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Galper EF, Gottfredson O'Shea N, Ritchie C, Kresovich A, Ma H, Sutfin EL, Sheeran P, Noar SM. Identifying promising themes and messages for youth vaping prevention: A national study. Soc Sci Med 2024; 348:116864. [PMID: 38608483 PMCID: PMC11056295 DOI: 10.1016/j.socscimed.2024.116864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/29/2023] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
Use of e-cigarettes and vapes among adolescents continues to be a major public health concern. Health communication efforts can discourage e-cigarette use among adolescents by influencing beliefs and behavior. However, to do so, studies need to identify the most promising themes and messages based on the latest evidence about the harms of e-cigarettes and vaping. Participants were a nationally representative sample of 1,603 US adolescents aged 13-17 years, recruited in the summer of 2022. Adolescents were randomly assigned to view 7 vaping prevention statements (one from each theme: nicotine addiction, chemical harms, health symptoms, mental health, organ effects, cosmetic effects, and monetary cost) and 1 control statement (vape litter theme) from a pool of 46 statements that were developed through a systematic process. Participants rated each statement on perceived message effectiveness (PME), awareness, and believability. Results of linear mixed models indicated that all vaping prevention themes out-performed control messages on PME, with chemical harms and organ effects having the largest effects, followed by nicotine addiction and then other themes. For most message themes, PME effects were stronger for youth susceptible to vaping compared to non-susceptible youth and users. Both awareness and believability predicted higher levels of PME. In secondary analyses, we found that statements specifying the target ("you") and longer statements were also rated higher on PME. Results suggests that the most potent vaping prevention messages for adolescents are those that focus on vape chemicals and the potential of vaping to damage organs and increase disease risk.
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Affiliation(s)
- Emily F Galper
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | - Caroline Ritchie
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alex Kresovich
- Public Health Department, NORC at the University of Chicago, Chicago, IL, USA
| | - Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Lin C, Mathur Gaiha S, Halpern-Felsher B. E-cigarette and combustible cigarette cessation patterns, reasons, and methods among adolescents, young adults, and adults. Addict Behav 2024; 150:107918. [PMID: 38070362 PMCID: PMC10845159 DOI: 10.1016/j.addbeh.2023.107918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/25/2023]
Abstract
Research is limited regarding adolescents' and young adults' (AYA) patterns, methods of, and reasons for cigarette or e-cigarette cessation. Further, while adults may try to use e-cigarettes to quit combustible cigarettes, little is known about how adults then quit e-cigarettes. This study utilizes a national, cross-sectional online survey of 6131 diverse participants aged 13-40 years to examine reasons for quitting e-cigarettes or cigarettes, quit methods, and quit attempt outcomes among AYAs and adults. In our sample, 3137 (51.2%) had ever used an e-cigarette, of whom 2310 (37.7%) were aged 13-24 years and 827 (13.5%) were 25-40 years old; 2387 (38.9%) had ever used a combustible cigarette (1440 [23.5%] were 13-24 years old and 947 [15.4%] were 25-40 years old). Among e-cigarette ever-users, 39.4% of 13-24-year-olds intended to quit in the next 6 months, and 36.9% had a serious plan for quitting in the next 30 days; 25.2% wanted to decrease the amount they used while 34.8% wanted to quit completely. Similar rates were found among e-cigarette ever users aged 25-40 years, as well as past 30-day e-cigarette users, cigarette ever-users, and past 30-day cigarette users across all ages. "Cold turkey" (41.0%) followed by "tried to cut down slowly by vaping/smoking less often or fewer puffs" (25.5%) was the most common quit method among e-cigarette ever-users and cigarette ever-users of all ages. Further study of effective tobacco cessation methods to help both AYAs and adults successfully quit nicotine, whether from cigarettes or e-cigarettes, is urgently needed.
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Affiliation(s)
- Crystal Lin
- Stanford School of Medicine, Stanford University, Palo Alto, CA, United States; REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States
| | - Shivani Mathur Gaiha
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States
| | - Bonnie Halpern-Felsher
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States.
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Holt LJ, Latimer LJ. Emerging Adults' Experiences with E-Cigarette Cessation. Subst Use Misuse 2024; 59:405-410. [PMID: 37932876 DOI: 10.1080/10826084.2023.2275563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Background: The use of electronic nicotine delivery systems (ENDS) is one of the most common substance use behaviors in college students, yet most individuals show some interest in quitting. The current study added to the limited literature on ENDS cessation by examining readiness to quit and the use and perceived efficacy of ENDS cessation methods in a heterogeneous sample of college students. Methods: Students 18-24 years in Psychology courses (N = 1563; 73% female) from six US universities completed an online survey between September 2021-April 2022. Results: Nearly half the sample (n = 738, 47%) reported lifetime ENDS use and nearly half of lifetime users (n = 356, 48%) reported a quit attempt. Most ENDS users reported some readiness to quit (n = 251, 67%). Quitting "cold turkey", using willpower, and replacing ENDS use with another activity were endorsed most frequently; strategies were perceived as more helpful if students had direct experience with them. Social support (e.g., counseling, groups, family/friend support) and nicotine replacement products were perceived as effective but were utilized infrequently. Digital tools (i.e., apps, text messaging) were perceived to be least helpful and were utilized infrequently. Conclusion: Most college students who use ENDS are interested in quitting and have relied on unassisted methods for cessation. Our data suggest a significant opportunity for college personnel and public health officials to further enhance awareness and uptake of ENDS cessation resources for this demographic. Digital tools that integrate social support may be especially effective given their low cost, demonstrated efficacy, and alignment with students' preferences for social support.
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Ahuja N, Kedia S, Ward KD, Jiang Y, Dillon PJ. Predictors of Adolescents' Transition Through the Stages of Change for Quitting E-Cigarettes: Findings From the Population Assessment of Tobacco and Health Study. Am J Health Promot 2024:8901171231222077. [PMID: 38258817 DOI: 10.1177/08901171231222077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
PURPOSE To identify predictive factors associated with US adolescents' transition through the stages of change for potentially quitting e-cigarettes using the Trans-theoretical model of behavior change. DESIGN Prospective cohort study. SETTING United States. SUBJECTS We utilized data from adolescents (12-17 years) in Wave 3 of the Population Assessment of Tobacco and Health study who used e-cigarettes exclusively over the past 30 days (n = 177) and were followed up with in Wave 4. MEASURES Outcome variables were 3 transition categories: those who remained stagnant, those who progressed, and those who regressed in their stage of quitting e-cigarettes. Predictor variables were socio-demographics, e-cigarette harm perception, e-cigarette use at home or by important people, social norms, e-cigarette and anti-tobacco advertisements, and e-cigarette health warnings. ANALYSIS Weighted-adjusted multinomial regression analysis was performed to determine the association between predictor and outcome variables. RESULTS From Wave 3 to Wave 4, 19% of adolescents remained stagnant; 73.3% progressed; and 7.7% regressed. Adolescents were less likely to progress in their stage of change if they perceived nicotine in e-cigarettes to be "not at all/slightly harmful" (AOR = .26 [95% CI: .25, .27], P < .001); reported important people's use of e-cigarettes (AOR = .18 [95% CI: .05, .65, P = .009); and "rarely" noticed e-cigarette health warnings (AOR = .28 [95% CI: .08, .98, P = .054). CONCLUSION Intervention efforts must target specific predictive factors that may help adolescents quit e-cigarettes.
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Affiliation(s)
- Nikhil Ahuja
- Department of Public Health, Slippery Rock University of Pennsylvania, Slippery Rock, PA, USA
| | - Satish Kedia
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, TN, USA
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, TN, USA
| | - Yu Jiang
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, TN, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
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Orfin RH, Siddalingaiah S, Dontu V, Estrada B, Martinez C, Guerra D, Carrillo H, Cervantes-Díaz MJ, Rodríguez-Rojas DV, Rahman I, McIntosh S, Ossip DJ, Cupertino AP, Cartujano-Barrera F. Development of a Vaping Cessation Text Messaging Intervention for Latino Young Adults: A Participatory Research Approach. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024:2752535X231225928. [PMID: 38183157 DOI: 10.1177/2752535x231225928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
OBJECTIVE Describe the participatory research procedures of developing Kick Vaping, a vaping cessation text messaging intervention for Latino young adults, available in English and Spanish. METHODS Using community-based recruitment strategies, we convened a Community Advisory Board (CAB) of eight Latino young adults (ages 18-25) with different vaping experiences (never users, ex-users, and current users of e-cigarettes). Members held a series of working meetings to adapt Decídetexto, a smoking cessation text messaging intervention, for vaping cessation. Members provided iterative feedback on the text messages until reaching a consensus on content. Messages were translated from English to Spanish following a committee approach. Readability assessments were used to evaluate the legibility of the text messages. RESULTS At baseline, members' mean age was 22.6 years old (SD 3.1), 75% were female, and 50% used both English and Spanish equally. Three members (37.5%) were ex-users and one member (12.5%) was a current user of e-cigarettes. 18 meetings provided sufficient opportunities for iterative feedback on the text messages for developing the intervention. The Kick Vaping intervention consists of 208 text messages. Readability scores of the text messages in English were equivalent to fourth and fifth grade, and in Spanish were equivalent to easy and somewhat easy. CONCLUSION It is feasible and practical to build participatory research among Latino young adults focused on vaping cessation. Members of the CAB added innovation and creativity to the development of the vaping cessation text messaging intervention. Future research is needed to evaluate the impact of the intervention on vaping cessation.
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Affiliation(s)
- Rafael H Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Simran Siddalingaiah
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Vignya Dontu
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Bianca Estrada
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Chabeli Martinez
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Darcy Guerra
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Hanzell Carrillo
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - María José Cervantes-Díaz
- Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosi, Mexico
- Residencia de Medicina Preventiva, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Irfan Rahman
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
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Jones E, Endrighi R, Weinstein D, Jankowski A, Quintiliani LM, Borrelli B. Methods used to quit vaping among adolescents and associations with perceived risk, addiction, and socio-economic status. Addict Behav 2023; 147:107835. [PMID: 37598643 DOI: 10.1016/j.addbeh.2023.107835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023]
Abstract
Despite widespread evidence suggesting that e-cigarettes are harmful to youth, the prevalence of adolescent vaping continues to rise. The first aim of this cross-sectional study was to determine which methods adolescents have previously used to quit vaping and their interest in using various methods to quit vaping in the future. The second aim was to investigate the associations between vaping-related characteristics and (1) motivation to quit vaping and (2) previous use of pharmacological methods to quit vaping or previous use of unassisted quitting. Participants were 185 current or former vapers, aged 14-19 (M age = 16.9 years, SD = 1.1; 52% female), recruited online from different U.S. regions. Data were collected through online questionnaires. Most participants reported at least one prior attempt to quit vaping (81.3%). Unassisted quitting was the most prevalent method to quit vaping (78.4%), followed by "advice from a friend" (51.9%). Participants were interested in using a variety of methods for quitting vaping in the future, including medication (28.8%), and mobile apps (34.6%). Greater perceived harm of vaping was significantly associated with motivation to quit vaping, while greater perceived risk of addiction and higher SES were significantly associated with lifetimeuse of nicotine replacement to quit vaping. Adolescents may be open to trying methods to quit that are different from what they have used previously. These findings could help direct resources toward the development of vaping cessation programs that are acceptable to adolescents.
