences in the reported results suggest that developing an understanding of inhaled nicotine/e-cigarettes cannot proceed solely from a substance perspective but should also occur within a complex social framework and with consideration of individual psychological dimensions. In this way, how this difference arises and what causes it to exist can be uncovered.By developing both social and psychological dimensions, we next categorized the complexity of young adult perceptions and behaviors regarding e-cigarette use into exogenous and endogenous dynamics. The exogenous dynamics refer to the crossroads at which young adults find themselves in their social environment, while the endogenous dynamics analyze the decision processes that influence youth e-cigarette use through six-dimensional psychological criteria. This approach is related to Hughes’ multilinear connections perspective , which cIn this study, placing nicotine/inhaled nicotine into a social framework in order to understand user behavior revealed that certain cognitive logics and use behaviors, such as harmfulness or harmlessness, dose and frequency of use, and abstinence, are born out of relatively complex contextual and relational considerations (findings that are similar to those of Hughes’ study ). ThrougAs shown in Medical discourse on e-cigarettes frames them as an alternative to tobacco  . In counAs mentioned in “Health concerns, obviously because of the knowledge that this thing has nicotine will have an impact on , so I control use times, circumvent some health risks.”(Xiaoyu 20220614)“I think no matter what it is, addictive is not good. this amount is now the upper limit of three cigarettes bomb a month, and if it exceeds this frequency, I will not buy.”(Maimai 20220302)This idea of “Controlled addiction” among e-cigarette users differs from the medical assumption that e-cigarette addiction is out of control. The documented youth response to the substitution effect enriches the single idea chain of “tobaccos—e-cigarettes,” and the participants’ practical use of e-cigarettes included replacing traditional cigarettes with e-cigarettes, using a mix of tobacco and e-cigarettes, and directly using e-cigarettes.“I feel completely replaced. No e-cigarettes, okay, but no cigarettes, I do not feel good. I have been in Shenzhen for 21 days in isolation. For the first few days, I am vaping. I need to say it is not an alternative, only a supplement. That means, smoking is probably important for me than vaping.”(Hetian 20220614)“I think the replacement is a process, the original you mainly use cigarettes, and then use e-cigarettes, we can perhaps say in this case is a replacement, but there is a meaning, this is your own choice, not because all cigarettes are out of stock, I can only vape.”(Xiaochen 20220619)“My friend in the United States, who took me to smoke e-cigarettes, itself from the traditional cigarette to go over, is considered to replace the successful one.”Medical discourse, being at one end of the crossroads outlined above, influences e-cigarette users’ perceptions and behaviors through the power of knowledge, and in particular through the scientific exploration of e-cigarettes and their hazards. Inevitably, however, changes to these users’ perceptions and behaviors will be caused by influences outside of this discourse.Social networks or interaction ports, and interpersonal relationships more generally, exert an influence on e-cigarette use . In this“It depends on what kind of occasion, if t a group of people are more fun-loving, and then all vape, you also vape, there may be a topic of entry point, or sometimes we will taste each other. although it is dirty, I am not reasonable to reject because they are friends.”“Go to a place like a bar, talk about the packaging of the electronic cigarette, the feel of the stick, and so on, other times less will be the topic of e-cigarettes.”(Xiaochen 20220619)However, on most occasions, the interviewees reported deliberately avoiding their use behavior to avoid causing secondary harm to others. Further, they noted how they did not want those they were in close relationships with, especially their parents, to know about their e-cigarette use behavior.“The boy in the dormitory building would use his whole hand to cover the e-cigarette and then vape it tightly to his mouth. It’s quite a covert way to vape, and he may not be willing to let others know that he is vaping, and so am I. You don’t have any benefit in announcing that you’re vaping; it’s unnecessary for me.”“I am careful to smoke and avoid my relatives. When my mom caught me smoking e-cigarettes before, they would strongly urge me to quit, send me the news about the dangers of e-cigarettes every day, and then limit my living expenses.”Social interactions influence use behaviors in different contexts and settings by facilitating socialization, reinforcing relationships, and managing impressions. E-cigarette users may avoid family members and strangers who dislike the smell of vaping, and they may use them primarily in environments  where e-cigarettes are allowed and encouraged.The cultural dimension of e-cigarette use has three main aspects: the recognition of and participation in the e-cigarette subculture ,61; the “My earliest use e-cigarettes, from a store called Spartacus, they will organize the community, we communicate the type of machine, they call the e-cigarette “machine”, like people playing motorcycle, there will be a variety of aesthetic communication, what emphasizes the mechanical sense, comfort. Often use these ergonomic, mechanical words as if in the description of the upper motorcycle. They will also communicate the play, and the play refers not only to how to blend the taste but also a variety of evaluations, what the richness of the smoke, how much smoke out of the taste, is to measure a variety of physical indicators, these physical indicators are certainly with this meaning in, they determine a unique for this thing, each machine, give it a very anthropomorphic title, this is What is it? The Terminator, that’s Napoleon, that sort of thing.”