Textbooks are an important information resource for tertiary students. E-textbooks are now widely available and accessible to students offering them distinct advantages over print books at lower costs. However the uptake of e-textbooks has been slow and student preferences for either medium are not well understood. This study adopts a qualitative approach using an expectation-confirmation theory (ECT) lens and revealed causal mapping to understand from students participating in focus groups, their intentions to continue using e-textbooks. We extend ECT by including two new constructs: perceived quality and perceived value. The results assist in interpreting students’ behavior regarding intentions to continue using e-textbooks and the efficacy of the extended ECT model.