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Affiliation(s)
- Emily Jones
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Romano Endrighi
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Daniel Weinstein
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Alexis Jankowski
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Lisa M Quintiliani
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, USA; Section of General Internal Medicine, Boston Medical Center, USA
| | - Belinda Borrelli
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA.
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Do EK, Tulsiani S, Edwards G, Cha S, Amato MS, Hair EC. Treatment-seeking young people enrolled in a United States vaping cessation intervention trial report high frequency of use and nicotine dependence. Prev Med Rep 2023; 36:102533. [PMID: 38116264 PMCID: PMC10728452 DOI: 10.1016/j.pmedr.2023.102533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023] Open
Abstract
Objective This study examines characteristics of participants enrolled in a vaping cessation intervention trial and study generalizability of the treatment-seeking sample to the broader population of young people interested in quitting vaping to evaluate dissemination of an evidence-based treatment program. Methods Data was obtained from 697 treatment-seeking participants (aged 13-24 years) from a vaping cessation intervention trial conducted between February and March 2023 with This is Quitting and 665 participants who expressed intent to quit vaping in the Truth Longitudinal Cohort, a nationally representative longitudinal study of United States youth and young adults (aged 15-24 years), collected October 2022 to February 2023. Comparisons were made using two-sample Pearson Chi-square tests and t-tests. Results Treatment-seeking young people were younger, less racially diverse, more diverse in sexual orientation, and reported higher psychological distress, frequency of e-cigarette use, and nicotine dependence, relative to the nationally representative sample of young people expressing intentions to quit vaping. Conclusions Participants enrolled in treatment reported higher levels of dependence and use frequency than the broader population, suggesting that many young e-cigarette users with lower dependence who want to quit might not be reached by current treatment dissemination efforts. The implication of these findings is that communications for vaping cessation programs may need to be adjusted to have broader appeal among young people.
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Affiliation(s)
| | | | | | - Sarah Cha
- Innovations, Truth Initiative, Washington, DC, USA
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Kreslake JM, Aarvig K, Liu MS, Vallone DM, Hair EC. Pathways to Quitting E-cigarettes Among Youth and Young Adults: Evidence From the truth® Campaign. Am J Health Promot 2023:8901171231218492. [PMID: 38029725 DOI: 10.1177/08901171231218492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE This study examines the pathways through which e-cigarette users' awareness of the truth® campaign influences e-cigarette use frequency over time. DESIGN AND SETTING Data included four waves (2020-2023) of the Truth Longitudinal Cohort, a probability-based, nationally representative survey. PARTICIPANTS The analytic sample was 15-24-year-olds who reported current e-cigarette use at baseline (N = 718). Wave-by-wave retention rates were 64% to 69%. MEASURES Respondents' cumulative awareness of truth® ads was calculated (Waves 1-2). Strength of agreement with campaign-targeted attitudes was measured on five-point scales (Wave 2). The outcome was change in the 4-level frequency of e-cigarette use (Waves 2-4). ANALYSIS Latent growth structural equation modeling examined the pathway from cumulative ad awareness to the frequency of e-cigarette use via campaign-targeted attitudes. RESULTS Model fit estimates identified a three-step pathway by which awareness of the campaign reduced e-cigarette use. Ad awareness was significantly associated with stronger campaign-targeted attitudes: perceived risk (β = .20, P < .0001); anti-vape industry (β = .13, P = .003); independence from addiction (β = .13, P = .004); and affinity with groups that reject vaping (β = .18, P < .0001). Each attitude was significantly associated with stronger perceived norms against e-cigarette use (respectively: β = .25, P < .0001; β = .15, P < .0001; β = .12, P = .018; β = .27, P < .0001). Perceived norms against e-cigarette use had a significant negative relationship with growth in e-cigarette use frequency over time (β = -.23, P < .0001). CONCLUSION Greater truth® anti-vaping ad awareness strengthens campaign-targeted attitudes among current users, increasing perceived norms against e-cigarette use and reducing use over time.
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Affiliation(s)
- Jennifer M Kreslake
- Truth Initiative, Schroeder Institute, Washington, DC, USA
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | | | | | - Donna M Vallone
- Truth Initiative, Schroeder Institute, Washington, DC, USA
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
- New York University, College of Global Public Health, New York, NY, USA
| | - Elizabeth C Hair
- Truth Initiative, Schroeder Institute, Washington, DC, USA
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
- New York University, College of Global Public Health, New York, NY, USA
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Le D, Ciceron AC, Romm KF, Clausen ME, Abroms LC, Evans WD, Graham AL, Berg CJ. E-cigarette cessation interest and quit attempts among young adults reporting exclusive e-cigarette use or dual use with other tobacco products: How can we reach them? Tob Prev Cessat 2023; 9:33. [PMID: 38026820 PMCID: PMC10652571 DOI: 10.18332/tpc/172416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION There is limited evidence to inform e-cigarette quitting interventions. This mixed-methods study examined: 1) e-cigarette and other tobacco product perceptions and cessation-related factors; and 2) potential behavioral intervention strategies among young adults reporting exclusive e-cigarette use or dual use with other tobacco products. METHODS We analyzed Fall 2020 survey data from 726 participants reporting past 6-month e-cigarette use (mean age=24.15 years, 51.1% female, 38.5% racial/ethnic minority) from 6 US metropolitan areas and Spring 2021 qualitative interview data from a subset (n=40), comparing tobacco-related perceptions and cessation-related factors among those reporting exclusive use versus dual use. RESULTS Among survey participants (35.5% exclusive e-cigarette use, 64.5% dual use), those reporting dual use indicated greater importance of quitting all tobacco or nicotine products (mean=5.28, SD=3.44 vs mean=4.65, SD=3.75, p=0.033), whereas those reporting exclusive use expressed greater confidence in quitting e-cigarettes (mean=7.59, SD=3.06 vs mean=7.08, SD=3.01, p=0.029) and all tobacco and nicotine products (mean=7.00, SD=3.16 vs mean=6.31, SD=3.13, p=0.008), as well as less favorable perceptions (i.e. more harmful to health and addictive, less socially acceptable) of cigarettes, cigars, and smokeless tobacco (p<0.05). Interview participants (50.0% exclusive e-cigarette use; 50.0% dual use) attributed previous failed e-cigarette quit attempts to their inability to cope with social influences, stress, and withdrawal symptoms. Although most expressed disinterest in quitting due to belief of eventually outgrowing e-cigarettes (among those reporting exclusive use) or unreadiness to abstain from nicotine (among those reporting dual use), many acknowledged the need for quitting interventions. CONCLUSIONS Young adult e-cigarette cessation interventions should target risk perceptions, cessation barriers, and social influences/support.
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Affiliation(s)
- Daisy Le
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington DC, United States
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
| | - Annie C. Ciceron
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington DC, United States
| | - Katelyn F. Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, OK, United States
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, OK, United States
| | - Michelle E. Clausen
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington DC, United States
| | - Lorien C. Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
| | - W. Douglas Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
| | - Amanda L. Graham
- Innovations Center, Truth Initiative, Washington DC, United States
- Department of Medicine, College of Medicine and Science, Mayo Clinic, Rochester, MN, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
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Barnes C, Turon H, McCrabb S, Hodder RK, Yoong SL, Stockings E, Hall AE, Bialek C, Morrison JL, Wolfenden L. Interventions to prevent or cease electronic cigarette use in children and adolescents. Cochrane Database Syst Rev 2023; 11:CD015511. [PMID: 37965949 PMCID: PMC10646968 DOI: 10.1002/14651858.cd015511.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND The prevalence of e-cigarette use has increased globally amongst children and adolescents in recent years. In response to the increasing prevalence and emerging evidence about the potential harms of e-cigarettes in children and adolescents, leading public health organisations have called for approaches to address increasing e-cigarette use. Whilst evaluations of approaches to reduce uptake and use regularly appear in the literature, the collective long-term benefit of these is currently unclear. OBJECTIVES The co-primary objectives of the review were to: (1) evaluate the effectiveness of interventions to prevent e-cigarette use in children and adolescents (aged 19 years and younger) with no prior use, relative to no intervention, waitlist control, usual practice, or an alternative intervention; and (2) evaluate the effectiveness of interventions to cease e-cigarette use in children and adolescents (aged 19 years and younger) reporting current use, relative to no intervention, waitlist control, usual practice, or an alternative intervention. Secondary objectives were to: (1) examine the effect of such interventions on child and adolescent use of other tobacco products (e.g. cigarettes, cigars types, and chewing tobacco); and (2) describe the unintended adverse effects of the intervention on individuals (e.g. physical or mental health of individuals), or on organisations (e.g. intervention displacement of key curricula or learning opportunities for school students) where such interventions are being implemented. SEARCH METHODS We searched CENTRAL, Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Clarivate Web of Science Core Collection from inception to 1 May 2023. Additionally, we searched two trial registry platforms (WHO International Clinical Trials Registry Platform; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov), Google Scholar, and the reference lists of relevant systematic reviews. We contacted corresponding authors of articles identified as ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, factorial RCTs, and stepped-wedge RCTs. To be eligible, the primary targets of the interventions must have been children and adolescents aged 19 years or younger. Interventions could have been conducted in any setting, including community, school, health services, or the home, and must have sought to influence children or adolescent (or both) e-cigarette use directly. Studies with a comparator of no intervention (i.e. control), waitlist control, usual practice, or an alternative intervention not targeting e-cigarette use were eligible. We included measures to assess the effectiveness of interventions to: prevent child and adolescent e-cigarette use (including measures of e-cigarette use amongst those who were never-users); and cease e-cigarette use (including measures of e-cigarette use amongst children and adolescents who were e-cigarette current-users). Measures of e-cigarette use included current-use (defined as use in the past 30 days) and ever-use (defined as any lifetime use). DATA COLLECTION AND ANALYSIS Two review authors independently screened the titles and abstracts of references, with any discrepancies resolved through consensus. Pairs of review authors independently assessed the full-text articles for inclusion in the review. We planned for two review authors to independently extract information from the included studies and assess risk of bias using the Cochrane RoB 2 tool. We planned to conduct multiple meta-analyses using a random-effects model to align with the co-primary objectives of the review. First, we planned to pool interventions to prevent child and adolescent e-cigarette use and conduct two analyses using the outcome measures of 'ever-use' and 'current-use'. Second, we planned to pool interventions to cease child and adolescent e-cigarette use and conduct one analysis using the outcome measure of 'current-use'. Where data were unsuitable for pooling in meta-analyses, we planned to conduct a narrative synthesis using vote-counting approaches and to follow the Cochrane Handbook for Systematic Reviews of Interventions and the Synthesis Without Meta-analysis (SWiM) guidelines. MAIN RESULTS The search of electronic databases identified 7141 citations, with a further 287 records identified from the search of trial registries and Google Scholar. Of the 110 studies (116 records) evaluated in full text, we considered 88 to be ineligible for inclusion for the following reasons: inappropriate outcome (27 studies); intervention (12 studies); study design (31 studies); and participants (18 studies). The remaining 22 studies (28 records) were identified as ongoing studies that may be eligible for inclusion in a future review update. We identified no studies with published data that were eligible for inclusion in the review. AUTHORS' CONCLUSIONS We identified no RCTs that met the inclusion criteria for the review, and as such, there is no evidence available from RCTs to assess the potential impact of interventions targeting children and adolescent e-cigarette use, tobacco use, or any unintended adverse effects. Evidence from studies employing other trial designs (e.g. non-randomised) may exist; however, such studies were not eligible for inclusion in the review. Evidence from studies using non-randomised designs should be examined to guide actions to prevent or cease e-cigarette use. This is a living systematic review. We search for new evidence every month and update the review when we identify relevant new evidence. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Heidi Turon
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
- Global Centre for Preventive Health and Nutrition, Institute of Health Technology, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Emily Stockings
- Matilda Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Caitlin Bialek
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Jacob L Morrison
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
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11
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Dobbs PD, Schisler E, Colditz JB, Primack BA. Miscommunication about the US federal Tobacco 21 law: a content analysis of Twitter discussions. Tob Control 2023; 32:696-700. [PMID: 35173067 PMCID: PMC9378749 DOI: 10.1136/tobaccocontrol-2021-057099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/03/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Tobacco 21 is a law that sets the minimum legal sales age of tobacco products to 21. On 20 December 2019, the USA passed a federal Tobacco 21 law. The objective of this study is to explore Twitter discussions about the federal Tobacco 21 law in the USA leading up to enacted. METHODS Twitter messages about Tobacco 21 posted between September and December 2019 were collected via RITHM software. A 2% sample of all collected tweets were double coded by independent coders using a content analysis approach. RESULTS Findings included three content categories of tweets (news, youth and young adults and methods of avoiding the law) with eight subcodes. Most news tweets incorrectly described the law as a purchase law (54.7%). However, Tobacco 21 is in fact a sales law-it only includes penalties for tobacco retailers who sell to under-age purchasers. About one-fourth (27%) of the tweets involved youth and young adults, with some claiming the law would reduce youth smoking and others doubting its ability to limit youth access to tobacco products. Few tweets (2.5%) mentioned methods of circumventing the policy, such as having an older peer purchase tobacco. CONCLUSIONS As several countries explore raising their age of sale of tobacco laws to 21, they should couple policy enactment with clear and accurate communication about the law. Compliance agencies at all levels (eg, local, regional, national) can use social media to identify policy loopholes and support vulnerable populations throughout the policy implementation process.