(Hetian 20220602)Not all participants recognized the existence of this subculture, and many asserted that e-cigarettes have a low cultural identity or that they had not considered the impact of e-cigarettes in terms of their cultural values.“It does not have the so-called cultural connotation in it, unlike sneakers cultural connotation, such as the AJ series worn by Jordan, there are some special colorways, in the special field, such as how many points he scored this game, what colorway, there is a cultural background in doing endorsement, and then you go to buy those replicas of this colorway to collect and even have a lot of glory in it. The e-cigarette is a single product that can be used as a snack and as an accessory (if you hang around the neck), but it is not supported by the people and stories behind the circle.”The participants who did not recognize the sub-cultural characteristics of e-cigarettes spoke of the cultural context of items such as sneakers, discussing their production, purchase, and communication attributes, while noting that e-cigarettes did not have a sufficiently attractive set of cultural associations. Instead, this segment of users reported viewing e-cigarettes only as daily necessities or snacks.In addition, the understanding of tobacco in mainstream culture and the cultural connotations derived from this also influence e-cigarette use. Traditional Chinese cigarettes have a more mature cultural meaning than e-cigarettes, regarding providing access to the adult world and serving as a critical prop in “relationship” and “gift giving” activities.“Smoking is middle-aged feeling, while the e-cigarette’s more image younger.”“Generally, people like our parent’s generation, begging others to do something, on the delivery of tobaccos as gifts. Wine is also okay, but e-cigarettes are not good.”(Aman 20220614)“You will have the impression that when your mother is unhappy, your mother will smoke, and when your father is annoyed, your father will smoke, is a pattern. This pattern is as if you learned it at a very young age, you know when you one day become like them, you may seek such a kind of, maybe this thing is always there, is something that can provide you with comfort.”(Xiaoqi 20220531)Accepting some degree of pain is considered a sign of youth maturity and growth, and this is reflected in the ability to tolerate and endure choking during tobacco use. The tarry feeling and burning of the throat associated with traditional cigarettes both align with this pain-tolerant maturity. Thus, e-cigarette and tobacco users can be divided into young adults and middle-aged adults, respectively. In addition, compared to e-cigarettes, tobacco is more able to facilitate Chinese society’s expectations regarding asking for a job or giving a gift.In the present study, the participants who reported mixing tobacco and e-cigarettes noted that there was also a hierarchy of tobacco use, mainly in terms of contempt and low acceptance. That is, this hierarchy is related to the predominantly adult social sample, the dominant culture, and the far-reaching nature of different types of nicotine use. Some participants said that they perceived traditional cigarettes to be superior to e-cigarettes, and that this superiority was not tangible but rather somewhat scattered throughout daily life.“They will be more superior to the trendy thing of the moment (e-cigarettes), it is something for kids to play with.”“It feels like there is a gap where, if they smoke traditional cigarettes at the dinner party, I will follow, not quite yell at everyone to smoke e-cigarettes.”“I think cigarettes are also really a definite grade thing. Sometimes e-cigarettes are at the lower end of the hierarchy, and when you are with young people, people may think how cool you are, but now the electronic cigarette seems to be children’s play in educated or mainstream mature people.”(Xiaoqi 20220602)Gender culture limits whether women can freely and comfortably use e-cigarettes . The you“I label myself as someone who is also a gender equalist in society. I may think that what boys can do, girls can do. But when I see girls vaping, I feel a little bit uncomfortable, so maybe subconsciously, I still think vaping is a male privilege, but when I see the abstract of girls vaping on the movie screen, I feel so cool.”“Seeing a girl vaping, I would still be more shocked, but I wouldn’t use it to judge her character. I would be shocked at the act of vaping.”“Because I find that there are quite a lot of girls vaping inside young people, so I think it’s quite normal, we all have hobbies.”In general, a youth’s use of e-cigarettes will differ according to their interest in the e-cigarette subculture, their recognition and understanding of the place of e-cigarettes in mainstream tobacco culture, and the influence of gender culture. Where a user recognizes the e-cigarette subculture, their frequency of use is likely to increase, and their user behavior will likely become more profound and systematic. Recognizing the superiority of tobacco in mainstream culture may encourage e-cigarette users to gradually attempt to enter adult culture by using tobacco. Further, the female stereotypes surrounding e-cigarette use will likely encourage women to participate in affirmative and firm use of e-cigarettes or otherwise decide to follow the rules and regulations regarding