E-cigarettes are the most commonly used tobacco products among adolescents in the U.S. Vaping is not safe, however, for teens and tweens. Most e-cigarettes contain nicotine, and nicotine use during adolescence can negatively affect learning, memory and attention span. It can also raise kids' risk for mental health issues and addiction to other substances later in life.
Developing interventions to help teens and young adults stop vaping has become a public health mandate. Several vaping-cessation programs are available, but no clinical trials have been done to determine how effective these programs are in adolescents.
A team from Truth Initiative, an organization founded to prevent nicotine addiction among youth and young adults, recently ran a clinical trial of an intervention to help adolescents quit vaping. After seven months, participants in the intervention were 35 percent more likely to quit vaping than those in the control group.
Teens start vaping for a variety of reasons. “Many teens are confused about the safety of tobacco products, and often do not know that most e-cigarettes contain nicotine, which is highly addictive,” the study's lead author, Amanda Graham, told TheDoctor. Social pressure to vape, anxiety, stress and boredom are among the reasons adolescents start vaping, she added.Social pressure to vape, anxiety, stress and boredom are among the reasons adolescents start vaping.
More than 15,000 adolescents between the ages of 13 and 17 years old participated in the study. They reported using e-cigarettes within the past 30 days but also said they wanted to quit vaping within the next 30 days. About 76 percent reported they vaped within 30 minutes of waking and about 94 percent said they felt somewhat/very addicted to vaping.
Participants were divided into two groups and randomized to either an intervention called This is Quitting or a control group which received only text messages asking whether their vaping habits had changed.
The This is Quitting intervention is an automated text messaging program designed for young people. The program is tailored to their age, their enrollment date/quit date and vape brand. Participants received mental health support, including mindfulness training and self-care prompts, breathing training and information on a text-based mental health support, and a crisis intervention program called Crisis Text Line. The intervention group also received the same texts about changes in vaping habits as the control group.
After seven months, almost 38 percent of those who participated in This is Quitting said they abstained from vaping, compared to 28 percent of those in the control group.
The results echo those from a study of young adults, aged 18 to 24, that Graham's team had published three years ago. In that study, however, quit rates among young adults in the intervention group were about 10 percent lower than those of adolescents in the current study. This may be related to changing norms around e-cigarette use. “Quitting vaping is becoming more accepted among young people,” explained Graham, an adjunct professor of medicine at the Mayo Clinic and chief health officer of innovations at Truth Initiative.
She added that the This is Quitting program was also effective in promoting abstinence from both e-cigarettes and conventional cigarettes. Almost 53 percent of those in the intervention group reported abstinence from both vaping and smoking conventional cigarettes, compared to 35 percent in the control group. Among participants who were able to quit, fewer than four percent started using conventional cigarettes.About 76 percent reported they vaped within 30 minutes of waking and about 94 percent said they felt somewhat/very addicted to vaping.
The intervention, This is Quitting, is now available nationally free of charge as part of the EX program from Truth Initiative and the Mayo Clinic. Anyone ages 13 to 24 can text DITCHVAPE to 88709 to enroll. Graham explained that Truth Initiative works with state health departments, school systems and other organizations who serve young people to promote the program across the U.S.
The study and two related editorials are published in JAMA.