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Affiliation(s)
- Page D Dobbs
- Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Eric Schisler
- Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Jason B Colditz
- Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brian A Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, AR, USA
- College of Public Health and Human Science, Oregona State University, Corvallis, OR, USA
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12
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Liu J, Roberts J, Reynolds MJ, Hanby E, Gundersen DA, Winickoff JP, Rees VW, Emmons KM, Tan ASL. Barriers and facilitators to address vaping in Massachusetts schools: a mixed-methods study of school-based stakeholders. Transl Behav Med 2023; 13:589-600. [PMID: 37084410 PMCID: PMC10415734 DOI: 10.1093/tbm/ibad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
We assessed vaping behaviors, environments, COVID-19 influences, and barriers and facilitators of existing approaches that address adolescent vaping in Massachusetts middle and high schools. Findings from this study will provide considerations for individual schools or districts as they advance adolescent vaping prevention and treatment efforts. We analyzed 310 open-ended comments from Massachusetts school administrators who completed a survey between November 2020 and January 2021. Further, we analyzed nine semi-structured interviews with administrators (e.g., principals, vice principals, school nurses) from Massachusetts school systems (n = 6) and school-based anti-tobacco advocates (n = 3); interviews took place between May and December 2021. Informed by Green's PRECEDE model, we conducted a framework analysis using deductive codes based on the model constructs (enabling, reinforcing, and predisposing factors) and inductive codes of key themes emerging from the interviews. Challenges to addressing adolescent vaping included staff capacity, funding, and lack of mental health and counseling supports. The COVID-19 pandemic was a major barrier to conducting usual in-person vaping programs, but also reduced student vaping at school due to new social distancing practices and bathroom use policies. Facilitators of vaping interventions included peer-led initiatives and parental involvement. Participants discussed the importance of educating adolescents on the harms of vaping and the move toward alternatives-to-suspension programs rather than disciplinary action. School-based anti-vaping program implementers-such as school districts, state departments of education, or local health departments-will need to leverage facilitators such as peer-led initiatives, alternatives-to-suspension approaches, and parental involvement, to increase the potential impact of these programs.
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Affiliation(s)
- Jessica Liu
- Harvard University, T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
| | - Jane Roberts
- Dana-Farber Cancer Institute, Survey and Qualitative Methods Core, Boston, MA, USA
| | | | - Elaine Hanby
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA
| | - Daniel A Gundersen
- Harvard University, T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
- Dana-Farber Cancer Institute, Survey and Qualitative Methods Core, Boston, MA, USA
| | - Jonathan P Winickoff
- MassGeneral Hospital Division of General Academic Pediatrics, Boston, MA, USA
- MGH Tobacco Research and Treatment Center, Boston, MA, USA
- American Academy of Pediatrics Julius B. Richmond Center, Itasca, IL, USA
| | - Vaughan W Rees
- Harvard University, T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
| | - Karen M Emmons
- Harvard University, T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
| | - Andy S L Tan
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA
- University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PA, USA
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13
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Maheta B, Khan A, Skinner S, Dove M. Initial impacts of the COVID-19 pandemic on tobacco use among college students in California. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-6. [PMID: 37487206 PMCID: PMC10805952 DOI: 10.1080/07448481.2023.2232458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/19/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023]
Abstract
Objective: To evaluate the change in tobacco use by college students in California during the COVID-19 pandemic. Participants: Young adults (18-24 years) currently enrolled in a California college or university (N = 212). Methods: Students recruited through social media posts and by student tobacco advocate members completed an online survey of 59 questions in Spring 2021. Results: Almost 80% of current tobacco users reported a change in tobacco use during the pandemic. Most current tobacco users who changed their tobacco use reported an increase in use during the pandemic (43.2%) and 38.7% reported a decrease in use. Conclusion: As a result of COVID-19, many college students changed their tobacco use. As students return to campus and COVID-19 regulations are lifted, this may be an ideal time for prevention and cessation messages, which could include information on health risks associated with tobacco and e-cigarette use, and healthy methods for stress reduction.
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Affiliation(s)
| | - Afroze Khan
- Department of Molecular and Cell Biology, University of California, Berkeley
| | | | - Melanie Dove
- Department of Public Health Sciences, University of California, Davis
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14
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Caponnetto P, Campagna D, Ahluwalia JS, Russell C, Maglia M, Riela PM, Longo CF, Busa B, Polosa R. Varenicline and counseling for vaping cessation: a double-blind, randomized, parallel-group, placebo-controlled trial. BMC Med 2023; 21:220. [PMID: 37403047 DOI: 10.1186/s12916-023-02919-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 06/01/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Vaping cessation is virtually unexplored. The efficacy and safety of varenicline for vaping cessation has not been studied and rigorous research is required to advance best practice and outcomes for people who use electronic cigarettes (EC) and want to quit. The objective is to evaluate the efficacy and safety of varenicline (1 mg BID, administered for 12 weeks, with follow-up to week 24) combined with vaping cessation counseling in exclusive daily EC users intending to quit vaping. METHODS Design: Double-blind, randomized, parallel-group, placebo-controlled trial. SETTING The study took place at a University-run smoking cessation center. PARTICIPANTS People who exclusively use ECs daily and intend to quit vaping. INTERVENTION A total of 140 subjects were randomized to either varenicline (1 mg, administered twice daily for 12 weeks) plus counseling or placebo treatment (administered twice daily, for 12 weeks) plus counseling. The trial consisted of a 12-week treatment phase followed by a 12-week follow-up, nontreatment phase. MAIN OUTCOMES AND MEASURES The primary efficacy endpoint of the study was biochemically validated continuous abstinence rate (CAR) at weeks 4 to 12. Secondary efficacy end points were CAR at weeks 4 to 24 and 7-day point prevalence of vaping abstinence at weeks 12 and 24. RESULTS CAR was significantly higher for varenicline vs placebo at each interval: weeks 4-12, 40.0% and 20.0%, respectively (OR = 2.67, 95% CI = [1.25-5.68], P = 0.011); weeks 4-24, 34.3% for varenicline with counseling and 17.2% for placebo with counseling (OR = 2.52, 95% CI = [1.14-5.58], P = 0.0224). The 7-day point prevalence of vaping abstinence was also higher for the varenicline than placebo at each time point. Serious adverse events were infrequent in both groups and not treatment-related. CONCLUSIONS The findings of the present RCT indicate that inclusion of varenicline in a vaping cessation program for people who use electronic cigarettes and intending to quit may result in prolonged abstinence. These positive findings establish a benchmark of intervention effectiveness, may support the use of varenicline combined with counseling in vaping cessation programs, and may also help guiding future recommendations by health authorities and healthcare providers. TRIAL REGISTRATION The study has been registered in EUDRACT with Trial registration ID: 2016-000339-42.
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Affiliation(s)
- Pasquale Caponnetto
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Science of Education, Section of Psychology, University of Catania, Catania, Italy
| | - Davide Campagna
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
- UOC MCAU, University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy
| | - Jasjit S Ahluwalia
- Brown University School of Public Health and Alpert School of Medicine, RI, Providence, USA
| | | | - Marilena Maglia
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Paolo Marco Riela
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - Carmelo Fabio Longo
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - Barbara Busa
- UOC Farmacia Ospedaliera, ARNAS Hospital "Garibaldi", Catania, Italy
| | - Riccardo Polosa
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy.
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy.
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy.