e-cigarettes and give up using these products.The policy and political dimensions of e-cigarette use relate to the regulatory programs and laws surrounding e-cigarettes. During the research process of this study, China’s Tobacco Management Monopoly Bureau (TMB) and the General Administration of Market Regulation (GAMR) published e-cigarette management measures that restrict the sale of e-cigarette flavors other than tobacco flavors. Specifically, on 11 March 2022, the State Tobacco Monopoly Administration published the Measures for the Administration of Electronic Cigarettes, which explicitly prohibits the sale of e-cigarette flavors other than tobacco flavors, a regulation that has been in effect since May 1. On April 8, the State Administration of Market Regulation issued GB 41700-2022, the mandatory national standard for electronic cigarettes, which imposes strict restrictions on e-cigarette flavors and set a five-month transition period, from October 1 onwards.In this study, we asked the interview participants to discuss this new policy’s impact on their e-cigarette use behavior. Some interviewees reported that the external force of flavor control provided an opportunity for them to quit, while others said that they had chosen to stockpile some e-cigarette products and maintain good purchasing channels.“I will sometimes feel dizzy and uncomfortable after smoking. It indirectly reduces my frequency of use or the degree of my liking. I do not have any resistance, just let it go.”(Xiaoqi 20220531)“Because of the control, I added the merchant store in WeChat, a box before ¥60, now up to more than ¥70. I also bought ten boxes of hoarded. In May, the Policy was introduced, I will quit no longer use.”“Tobacco taxes earn too much, cannot reduce on tobacco, only on the e-cigarette sales control.”(Hetian 20220602)By influencing the market, this new policy has led to changes in youth usage behavior. In the April-May period following the policy’s introduction, the participants reported two behavioral outcomes: continued use and discontinued use, depending on their circumstances. Then, in June 2022, when the market became slightly less regulated and e-cigarette flavors other than tobacco began to be openly sold again, the user behavior of some participants shifted again.“I helped a friend stock up on ten boxes of Dragon Well in April. But now you can rebuy it. There is no intention to go to hoard.”(Xiaoyu 20220614)“Although I can buy it, do not affect me. I have gradually stopped using it since April, and the process is not very difficult, now it is good to use a smoke bomb a month, the key is not to take the initiative to vape, and there is no idea to smoke again”(Wasi 20220618)As our analysis of each of the four forces shows, changes to any of these forces, i.e., their expansion or reduction, will affect youth e-cigarette use behavior. However, in addition to the external social forces that change youth e-cigarette users’ perceptions and behaviors, these users’ judgment, as a type of internal motivation, is also worthy of attention.As outlined above, youth at the crossroads will behave differently according to the varying influence of the four forces. However, these forces ultimately impacting an individual’s final actions inevitably involves them accepting these external forces and forming judgments that guide their behavior. Thus, exploring the psychological judgment factors that drive e-cigarette use behavior is the focus of this section.Through further regression analysis and assessment of qualitative data from previous studies, we categorized the psychological judgments that bridge external influences and behavioral outcomes into a hexagonal judgment model . This moRegarding the six conditions, as presented in “It this price is quite high, you if the normal channel is ¥99, I brought it online firstly, it was ¥61 a box, and then I added the WeChat to buy, the price is ¥70, not recently, and the canceled fruit flavor rose again to ¥80, no matter what, it is still costly. I am a student, the cost per month is too high. I will now gradually stop using it.”“I like the watermelon flavor. After the policy change, I had no stock on hand, and nearby downstairs stores were not available for sale. Friends later recommended me online shopping, but all needed to express 2−3 days. Now also the e-cigarette is used less and less.”(Alee 20220620)Acceptability involves the acceptance of e-cigarette use behavior and information exposure and disclosure . Our“I vaped, and if they (parents) saw me, they would not give me money. I am not working now. I still need them to give me living expenses; they supervise me. First, they quarrel with me, then they educate me, and finally, they don’t give me money and don’t take care of me this way.”(Wasi 20220618)“Some people hang their e-cigarettes around their neck like a fashion item. They think it’s a little bit fashionable, but I think you don’t have any benefit to announcing that you’re smoking an e-cigarette. There’s no image plus, so that’s not necessary for me.”(Xiaochen 20220620)“In public, some people, even a ride, parking a moment to go out to vape, I will not. There is no need. I also do not have such a big addiction generally. In public places will not vape.”(Maimai 20220302)Substitutability does not refer to replacing traditional cigarettes with e-cigarettes but rather to whether e-cigarettes play a role in replacing a product used in daily life. Suppose e-cigarettes can act as a substitute in certain situations, for example, during attempts to lose weight. In this case, and as found in this study, they can attract high-frequency use by women due to their sweet taste but lack of fat and calorie content . As a r“Taro flavor is very popular with girls. I recommend this flavor to everyone. Smoke the first puff, all feel like eating dessert, I lost weight, a few days without dessert intake, its taste replaces the taste experience of dessert, very amazing. At that time, smoking is quite a lot.”