Using a formative research approach, this qualitative study examined knowledge and perceptions of e-cigarette use among college students. The study utilized the transtheoretical model to gain a deeper understanding of college students’ reasons for using e-cigarettes, readiness to quit, and barriers to cessation. Individual semi-structured interviews were conducted among 19 college students aged 21-53 years old from a large university in the Pacific region of the United States, who self- identified as current e-cigarette users. The study results indicated that participants’ initial e-cigarette use was influenced by their peers, an attraction to flavored products and the convenience associated with use. The majority of participants reported having knowledge of the negative health effects of e-cigarettes, primarily through social media. The vast majority of participants reported one or more unsuccessful quit attempts and that they attempted to quit on their own without cessation support. The study findings demonstrate the importance of developing cessation programs for college students with a peer group focus, as well as using social media as a platform to provide cessation support. Incorporating the transtheoretical model into these programs could also enable college students to understand the e-cigarette cessation process and increase their confidence and motivation to quit.