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15
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Kreski NT, Ankrum H, Cerdá M, Chen Q, Hasin D, Martins SS, Olfson M, Keyes KM. Nicotine Vaping and Co-occurring Substance Use Among Adolescents in the United States from 2017-2019. Subst Use Misuse 2023; 58:1075-1079. [PMID: 37198725 PMCID: PMC10277150 DOI: 10.1080/10826084.2023.2188462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Background: The use of electronic cigarettes (or "vaping") among adolescents remains a public health concern given exposure to harmful substances, plus potential association with cannabis and alcohol. Understanding vaping as it intersects with combustible cigarette use and other substance use can inform nicotine prevention efforts. Methods: Data were drawn from 51,872 US adolescents (grades 8, 10, 12, years: 2017-2019) from Monitoring the Future. Multinomial logistic regression analyses assessed links of past 30-day nicotine use (none, smoking-only, vaping-only, and any smoking plus vaping) with both past 30-day cannabis use and past two-week binge drinking. Results: Nicotine use patterns were strongly associated with greater likelihood of cannabis use and binge drinking, particularly for the highest levels of each. For instance, those who smoked and vaped nicotine had 36.53 [95% CI:16.16, 82.60] times higher odds of having 10+ past 2-week binge drinking instances compared to non-users of nicotine. Discussion: Given the strong associations between nicotine use and both cannabis use and binge drinking, there is a need for sustained interventions, advertising and promotion restrictions, and national public education efforts to reduce adolescent nicotine vaping, efforts that acknowledge co-occurring use.
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Affiliation(s)
- Noah T Kreski
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Hadley Ankrum
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Qixuan Chen
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Deborah Hasin
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Mark Olfson
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Katherine M Keyes
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
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16
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Palmer AM, Carpenter MJ, Rojewski AM, Haire K, Baker NL, Toll BA. Nicotine replacement therapy for vaping cessation among mono and dual users: A mixed methods preliminary study. Addict Behav 2023; 139:107579. [PMID: 36549102 PMCID: PMC9872945 DOI: 10.1016/j.addbeh.2022.107579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Many adults express interest in e-cigarette cessation; however, there are few empirically tested interventions for quitting vaping. This study seeks to (1) evaluate reasons for quitting e-cigarettes in treatment-seeking adults, and (2) assess the feasibility and acceptability of nicotine replacement therapy (NRT) for e-cigarette cessation. Adult daily e-cigarette users completed qualitative interviews about quitting e-cigarettes, then were randomized to either 28-day supply of combination NRT (21 mg patches, 4 mg lozenges) + supportive booklet or Quitline referral. Primary aims were feasibility (number who enrolled) and acceptability (NRT use, adverse side effects). Exploratory aims evaluated abstinence (7-day point-prevalence) at end of treatment. Of the 30 participants who were enrolled, 50 % (n = 15) were dual users, and 50 % (n = 15) were mono-vapers, 26.6 % (n = 8) of whom were former smokers. Participants reported seeking treatment due to health concerns, dependence, stigma, and cost. Anticipated challenges of quitting vaping were withdrawal, negative mood, sensorimotor habits, and convenience. Most completed the end of treatment survey (n = 24; 80 %). Participants who received NRT reported using the patch M = 10.89 days and lozenges M = 6.39 days, with few days of adverse effects (M = 2.67). At end of treatment, 6/18 (33.3 %; 6 mono and 0 dual users) in the intervention group reported abstinence from vaping, compared to 0 in the control group (Fisher = 5.00, p =.057). In conclusion, adults are interested in quitting e-cigarettes due to negative consequences of use and are willing to use pharmacotherapy. Future research should confirm these results in a larger trial, address cigarette smoking in dual users, and aim to disseminate treatments.
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Affiliation(s)
- Amanda M Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; Department of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Matthew J Carpenter
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Alana M Rojewski
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kayla Haire
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Benjamin A Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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17
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Schuster RM, Cather C, Pachas GN, Nielsen L, Iroegbulem V, Dufour J, Potter K, Levy S, Gray KM, Evins AE. A randomized controlled trial of varenicline and brief behavioral counseling delivered by lay counselors for adolescent vaping cessation: Study protocol. Front Psychiatry 2023; 14:1083791. [PMID: 37009114 PMCID: PMC10050714 DOI: 10.3389/fpsyt.2023.1083791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/22/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundApproximately one-fifth of high-school seniors and college students currently vape nicotine. Adolescents express a desire to quit vaping, and case reports have shown promise for e-cigarette tapering with dual behavioral and pharmacologic therapies. However, there are no published clinical trials to date that test these intervention approaches for adolescent nicotine vaping cessation. In this three-arm randomized, placebo-controlled, parallel-group study, we aim to assess the efficacy of varenicline in combination with brief behavioral counseling and texting support on vaping cessation in adolescents dependent on vaped nicotine.MethodsThe study will enroll 300 individuals between the ages of 16–25 with daily or near-daily nicotine vaping who reside in the Greater Boston area. Participants will be randomly assigned in a 1:1:1 ratio in blocks of six to one of the three arms: (1) a 12-week course of varenicline titrated to 1 mg bid, brief behavioral counseling delivered by a lay counselor, and an introduction to This is Quitting (TIQ) texting support created by the Truth Initiative; (2) a 12-week course of placebo, brief behavioral counseling, and TIQ; and (3) 12 weeks of enhanced usual care, consisting of advice to quit and an introduction to TIQ. The primary outcome will be biochemically verified continuous vaping abstinence at the end of the treatment (week 12). Secondary outcomes include continuous abstinence at follow-up (week 24), 7-day point prevalence abstinence at weeks 12 and 24, safety and tolerability of varenicline in an adolescent vaping population, as well as change in mood and nicotine withdrawal symptoms across the intervention period. Exploratory outcomes include change in comorbid substance use behaviors and nicotine dependence. Analysis will be intent-to-treat, with multiple imputation sensitivity analyses for participants with missing or incomplete outcome data.DiscussionThis is the first study to evaluate varenicline in combination with a novel, brief, lay counselor delivered vaping cessation program for adolescents who vape nicotine. Results will inform clinicians on the effectiveness and acceptability of this promising, but not yet tested intervention.Clinical trial registration: ClinicalTrials.gov, identifier NCT05367492.
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Affiliation(s)
- Randi M. Schuster
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- *Correspondence: Randi M. Schuster,
| | - Corinne Cather
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Gladys N. Pachas
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Lindsay Nielsen
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Vanessa Iroegbulem
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Jason Dufour
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Kevin Potter
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Sharon Levy
- Harvard Medical School, Boston, MA, United States
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, MA, United States
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - A. Eden Evins
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- A. Eden Evins,
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18
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Kundu A, Kouzoukas E, Zawertailo L, Fougere C, Dragonetti R, Selby P, Schwartz R. Scoping review of guidance on cessation interventions for electronic cigarettes and dual electronic and combustible cigarettes use. CMAJ Open 2023; 11:E336-E344. [PMID: 37072138 PMCID: PMC10118292 DOI: 10.9778/cmajo.20210325] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Although evidence-based smoking cessation guidelines are available, the applicability of these guidelines for the cessation of electronic cigarette and dual e-cigarette and combustible cigarette use is not yet established. In this review, we aimed to identify current evidence or recommendations for cessation interventions for e-cigarette users and dual users tailored to adolescents, youth and adults, and to provide direction for future research. METHODS We systematically searched MEDLINE, Embase, PsycINFO and grey literature for publications that provided evidence or recommendations on vaping cessation for e-cigarette users and complete cessation of cigarette and e-cigarette use for dual users. We excluded publications focused on smoking cessation, harm reduction by e-cigarettes, cannabis vaping, and management of lung injury associated with e-cigarette or vaping use. Data were extracted on general characteristics and recommendations made in the publications, and different critical appraisal tools were used for quality assessment. RESULTS A total of 13 publications on vaping cessation interventions were included. Most articles were youth-focused, and behavioural counselling and nicotine replacement therapy were the most recommended interventions. Whereas 10 publications were appraised as "high quality" evidence, 5 articles adapted evidence from evaluation of smoking cessation. No study was found on complete cessation of cigarettes and e-cigarettes for dual users. INTERPRETATION There is little evidence in support of effective vaping cessation interventions and no evidence for dual use cessation interventions. For an evidence-based cessation guideline, clinical trials should be rigorously designed to evaluate the effectiveness of behavioural interventions and medications for e-cigarette and dual use cessation among different subpopulations.
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Affiliation(s)
- Anasua Kundu
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.
| | - Erika Kouzoukas
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Laurie Zawertailo
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Chantal Fougere
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Rosa Dragonetti
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Peter Selby
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Robert Schwartz
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
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19
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Bluestein MA, Bejarano G, Tackett AP, Duano JC, Rawls SG, Vandewater EA, Ahluwalia JS, Hébert ET. E-Cigarette Quit Attempts and Experiences in a Convenience Sample of Adult Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2332. [PMID: 36767698 PMCID: PMC9916273 DOI: 10.3390/ijerph20032332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/10/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Most e-cigarette users report planning to quit, but there is a paucity of evidence-based interventions for e-cigarette cessation. In the absence of interventions for e-cigarette cessation, we sought to understand how and why e-cigarette users attempt to quit on their own. Participants were recruited from Amazon Mechanical Turk, an online crowdsourcing platform. Those who reported they had ever used e-cigarettes regularly and had attempted to quit e-cigarette use were eligible for participation. Measures included demographic characteristics, other tobacco product use, e-cigarette device characteristics, barriers to quitting e-cigarettes, and facilitators to quitting e-cigarettes. A content analysis was conducted on twotwo open-ended questions that asked about advice respondents had for others trying to quit vaping and resources they wished they had during their quit attempt. Descriptive analyses were performed (means/standard errors; frequencies/proportions). A total of 89.0% reported using an e-cigarette with nicotine, 20.2% reported a nicotine concentration of 4-6 mg/mL%, 32.8% reported using multiple flavors, and 77.7% reported using their e-cigarette every day or some days. The primary reason reported for wanting to quit e-cigarettes was health concerns (42.2%), and 56.7% reported trying to quit "cold turkey". During quit attempts, 41.0% reported intense cravings and 53.1% reported stress as a trigger. From the content analysis, the most commonly cited suggestion for those wanting to quit e-cigarettes was distractions/hobbies (19.9%), followed by reducing/tapering down nicotine (16.9%). Descriptive information on demographics, e-cigarette use, device characteristics, barriers, facilitators, and quit methods provides a first step in identifying factors that contribute to successful interventions designed for e-cigarette cessation.
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Affiliation(s)
- Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Geronimo Bejarano
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Alayna P. Tackett
- Center for Tobacco Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, Division of Medical Oncology, The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Jaimie C. Duano
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Shelby Grace Rawls
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Elizabeth A. Vandewater
- Population Research Center, University of Texas at Austin, Austin, TX 78701, USA
- Department of Health Promotion and Behavioral Sciences, Austin Campus, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
- Legorreta Cancer Center, Brown University, Providence, RI 02912, USA
| | - Emily T. Hébert
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
- Department of Health Promotion and Behavioral Sciences, Austin Campus, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
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20
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Recognising the importance of chronic lung disease: a consensus statement from the Global Alliance for Chronic Diseases (Lung Diseases group). Respir Res 2023; 24:15. [PMID: 36639661 PMCID: PMC9838069 DOI: 10.1186/s12931-022-02297-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/15/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Chronic respiratory diseases are disorders of the airways and other structures of the lung, and include chronic obstructive pulmonary disease (COPD), lung cancer, asthma, bronchiectasis, interstitial lung diseases, occupational lung diseases and pulmonary hypertension. Through this article we take a broad view of chronic lung disease while highlighting (1) the complex interactions of lung diseases with environmental factors (e.g. climate change, smoking and vaping) and multimorbidity and (2) proposed areas to strengthen for better global patient outcomes. CONCLUSION We suggest new directions for the research agenda in high-priority populations and those experiencing health disparities. We call for lung disease to be made a research priority with greater funding allocation globally.