(Xiaoyu 20220614)Addiction controllability and safety refers to users being aware of their e-cigarette addiction but believing that they can control their dosage and withdrawal process, meaning that they always use e-cigarettes in a safe and controlled manner. This shows that e-cigarettes do not fit the traditional risk profile suggested by macro data . This in“There was an addiction, but I tried to quit, and I was quite successful. I was able to control it, I was more repulsive myself, and smoking still has a greater impact on my body.”(Aman 20220614)“I quit e-cigarettes for three months, is just starting to take a smoke every day, and suddenly did not carry, the habit has a subconscious fall, you may want to ingest the nicotine at the beginning, and then it is not much feeling. The throat feels comfortable.”(Alee 20220620)Health self-assessment, unlike controllability and safety, which relates to a user’s overall relationship with e-cigarettes, mainly refers to a user’s physical discomfort and self-perception of their health status. Health self-assessment involves the expression of medical discourse and knowledge under the logic of consent. Participants in this study reported reducing or ceasing their e-cigarette use for a period of time because of poor health, such as Hetian, due to breathing issues, Xiaoyu, due to the risk of pregnancy preparation, and Alee, due to a throat cough. Further, more negative self-assessments, such as Aman’s assessment regarding their stomach discomfort, led to active choices to quit .“Recently, I often feel that my lungs are not strong, very uncomfortable, gasping for air, and then my body is a little weak. E-cigarettes very easy to cause this situation. I will use less in all these cases.”“Coughing is also, probably after smoking for a month or two, you get that feeling. You can’t spit it out when you cough and feel like coughing up phlegm. after I stopped for a while, I found that it was much better, and then I thought, this is not very necessary, and then I am not vaping.”(Tongtong 20220607)Emotional and distressing events refer to a user’s current emotions (positive or negative) and distressing experiences ,71. Exte“I recently am the mental state is not very good, is how to speak, in the medication, so sometimes the attack will feel, like a lifesaver, you grab it (e-cigarettes), and then it will make you think, I can still be stable here again. And then the specific description, I do not know how to describe, that feeling, that is, it will not let you calm, but not to collapse, is that I grabbed it.”(Xiaoqi 20220531)“I vape because feeling happy.You drink a little bit on the head. Vaping can make me sober a bit, feel more refreshing.”(Tongtong 20220607)The six conditions discussed above are focused on exploring the successive changes that can occur in e-cigarette user behavior. While not only considering the influence of social forces on individuals (each condition is not one-to-one), they do explore how these forces guide e-cigarette users to make decisions, for instance, increasing or decreasing their dosage, quitting, and resuming smoking. Trade-offs are psychological processes that occur before judgment and decision making takes place. As these can vary according to individual differences, not all six conditions must be met, nor does there need to be a balanced mix of these conditions, for a user’s behavior to be influenced. As found in this study, youth e-cigarette users adjust their behavior when any of these six dimensions are met, and assign different levels of importance to these dimensions, with the dimension with the greatest weight potentially playing a decisive role in any behavioral changes see .As shown in The concept of the crossroads situation and the hexagonal judgment model discussed in this study provide pathways for interpreting youth cognition and behavior regarding e-cigarette use from both social and individual perspectives. As the two models are closely related, they can be considered in combination as providing a map for understanding differences in youth use behavior under temporal and spatial variations.“The District Health Board said it had been a great tool to help quit smoking, and they were 95% less harmful than cigarettes.”In June 2022, the Whanganui District Health Board of New Zealand announced that e-cigarettes were helping to make mental health wards smoke-free, and they described e-cigarettes as a good tool for smoking cessation, considering them as being 95% less harmful than cigarettes. Do e-cigarette users feel the same way? We explored this question in this study by conducting interviews and questionnaires. After compiling a narrative of young adults’ experiences, we found that e-cigarettes were perceived by youth users as a spiritual comfort item or snack. Further, the psychoactive attribute of e-cigarettes was found to be in line with the medical definition of the products themselves and their addictive nature. The snack attribute of e-cigarettes frames them as having practical, expressive, and diffuse symbolic cultural connotations that exist beyond the materiality of e-cigarettes as a social product, as these connotations interact with and are mutually shaped by users. At the same time, the narrative’s emphasis on this snack attribute implies that young users are aware of the controllability and relative safety of e-cigarettes, and also of concerns around their addictive nature. This perception was found to generate