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21
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Ahuja N, Kedia SK, Jiang Y, Xie L, Ward KD, Pichon LC, Dillon PJ, Yu X. Factors Associated With E-Cigarette Quitting Behavior Among Adolescents in the United States: A Prospective Observational Study. J Adolesc Health 2022; 71:729-736. [PMID: 36088234 DOI: 10.1016/j.jadohealth.2022.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE This prospective observational study examined the association of socioecological factors with quitting behavior among US adolescents who exclusively use electronic cigarettes (e-cigarettes). METHODS We used data from past 30-day adolescent exclusive e-cigarette users (n = 243) participating in Wave 3 of the Population Assessment of Tobacco and Health study, who were then followed-up with approximately 12 months later for Wave 4. Weighted unadjusted and adjusted multivariate logistic regression models and structural equation modeling were performed to analyze the data. RESULTS Adolescents were significantly less likely to quit e-cigarettes if they perceived that nicotine in e-cigarettes was "slightly/somewhat harmful" to health (adjusted odds ratio [aOR] = 0.38; 95% confidence interval [CI]: 0.16-0.90, p = .02). Similarly, adolescents who reported that someone else in their home owned an e-cigarette (aOR = 0.43 [95% CI: 0.19-0.94], p = .03) or important people in their life used e-cigarettes (aOR = 0.45 [95% CI: 0.21-0.95], p = .03) were significantly less likely to quit e-cigarettes. The structural equation modeling showed a direct significant relationship of individual-level (b = 0.206, p = .02) and interpersonal-level factors (b = 0.170, p = .04) with e-cigarette quitting behavior. DISCUSSION Our findings suggest that individual-level (harm perception) and interpersonal-level (e-cigarette use at home and by important people) factors may play a significant role in e-cigarette quitting behavior among US adolescents.
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Affiliation(s)
- Nikhil Ahuja
- Department of Public Health and Social Work, Slippery Rock University of Pennsylvania, Slippery Rock, Pennsylvania.
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Yu Jiang
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Lu Xie
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, Ohio
| | - Xinhua Yu
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
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22
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Sharma M, Batra K, Batra R, Dai CL, Hayes T, Ickes MJ, Singh TP. Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12139. [PMID: 36231439 PMCID: PMC9566211 DOI: 10.3390/ijerph191912139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/12/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Given the increased exposure to e-cigarettes and nicotine among young adults, difficulty in quitting vaping is likely, which supports the need for effective behavioral interventions. Therefore, this cross-sectional study aims to assess the testability of the contemporary multi-theory model of health behavior change in predicting the vaping quitting behavior among young adults in the United States. METHODS A nationally representative sample of 619 young adults engaged in vaping behavior and aged 18-24 years was recruited to complete a 49-item web-based survey. A structural equation model was used to test relationships between MTM constructs. Hierarchical multiple regression was utilized to predict the variance in the initiation and sustenance of vaping quitting behavior by predictor variables, such as demographic characteristics, history of behaviors, and MTM constructs. RESULTS Of 619 respondents, over 75% were White and nearly 70% had educational attainment equal to high school or some college. In total, 62% of respondents were using nicotine, followed by 33.3% were using cannabis. About 80% of the respondents reported being engaged in drinking alcohol, and nearly 45% were engaged in cigarette smoking. The predictive effect of all MTM constructs on vaping quitting initiation (adjusted R2 = 0.417, F (23, 595) = 20.215, p < 0.001) and sustenance (adjusted R2 = 0.366, F (23, 595) = 16.533, p < 0.001) was statistically significant. CONCLUSIONS The findings of this study point to the usability and applicability of MTM in operationalizing and developing vaping quitting behavior interventions targeting young adults.
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Affiliation(s)
- Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
| | - Ravi Batra
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Department of Information Technology, Coforge Ltd., Atlanta, GA 30338, USA
| | - Chia-Liang Dai
- Department of Teaching and Learning, College of Education, University of Nevada, Las Vegas, NV 89154, USA
| | - Traci Hayes
- College of Nursing, School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Melinda J. Ickes
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY 40509, USA
| | - Tejinder Pal Singh
- Department of Family and Preventive Medicine, Division of Public Health, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA
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23
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Palmer AM, Price SN, Foster MG, Sanford BT, Fucito LM, Toll BA. Urgent Need for Novel Investigations of Treatments to Quit E-cigarettes: Findings from a Systematic Review. Cancer Prev Res (Phila) 2022; 15:569-580. [PMID: 35816038 PMCID: PMC9444997 DOI: 10.1158/1940-6207.capr-22-0172] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/01/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022]
Abstract
E-cigarette use has been increasing globally over the past decade. Many use e-cigarettes as an alternative or method to quit cigarette smoking, whereas others use these products recreationally. As technology has advanced, many individuals have reported symptoms of dependence on these products and continue to use them beyond achieving abstinence from smoking. Despite individuals reporting interest in quitting, little is known about e-cigarette cessation. This systematic review sought to identify and evaluate all human subjects literature published on the outcome of e-cigarette cessation through September 2021. Of the 79 articles identified, 56 were cross-sectional, 6 were qualitative, 5 were cohort studies, 3 were experimental, 2 were mixed methods, and 7 reported intervention or case studies of e-cigarette cessation. Results showed youth generally had high intent to quit e-cigarettes, whereas results were mixed with adult samples. Youth were motivated to quit e-cigarettes by health concerns, whereas adults were motivated to quit e-cigarettes by cost, lack of satisfaction, and psychologic factors. Adults were more likely to report past e-cigarette quit attempts, most commonly "cold turkey." Few interventions tested strategies for e-cigarette cessation, with a majority targeted for youth. Given the lack of information on e-cigarette cessation, recommendations for future studies are outlined.
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah N. Price
- Department of Psychology, University of Arizona, Tucson, AZ, USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Madeline G. Foster
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Brandon T. Sanford
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Family Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Lisa M. Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT USA,Yale Cancer Center, New Haven, CT USA
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA,Department of Psychiatry, Yale School of Medicine, New Haven, CT USA
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24
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Wood LA, Agbonlahor O, Tomlinson MM, Kerstiens S, Vincent K, McLeish AC, Walker KL, Hart JL. Readability of online e-cigarette cessation information. Tob Induc Dis 2022; 20:53. [PMID: 35795399 PMCID: PMC9175538 DOI: 10.18332/tid/149906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/08/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Given the growing awareness of the health risks associated with e-cigarettes, many users will access information about how to effectively quit using e-cigarettes, and the internet likely will be a popular source of information. However, little is known about the readability of online e-cigarette cessation information. Therefore, the goal of the current study was to assess the readability of webpage information about e-cigarette cessation. METHODS A search of webpages was conducted using the following search terms: vaping addiction, quit vaping, quit Juul, stop vaping, stop Juul, and vaping cessation. The 464 webpages identified were coded for target audience, message valence, and source, and then assessed for reading level with the Flesch-Kincaid Grade Level assessment. RESULTS On average, webpage content was written at a 7th grade reading level (Flesch-Kincaid Grade Level Mean=7.34, SD=2.22) and less than 25% of webpages met readability guidelines (i.e. ≤6th grade reading level). There were no differences in readability by target audience, message valence, or webpage source. CONCLUSIONS The results suggest that most online content related to e-cigarette cessation is not written at a level that is easily understood by general audiences. Thus, tobacco control advocates should assess the reading level of their messaging to ensure wide accessibility of information.
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Affiliation(s)
- Lindsey A Wood
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Osayande Agbonlahor
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Madeline M Tomlinson
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Savanna Kerstiens
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Kolbie Vincent
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Alison C McLeish
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,Department of Psychological and Brain Sciences, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
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25
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Exploring Definitions of "Addiction" in Adolescents and Young Adults and Correlation with Substance Use Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138075. [PMID: 35805733 PMCID: PMC9266281 DOI: 10.3390/ijerph19138075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022]
Abstract
(1) Background: Young people engage in addictive behaviors, but little is known about how they understand addiction. The present study examined how young people describe addiction in their own words and correlations between their definitions and substance use behaviors. (2) Methods: Young adults (n = 1146) in the PACE Vermont Study responded to an open-ended item “what does “addiction” mean?” in 2019. Responses were coded using three inductive categories and fifteen subcategories. Quantitative analyses examined correlations between addiction theme definitions, demographics, and substance use behaviors. (3) Participants frequently defined addiction by physiological (68%) and psychological changes (65%) and less by behavioral changes (6%), or all three (3%); young adults had higher odds of defining addiction as physiological or behavioral changes than adolescents. Participants who described addiction as “psychological changes” had lower odds of ever electronic vapor product use (OR 0.75, 95% CI 0.57−1.00) than those using another definition, controlling for age and sex. (4) Perceptions of addiction in our sample aligned with existing validated measures of addiction. Findings discriminated between familiar features of addiction and features that may be overlooked by young adults. Substance users may employ definitions that exclude the symptoms they are most likely to experience.
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Sanchez S, Kundu A, Limanto E, Selby P, Baskerville NB, Chaiton M. Smartphone Apps for Vaping Cessation: Quality Assessment and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e31309. [PMID: 35343904 PMCID: PMC9002586 DOI: 10.2196/31309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/08/2021] [Accepted: 01/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background As the prevalence of electronic cigarette (e-cigarette) use, or vaping, continues to grow, particularly among young people, so does the need for research and interventions to address vaping. Objective This study examines the quality of free vaping cessation apps, their contents and features, popularity among users, and adherence to evidence-based principles. Methods A systematic search of existing apps for vaping cessation was conducted in December 2020. Eligible apps were free, in English, and included features specifically targeting vaping cessation. Each app included in the analysis was used daily for at least seven consecutive days, assessed using the Mobile App Rating Scale, and rated by at least two authors (AK, EL, or SS) based on adherence to evidence-based practices. Intraclass correlation coefficient (ICC) estimates were computed to assess interrater reliability (excellent agreement; ICC 0.92; 95% CI 0.78-0.98). Results A total of 8 apps were included in the quality assessment and content analysis: 3 were developed specifically for vaping cessation and 5 focused on smoking cessation while also claiming to address vaping cessation. The mean of app quality total scores was 3.66 out of 5. Existing vaping cessation apps employ similar approaches to smoking cessation apps. However, they are very low in number and have limited features developed specifically for vaping cessation. Conclusions Given the lack of vaping cessation interventions at a time when they are urgently needed, smartphone apps are potentially valuable tools. Therefore, it is recommended that these apps apply evidence-based practices and undergo rigorous evaluations that can assess their quality, contents and features, and popularity among users. Through this process, we can improve our understanding of how apps can be effective in helping users quit vaping.
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Affiliation(s)
- Sherald Sanchez
- Institute of Medical Science, Termerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anasua Kundu
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Limanto
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Michael Chaiton
- Institute of Medical Science, Termerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
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27
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Palmer AM, Tomko RL, Squeglia LM, Gray KM, Carpenter MJ, Smith TT, Dahne J, Toll BA, McClure EA. A pilot feasibility study of a behavioral intervention for nicotine vaping cessation among young adults delivered via telehealth. Drug Alcohol Depend 2022; 232:109311. [PMID: 35123362 PMCID: PMC8885867 DOI: 10.1016/j.drugalcdep.2022.109311] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nicotine vaping among youth has increased, warranting concern from tobacco control proponents. Many youth who vape indicate interest in quitting; however, few empirically supported vaping cessation interventions exist. This pilot feasibility study adapted an established behavioral intervention, contingency management (CM), delivered via telehealth to promote vaping cessation among young adults. METHODS Participants (N = 27; ages 17-21) vaping nicotine regularly were recruited via social media and digital advertisements from across the US (June 2020-January 2021). Participants were randomized at approximately 4:1 to CM or Monitoring control (22:5). CM was delivered through DynamiCare Health's smartphone app for 4 weeks, in which financial incentives were delivered contingent on abstinent cotinine samples after the quit day until the end of treatment (EOT; Days 7-28; 10 expected submissions). Control participants earned incentives for submitting cotinine, regardless of abstinence. Feasibility, acceptability, and abstinence was collected throughout treatment, at EOT, and at 1-month follow-up. RESULTS The majority of enrolled participants completed treatment (Monitoring: 5/5; CM: 20/22), and intervention components were rated favorably overall (> 80%). CM participants submitted 112/220 (55%) abstinent cotinine samples throughout the quit attempt, while the Monitoring group submitted 4/50 (8%) negative samples. There were no differences in abstinence between groups at EOT or follow-up. CONCLUSION This pilot study of a telehealth-based youth vaping cessation intervention demonstrated preliminary feasibility and acceptability. These results suggest that CM for young adult vaping cessation, delivered remotely, is a promising direction for future work and fully powered trials are warranted to assess intervention efficacy.
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Rachel L. Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew J. Carpenter
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Tracy T. Smith
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Erin A. McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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Hobkirk AL, Hoglen B, Sheng T, Kristich A, Yingst JM, Houser KR, Krebs NM, Allen SI, Bordner CR, Livelsberger C, Foulds J. Intentions and Attempts to Quit JUUL E-Cigarette Use: The Role of Perceived Harm and Addiction. Prev Chronic Dis 2022; 19:E06. [PMID: 35113784 PMCID: PMC8880109 DOI: 10.5888/pcd19.210255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Research on electronic cigarette (e-cigarette) quit intentions and attempts is limited despite the potential health benefits of quitting, especially for long-term users. The current study aimed to investigate perceptions of harm and addictiveness and tobacco use characteristics associated with quit variables among users of a popular e-cigarette brand, JUUL. Methods We surveyed 301 US adult JUUL users on their tobacco use characteristics, perceptions of JUUL harm and addictiveness, and quit variables at 3 time points, from July 2019 to April 2020. We used logistic regression models to assess demographic characteristics, smoking characteristics, and perceptions of JUUL harm and addictiveness as correlates of e-cigarette quit intentions, attempts, importance, and confidence. Results Twenty-three percent of the sample had intentions to quit using JUUL within the year, and 22.6% reported making a lifetime quit attempt. The average rating of quit importance was 4.1 and quit confidence was 5.8 on a Likert scale of 1 to 10. More than 90% of the sample indicated that JUUL was at least moderately addictive, whereas less than one-quarter indicated that JUUL was as harmful or more harmful than smoking. Higher levels of perceived JUUL addictiveness were associated with more quit intentions, attempts, and importance. Higher levels of perceived JUUL harm compared with smoking were associated with more quit importance. Conclusion Our findings suggest that a small proportion of adult JUUL users are interested in quitting. Self-reported perceptions of JUUL’s addiction potential may be related to more quit attempts. Findings highlight the need for evidence-based information on e-cigarette addictiveness and effective strategies for cessation.
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Affiliation(s)
- Andréa L Hobkirk
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Pennsylvania State University College of Medicine, 500 University Dr, Mail Code CH69, Hershey, PA 17033.
| | - Brianna Hoglen
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Tianhong Sheng
- Department of Statistics, Pennsylvania State University, State College, Pennsylvania
| | - Ava Kristich
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Jessica M Yingst
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Kenneth R Houser
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Nicolle M Krebs
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Sophia I Allen
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Candace R Bordner
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Craig Livelsberger
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Jonathan Foulds
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Center for Research on Tobacco and Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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Bold K, Kong G, Cavallo D, Davis D, Jackson A, Krishnan-Sarin S. School-based E-cigarette cessation programs: What do youth want? Addict Behav 2022; 125:107167. [PMID: 34753093 PMCID: PMC8629945 DOI: 10.1016/j.addbeh.2021.107167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE E-cigarette use is a problem among youth, yet few vaping cessation programs exist. This study aimed to understand what youth want in a school-based vaping cessation program to inform intervention development. METHODS We conducted 8 focus groups in Fall 2019 with Connecticut high school youth (N = 4-10 adolescents per group, total N = 62, 50% female). 6 groups were with youth who were current (i.e., past-month) e-cigarette users and 2 groups were with past users (i.e., lifetime users with no past-month use). Discussions focused on desired features and concerns about a vaping cessation program and analyses used an iterative inductive and deductive approach to identify qualitative themes. We also collected brief survey data assessing skills youth wanted to learn from a vaping cessation program. RESULTS Qualitative themes emerged indicating that youth want a vaping cessation program to include education about health effects of vaping, relatable personal anecdotes from others, and rewards for quitting. Potential concerns include confidentiality (e.g., ensuring teachers/coaches would not know about e-cigarette use), perceptions that youth may not want to participate due to lack of interest/apathy or embarrassment, and needing methods to verify abstinence to limit inaccurate reporting. The most frequently endorsed skills from the survey indicated youth want to learn ways to deal with stress (92%), relax (60%), and deal with poor concentration/attention (55%). CONCLUSIONS Findings identified key features to include and issues to address when developing school-based vaping cessation programs. Developing effective vaping cessation programs that appeal to youth is important for addressing youth e-cigarette use.
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Affiliation(s)
- Krysten Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Dana Cavallo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Danielle Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Asti Jackson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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30
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Sidani JE, Hoffman BL, Colditz JB, Melcher E, Taneja SB, Shensa A, Primack B, Davis E, Chu KH. E-Cigarette-Related Nicotine Misinformation on Social Media. Subst Use Misuse 2022; 57:588-594. [PMID: 35068338 PMCID: PMC9257904 DOI: 10.1080/10826084.2022.2026963] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background. Twitter provides an opportunity to examine misperceptions about nicotine and addiction as they pertain to electronic nicotine delivery systems (ENDS). The purpose of this study was to systematically examine a sample of ENDS-related tweets that presented information about nicotine or addiction for the presence of potential misinformation.Methods. A total of 10.1 million ENDS-related tweets were obtained from April 2018 through March 2019 and were filtered for unique tweets containing keywords for nicotine and addiction. A subsample (n = 3,116) were human coded for type of account (individual, group, commercial, or news) and presence of potential misinformation.Results. Of tweets that presented ENDS-related nicotine or addiction information (n = 904), 41.7% (n = 377) contained potential misinformation coded as anti-vaping exaggeration, pro-vaping exaggeration, nicotine is not addictive or is never harmful, or unproven health benefits.Conclusions. Anti-vaping exaggeration tweets distorted or embellished claims about ENDS nicotine and addiction; pro-vaping exaggeration tweets misinterpreted results from scientific studies. Misinformation that nicotine is not addictive or is never harmful or has unproven health benefits appeared less but are potentially problematic. ENDS-related messaging should be designed to be easily understood by the public and monitored to detect the spread of misinterpretation or misinformation on social media.
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Affiliation(s)
- Jaime E Sidani
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Beth L Hoffman
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jason B Colditz
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eleanna Melcher
- Medical Scientist Training Program, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Sanya Bathla Taneja
- Intelligent Systems Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ariel Shensa
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, Arkansas, USA
| | - Esa Davis
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kar-Hai Chu
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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31
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Brooks JM, Mermelstein RJ. Negative Affect and Cigarette Cessation in Dual Users of Cigarettes and Electronic Nicotine Delivery Systems. Subst Use Misuse 2022; 57:1294-1302. [PMID: 35611915 PMCID: PMC10108370 DOI: 10.1080/10826084.2022.2079135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives: Dual use of cigarettes and electronic nicotine delivery systems (ENDS) is increasingly common in adult smokers, who often report using ENDS to quit smoking. Elevated negative affect is an established predictor of increased difficulty quitting smoking combustible cigarettes but has not yet been examined in the context of cigarette cessation for dual users. Method: This study examined whether mood-related factors predict cigarette smoking cessation among dual users (N = 364) over 12-months. Self-reported cigarette smoking at 12 months, with abstinence defined as no smoking for the past 7 days, was the primary outcome variable. Logistic regression included baseline levels of depression symptoms (CES-D), anxiety symptoms (MASQ), and negative affect expectancies for smoking, with baseline nicotine dependence for cigarettes (NDSS), motivation to quit, age, race/ethnicity, rate of cigarette smoking at baseline, and ENDS usage at baseline and 12 months as covariates. Interactions between CES-D, MASQ, and negative affect expectancies were examined. We predicted that negative affect, especially for smokers who had high negative affect expectancies for smoking, would be negatively associated with quitting. Results: Contrary to expectations, negative affect constructs did not predict quitting. Baseline nicotine dependence for cigarettes, gender, and race/ethnicity significantly predicted the likelihood of cigarette cessation. Higher rates of ENDS use, higher motivation, and lower negative affect smoking expectancies were significantly correlated with quitting cigarettes. Conclusion: In this non-treatment seeking sample of dual users, negative affect did not predict cigarette cessation over and above nicotine dependence for cigarettes, gender, and race/ethnicity.