different behaviors in the participants’ daily lives, such as frequency and dosage, relapse, and withdrawal behaviors.These two relatively static perspectives, while covering the diverse real-world cognitions and behaviors of youth users, involve both scientific perception and life experience. To further elucidate youth e-cigarette users’ process of cognitive generation, the study categorized their perceptions and behaviors regarding e-cigarette use as exogenous and endogenous dynamics. The exogenous dynamics involved a “crossroads situation” for the youth users in their social environment and were influenced by four social dimensions: medical, social, cultural, and political. The internal dynamics were analyzed using six psychological judgment conditions in order to examine the decision-making and trade-off processes of youth user behavior. The crossroads situation and the hexagonal judgment criteria provide pathways for interpreting youth cognition and behavior regarding e-cigarette use from both social and individual perspectives. The two models are closely related and provide clues for understanding the differential mapping of young adult use behavior under temporal and spatial changes.The main contributions of this study, regarding both current theoretical and empirical research developments, include the following three points:Firstly, the study enriches our perception of e-cigarettes at the public awareness level and offers insights from the Chinese context. For instance, in this context, it found that e-cigarettes are perceived by some youth users as snacks, and that e-cigarette use behavior is considered recreational. However, the hermeneutic view of recreational use is relatively macro and holistic. Both recreational and medical drug use is discussed in drug research, which enriches discussions surrounding drug practice and decriminalization from a drug user’s perspective. However, in this study, e-cigarette users were not found to exhibit non-recreational use behaviors. Therefore, instead of generalizing the view of e-cigarettes as being used recreationally, we should further explore the perceptions of and definitions used by e-cigarette users. Further, the emergence of the snack attribute of e-cigarettes dynamically and vividly describes the behavior of e-cigarette use in daily life as a “habitual desire to use but accompanied by intermittent aversion, readily adjusting the dose and time of use, and occasionally quitting when aware of health risks.”Secondly, two correlated models are provided that assess youth perceptions and behaviors surrounding e-cigarette use. Considering the models in combination is sufficient to explain “why some youth use e-cigarettes and believe addiction is manageable despite knowledge of the harms.”These models consider both social and individual perspectives and assess both external and internal motivations. Further, they assist in capturing empirical knowledge using analytical techniques, and also assist social workers in frontline addiction to understand and grasp the causes of behavior changes in e-cigarette users.Through exploring external motivations, this study analyzed the contextual pathways of social forces and their combined consequences. Thus, we described adolescents as being at a “crossroads” of multiple connections, with this linkage formulation being similar to Hughes’ multilinear connections perspective . We acknHaving a core focus on “how individuals make their logical trade-offs and decisions under the influence of social forces,” the internal motivation model explores six judgment conditions and considers the psychological process of young users’ guided behavior under different experiences and events. The model attempts to frame the decision-making and trade-off processes of e-cigarette users as forming a comprehensive and holistic set of conditions, therefore providing relatively complete and complex insights compared to some models that start with a single condition. In the user narratives, we also focused on the preferred meanings of different conditions for individuals, which helps to explain why seemingly illogical behaviors occur in situations where conditions present relative conflicts, such as confidence use behavior and controlled addiction prediction in youth experiencing harm.Finally, unlike adolescent users, young adult users are free from the dual control of family and school and face a more complex social situation and more accessible standards of judgment. The concept of the crossroads situation is close to these users’ real life situation, in which they have no strong direct supervisors . These users need to grasp the consequences of e-cigarette use on their own, which are impacted by the integrated and complex dimensions of culture, policy, medicine, and socialization. In addition, instead of just experiencing the motive of temptation, young adults’ motives for e-cigarette use involve six critical perspectives, and these users possess the decision-making ability to choose to actively use or not use e-cigarettes. The study of young adults therefore provides rich insights on the experiences and differential thinking of this demographic.This study had two limitations. First, screening young adults by age was the main criterion used, which perhaps excluded other potential participants who self-identified as young adults but were physically younger or older. Second, as the interviews for this study were conducted from May to June 2022, and the E-cigarette Regulation Notice in China was introduced at the end of 2022, the study did not assess whether e-cigarette users perceived changes in their e-cigarette use behavior after this regulation was declared. This will be considered in future research.