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Affiliation(s)
- Julia M Brooks
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Robin J Mermelstein
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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32
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Youth vaping: a review and update on global epidemiology, physical and behavioral health risks, and clinical considerations. Eur J Pediatr 2022; 181:453-462. [PMID: 34396473 PMCID: PMC8364775 DOI: 10.1007/s00431-021-04220-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/24/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022]
Abstract
Worldwide, youth electronic cigarette use (vaping) has risen significantly over the past decade. This public health concern has spurred many high-quality studies characterizing country-specific prevalence, risk factors, physical and behavioral health complications, and optimal methods of assessment and counseling for youth vaping. Clinicians remain underexposed to this recent work, limiting translation of evidence into higher quality patient care. This review aims to provide pediatricians and other clinicians working with youth a clinically focused survey of key research findings and considerations based on recent evidence. This narrative review surveys emerging trends in EC use across different countries, reasons for youth vaping, characteristics of vaping materials that promote youth use, associations with combustible cigarette use, relation with cannabis and other illicit substances, physical and behavioral health risks associated with vaping, and methods of assessment, counseling, and intervention for problematic vaping in youth. Since vaping remains a relatively new phenomenon, long-term health consequences remain unknown.Conclusion: Youth vaping is an increasingly well-studied phenomenon with both physical and behavioral health risks. Pediatricians and other youth-focused clinicians can apply the lessons of recent research in work with youth and their families. What is Known: • Youth vaping is an increasingly prevalent public health concern. • Recent research demonstrates physical and behavioral health risks associated with vaping as well as methods for assessment, counseling, and intervention. What is New: • The current review summarizes the latest evidence in a clinically focused framework to facilitate translation of emerging knowledge to practice.
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33
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Ahuja NA, Kedia SK, Jiang Y, Ward KD, Pichon LC, Dillon PJ, Yu X, Xie L. Factors Associated with E-Cigarette Quit Intention Among Adolescents in the United States. Subst Use Misuse 2022; 57:2074-2084. [PMID: 36205511 DOI: 10.1080/10826084.2022.2130000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
Background: Given increasing use of e-cigarettes among adolescents in the United States and its potential for nicotine addiction, encouraging adolescents to quit using these products has become a public health priority. This study examined factors at various socio-ecological levels associated with e-cigarette quit intention (pre-contemplation, contemplation, or preparation) using the Stages of Change of the Trans-theoretical Model among the U.S. adolescents. Methods: We used cross-sectional data from the past 30-day adolescent exclusive e-cigarette users participating in Wave 4 of the Population Assessment of Tobacco and Health study (n = 349). Weighted adjusted multinomial logistic regression models were used to analyze the data. Results: Compared to pre-contemplators and contemplators, preparators were more likely to believe that nicotine in e-cigarettes was "very/extremely harmful" (vs. "not at all harmful") to health (p < 0.001) and people cause a "lot of harm" (vs. "no harm") to themselves when they use e-cigarettes (p < 0.001). In comparison to pre-contemplators, contemplators and preparators were more likely to report that their parents/guardians talked with them about not using e-cigarettes than those whose parents/guardians did not talk with them (p < 0.001). Additionally, contemplators and preparators were also more likely to report that they "often/very often" (vs. never) noticed health warnings on e-cigarette packages (p < 0.001). Conclusion: Our findings suggest that harm perception, influence of family, and e-cigarette health warnings are some of the important factors associated with the stages of change for intention to quit among adolescent e-cigarette users. This study will help public health practitioners and researchers design multi-level e-cigarette cessation interventions for adolescents.
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Affiliation(s)
- Nikhil A Ahuja
- Department of Public Health and Social Work, Slippery Rock University of Pennsylvania, Slippery Rock, Pennsylvania, USA
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Yu Jiang
- Division of Epidemiology and Biostatistics, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, Ohio, USA
| | - Xinhua Yu
- Division of Epidemiology and Biostatistics, School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Lu Xie
- Division of Epidemiology and Biostatistics, School of Public Health, University of Memphis, Memphis, Tennessee, USA
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34
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Struik L, Yang Y. e-Cigarette Cessation: Content Analysis of a Quit Vaping Community on Reddit. J Med Internet Res 2021; 23:e28303. [PMID: 34694229 PMCID: PMC8576600 DOI: 10.2196/28303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/20/2021] [Accepted: 07/19/2021] [Indexed: 01/20/2023] Open
Abstract
Background e-Cigarette use, also known as vaping, has increased dramatically over the past few years, especially among younger demographics. However, researchers have found that a large number of e-cigarette users want to quit. Little is known about the unique aspects of vaping cessation, which is critical to informing the development of relevant resources and interventions for e-cigarette users who want to quit. Social media forums such as Reddit provide opportunities to understand the experiences of behavior change such as quitting vaping from the perspective of end users. Objective This study aims to examine a quit vaping subreddit to understand how e-cigarette users are experiencing and approaching vaping cessation. Specifically, we examine methods used to approach quitting, reasons for quitting, and barriers and facilitators to quitting. Methods A total of 1228 posts were collected. The posts were inductively coded to generate categories and subcategories using conventional content analysis. Data were analyzed using the NVivo 12 qualitative data analysis software. Results Most users reported a preference for approaching quitting through gradual reduction, particularly through the use of their own devices by tapering the nicotine content. Their reasons for quitting were primarily related to experiencing negative physical consequences associated with vaping, especially in relation to their lungs (eg, tight chest), and tired of feeling stuck to the vape because of nicotine addiction. Top barriers to quitting were related to withdrawal symptoms and intensity of addiction. The top facilitators to quitting were related to using distraction techniques (eg, hobby, gaming, and mindfulness exercises), as well as having a positive mindset. Conclusions The findings of this study reveal unique aspects that encompass the process of quitting vaping. These findings have significant implications for both policy and intervention development.
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Affiliation(s)
- Laura Struik
- School of Nursing, Department of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Youjin Yang
- School of Nursing, Department of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada
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35
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Kechter A, Cho J, Miech RA, Barrington-Trimis JL, Leventhal AM. Nicotine dependence symptoms in U.S. youth who use JUUL E-cigarettes. Drug Alcohol Depend 2021; 227:108941. [PMID: 34416679 PMCID: PMC8464491 DOI: 10.1016/j.drugalcdep.2021.108941] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/24/2021] [Accepted: 07/03/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To estimate the prevalence, patterns, and correlates of self-reported nicotine dependence symptoms among U.S. youth who use JUUL - a widely-sold e-cigarette brand - in 2019 and compare findings to nicotine dependence symptoms in youth who smoke cigarettes. METHODS Data were from a nationally-representative subsample of 8th, 10th, and 12th grade students in the Monitoring the Future Study who had used JUUL or cigarettes in the past 30 days. Participants self-reported presence/absence of 9 different nicotine dependence symptoms for JUUL or cigarettes. Weighted percentages for JUUL or cigarette nicotine dependence symptom status (≥1 vs. 0 symptoms) and severity (count, range: 0-9) were calculated. Among JUUL users, we estimated associations of sociodemographic characteristics and other substance use with nicotine dependence and severity. RESULTS Among 1,748 past 30-day JUUL users, 41.3 % screened positive for ≥1 nicotine dependence symptoms; the mean symptom count was 1.6 (SD = 2.6). Non-nicotine substance use and more frequent JUUL use was associated with significantly greater odds of dependence and more severe dependence symptoms in multivariable models. The severity distribution of most (craving) and least (inability to quit) dependence symptom types observed in JUUL dependence paralleled those observed in analysis of combustible cigarette dependence symptoms in past 30-day smokers. CONCLUSION A substantial proportion of U.S. adolescent JUUL users reported symptoms of nicotine dependence, which is greater for those who vape more frequently and use other substances. Nicotine dependence screening, prevention, and regulatory policies addressing use of JUUL or similar e-cigarette products should be considered to protect U.S. youth.
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Affiliation(s)
- Afton Kechter
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States.
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA
| | - Richard A. Miech
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | | | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA,Institute for Addiction Science, University of Southern California, Los Angeles, CA
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36
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Dai H. Prevalence and Factors Associated With Youth Vaping Cessation Intention and Quit Attempts. Pediatrics 2021; 148:peds.2021-050164. [PMID: 34408090 DOI: 10.1542/peds.2021-050164] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study sought to examine the prevalence and factors associated with youth vaping cessation behaviors. METHODS Current (past 30-day) electronic-cigarette (e-cigarette) users from the 2020 National Youth Tobacco Survey (n = 1660, typically aged 11-18 years) were analyzed to examine the prevalence of youth intention to quit vaping, past-year quit attempts, and the frequency of quit attempts. Multivariable logistic or linear regressions were performed to assess the correlates with youth vaping cessation behaviors. RESULTS In 2020, 53.4% of current e-cigarette users reported intention to quit vaping and 67.4% reported having tried to quit vaping. Intention to quit was lower among female individuals (versus male individuals, adjusted odds ratio [aOR] = 0.7, P = .0004), users of a modifiable system (versus disposable e-cigarettes, aOR = 0.4, P = .0204), and dual or poly users (versus sole e-cigarette use, aOR = 0.7, P = .0144). e-cigarette harm perception was positively associated with intention to quit (aOR = 2.2, P < .0001) and past-year quit attempts (aOR = 1.6, P = .0037). Reasons for e-cigarette use were related to cessation behaviors. Adolescents who vaped because of curiosity had higher odds of past-year quit attempts (aOR = 1.4, P = .0306), whereas users to disguise vaping had a lower likelihood of intention to quit (aOR=0.4, P < .0001) and past-year quit attempts (aOR = 0.7, P = .0126). The average number of past-year quit attempts was 5.3, and it was lower among female individuals (versus male individuals), users of e-cigarettes with prefilled pods or cartridges (versus disposable e-cigarettes), and those with nicotine cravings (versus no nicotine craving). CONCLUSIONS Intention to quit vaping and past-year quit attempts are prevalent among US adolescent e-cigarette users. The study findings inform the development of multifaceted vaping cessation programs to take sex, e-cigarette devices, vaping reasons and patterns, harm perception, and nicotine dependence into account.
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Affiliation(s)
- Hongying Dai
- College of Public Health, University of Nebraska Medical Center, University of Nebraska, Omaha, Nebraska
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37
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Gaiha SM, Halpern-Felsher B. Stemming the tide of youth E-cigarette use: Promising progress in the development and evaluation of E-cigarette prevention and cessation programs. Addict Behav 2021; 120:106960. [PMID: 33940340 DOI: 10.1016/j.addbeh.2021.106960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Shivani Mathur Gaiha
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, United States
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, United States.
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38
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Berg CJ, Krishnan N, Graham AL, Abroms LC. A synthesis of the literature to inform vaping cessation interventions for young adults. Addict Behav 2021; 119:106898. [PMID: 33894483 PMCID: PMC8113079 DOI: 10.1016/j.addbeh.2021.106898] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 12/01/2022]
Abstract
There is an urgent need to address young adult (YA) vaping. However, there is limited vaping cessation intervention research, particularly studies tested via experimental designs. This manuscript focuses on YA vaping and critical needs for research to advance vaping cessation interventions for YAs. The smoking cessation literature, especially regarding YA smoking, provides evidence and theory from which to draw. However, the extent to which this literature has utility for vaping cessation warrants investigation. Research to inform the development and optimization of effective vaping cessation interventions for YAs requires attention to both potential targets for behavioral intervention (e.g., conceptual framework) and how to best reach YAs (i.e., delivery modality). Regarding the former, such interventions must consider the complexity of YA vaping (e.g., complex social influences, limited negative outcome expectancies, quit intentions). One particularly challenging aspect of YA cessation is co-use of other tobacco products and marijuana and ensuring that those who quit vaping do not continue or increase other product use. With regard to intervention modality, technology-based interventions (e.g., text messaging, apps) may prove promising, and individualized intervention (e.g., one-on-one counseling) may be needed to carefully intervene on the complexity of substance use, particularly cigarette and marijuana use, within this population.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States.
| | - Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Amanda L Graham
- Innovations Center, Truth Initiative, Washington, DC, United States; Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States
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39
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Simpson KA, Kechter A, Schiff SJ, Braymiller JL, Yamaguchi N, Ceasar RC, Bluthenthal RN, Barrington-Trimis JL. Characterizing symptoms of e-cigarette dependence: a qualitative study of young adults. BMC Public Health 2021; 21:959. [PMID: 34016066 PMCID: PMC8138971 DOI: 10.1186/s12889-021-10945-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/15/2021] [Indexed: 12/04/2022] Open
Abstract
Background While rates of e-cigarette use (‘vaping’) continue to potentiate concern, there is limited data on common symptoms of e-cigarette dependence among young adults who vape. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives. Methods Between June 2018 and 2019, in-depth qualitative interviews were conducted with 62 young adults who use e-cigarettes (aged 18–25) and live in Southern California. We explored participants’ product preferences, daily e-cigarette use patterns, vaping history, withdrawal experiences, and quit attempts or periods of cessation. We used a thematic analysis approach to interpret the transcripts. Results Young adults discussed nine dimensions of vaping dependence that were organized into two categories: 1) general nicotine dependence symptoms, and 2) unique dependence symptoms related to vaping. Nicotine dependence symptoms included cravings and urgency to use, increased use to achieve desired effects, and unsuccessful quit attempts and withdrawal. Symptoms unique to vaping dependence included greater nicotine consumption due to accessibility and lack of restrictions, habitual vaping, inability to track vaping frequency, immediate gratification and comfort, social acceptability and norms, and awareness of vaping dependency. Conclusions In addition to nicotine dependence symptoms that have been characterized for other tobacco products, young adult e-cigarette users described unique symptoms of vaping dependence that necessitate the need for more refined measures. All dimensions of vaping dependence should be considered in discussions of policies as well as treatment and education efforts intended to protect young people from e-cigarette dependence. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10945-z.
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Affiliation(s)
- Kelsey A Simpson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.
| | - Afton Kechter
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Sara J Schiff
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Jessica L Braymiller
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.,Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Naosuke Yamaguchi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Rachel Carmen Ceasar
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Ricky N Bluthenthal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.,Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Jessica L Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.,Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
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Kong G, Bold KW, Cavallo DA, Davis DR, Jackson A, Krishnan-Sarin S. Informing the development of adolescent e-cigarette cessation interventions: A qualitative study. Addict Behav 2021; 114:106720. [PMID: 33162230 DOI: 10.1016/j.addbeh.2020.106720] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/15/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Adolescents are using e-cigarettes at high rates and there is limited information on how to help them quit. We aimed to inform e-cigarette cessation interventions by understanding why adolescents use and dislike e-cigarettes and their quit experiences. METHODS Six focus groups with current users (i.e., past-month use) and 2 focus groups with past users (i.e., no past-month use) were conducted in Fall 2019 in Connecticut (N = 62). We used a focus group guide and an iterative approach to identify themes. RESULTS Adolescents used e-cigarettes because of social reasons and to relieve stress and reported disliking e-cigarettes due to the cost, negative health effects, and addiction. They reported both intentional and unintentional experiences with quitting e-cigarettes. Reasons for unintentional quitting included lack of access to e-cigarettes. Reasons for intentional quitting included short-term "tolerance breaks" and health concerns. Of those who tried to quit, common quitting methods were "cold turkey," giving away their device, and limiting interactions with peer users. The most common withdrawal symptom was negative mood. Notable barriers to quitting included exposure to social influences at school, easy access to e-cigarettes, and lack of motivation to quit. DISCUSSION Our qualitative evidence suggests that e-cigarette cessation interventions need to motivate youth to quit, and teach them to manage social influences, stress and other negative mood, and withdrawal symptoms. Interventions that address social norms related to use of e-cigarettes in school and reduce cues related to e-cigarette use may also be beneficial.
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Klemperer EM, Villanti AC. Why and how do dual users quit vaping? Survey findings from adults who use electronic and combustible cigarettes. Tob Induc Dis 2021; 19:12. [PMID: 33603595 PMCID: PMC7885258 DOI: 10.18332/tid/132547] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Most adults who use electronic cigarettes (ECs) also smoke combustible cigarettes (CCs). Quitting ECs appears common among dual users but little is known regarding adult dual users’ motivations and methods to quit ECs or how this relates to quitting CCs. METHODS We used Amazon Mechanical Turk, a web-based crowd-sourcing service, to survey 366 US adults with a history of regular EC and CC use. This analysis examined motivations and methods to quit both products among a subset of 204 (55.7%) respondents with dual use and a history of one or more attempts to quit ECs. RESULTS Most respondents (95%) were using ECs at the time of this survey and had a lifetime median of five EC quit attempts. The most common motivations to quit ECs were health (74%), money/cost (45%), and to reduce risk of COVID-19 (25%). The most common EC quit methods were cutting down (68%), getting advice from a doctor (28%), quitting 'cold turkey' (24%), nicotine replacement therapy (24%), and switching to ECs with less nicotine (24%). Most motivations and methods to quit ECs and CCs were moderately to highly correlated, suggesting similarity in dual users’ approach to quitting the two products. CONCLUSIONS Dual users had a range of motivations and methods to quit ECs, most of which were similar to their motivations and methods to quit CCs. These findings support the need to develop treatment for adults motivated to quit ECs and demonstrate that dual users may currently engage in similar strategies to quit both products.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, United States.,Department of Psychological Science, University of Vermont, Burlington, United States
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, United States.,Department of Psychological Science, University of Vermont, Burlington, United States
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Dobbs PD, Lu Y, Dunlap CM, Newcombe KV, Baer CM, Hodges E, Cheney MK. Young adults' intention to quit using JUUL. Drug Alcohol Depend 2021; 218:108399. [PMID: 33250381 DOI: 10.1016/j.drugalcdep.2020.108399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND With research indicating some young audiences may desire to quit using JUUL, a high-nicotine e-cigarette, we sought to explore factors that may motivate them to quit. METHODS This sequential, mixed methods study included a cross-sectional online survey of college students (n = 631) followed by in-person interviews (n = 51) with survey participants. Data were collected March-April 2019. The survey asked about intention to quit using JUUL. A latent class analysis (LCA) identified participant groups who would quit for various reasons. Participants were also asked 'Can you be too old to JUUL?' during the survey. During the interviews, participants were provided preliminary survey findings and asked about their perceptions of the data. Interview participants were also asked about their expectations for future use of JUUL. RESULTS Four classes emerged from the LCA, indicating costs to self (i.e., harm to lungs/brain, price; 46.8%), financial costs (36.6%), all costs (e.g., social, monetary, health; 9.3%), and harm to self (7.3%) may have influenced our sample's decision to quit using JUUL. Interviewees affirmed desires to quit using JUUL, especially after leaving college. Only 27.19% of survey participants reported an age threshold for using JUUL (M = 31.8 years, SD = 10.0); however, several interviewees explained that although someone could not be too old to JUUL, it would be 'immature' or 'childish' for adults who were not trying to quit smoking to use JUUL socially. DISCUSSION Comprehensive tobacco control strategies such as taxing e-cigarettes, marketing campaigns, and nicotine cessation programs are needed to help nicotine dependent young adults quit using high-nicotine e-cigarettes.
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Affiliation(s)
- P D Dobbs
- Health, Human Performance and Recreation Department, University of Arkansas, 308A HPER Building, Fayetteville, AR, 72701, United States.
| | - Y Lu
- Health and Exercise Science Department, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, United States
| | - C M Dunlap
- Health and Exercise Science Department, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, United States
| | - K V Newcombe
- Health and Exercise Science Department, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, United States
| | - C M Baer
- Health and Exercise Science Department, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, United States
| | - E Hodges
- Health and Exercise Science Department, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, United States
| | - M K Cheney
- Health and Exercise Science Department, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, United States
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Pulvers K, Correa JB, Krebs P, El Shahawy O, Marez C, Doran N, Myers M. JUUL E-Cigarette Quit Attempts and Cessation Perceptions in College Student JUUL E-Cigarette Users. Am J Health Promot 2020; 35:624-632. [PMID: 33353369 DOI: 10.1177/0890117120982408] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study describes the frequency of JUUL e-cigarette (referred to as JUUL) quit attempts and identifies characteristics associated with confidence in quitting and perceived difficulty quitting JUUL. DESIGN Cross-sectional study from a self-administered online survey. SETTING Two public southern California universities. PARTICIPANTS A total of 1,001 undergraduate students completed the survey from February to May 2019. MEASURES Self-report measures about JUUL included use, history of quit attempts, time to first use, perceived difficulty with cessation/reduction, and confidence in quitting. ANALYSIS Binary logistic regressions were used to identify demographic and tobacco-related behavioral correlates of JUUL cessation-related perceptions and behaviors. RESULTS Nearly half of ever-JUUL users (47.8%) reported a JUUL quit attempt. Adjusting for demographic factors and other tobacco product use, shorter time to first JUUL use after waking was associated with lower confidence in quitting JUUL (aOR = 0.02, 0.00-0.13) and greater perceived difficulty in quitting JUUL (aOR = 8.08, 2.15-30.35). Previous JUUL quit attempt history was also associated with greater odds of perceived difficulty quitting JUUL (aOR = 5.97, 1.74-20.53). CONCLUSIONS History of JUUL quit attempts among college students was common. Those who had previously tried quitting were more likely to perceive difficulty with cessation. Time to first JUUL use, a marker of dependence, was linked with greater perceived cessation difficulty and lower confidence in quitting. These findings suggest that there is a need for cessation and relapse prevention support for college student JUUL users.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, 383559California State University San Marcos, San Marcos, CA, USA
| | - John B Correa
- VA San Diego Healthcare System, 19979University of California, San Diego, La Jolla, CA, USA
| | - Paul Krebs
- VA San Diego Healthcare System, 19979University of California, San Diego, La Jolla, CA, USA
| | - Omar El Shahawy
- Population Health Department, 12296New York University School of Medicine, New York, NY, USA
| | - Crystal Marez
- Department of Psychology, 383559California State University San Marcos, San Marcos, CA, USA
| | - Neal Doran
- VA San Diego Healthcare System, 19979University of California, San Diego, La Jolla, CA, USA
| | - Mark Myers
- VA San Diego Healthcare System, 19979University of California, San Diego, La Jolla, CA, USA
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