Background

An interactive and tailored text message program demonstrated increased self-reported vaping cessation rates for adolescents according to a recent study published in JAMA.¹

E-cigarettes are the most commonly-used tobacco products among adolescents, wrote the study investigators, led by Amanda L. Graham, PhD, of Innovations Center, Truth Initiative, in Washington, DC. Most e-cigarettes contain nicotine, which can harm parts of the adolescent's brain that control learning, attention, mood, and impulse control, according to the Centers for Disease Control and Prevention.^1,2

"Although several vaping cessation programs are available with evaluation efforts underway, there are no published randomized trials of interventions to stop e-cigarette use among adolescents," wrote Graham and authors. "To fill this gap, a comparative effectiveness randomized clinical trial (RCT) of a vaping cessation intervention for adolescents was conducted. Delivered via text message, the intervention was proven effective among young adults in the only vaping cessation trial published to date. The present study tested the hypothesis that adolescents in the intervention group would be more likely to be abstinent at 7 months than participants in an assessment-only control group."

Study details and results

The study's primary outcome was to compare effectiveness of a text message program for nicotine vaping among adolescents with assessment-only control. The objective was sought via a parallel, 2-group, double-blind, individually RCT with follow-ups at 1 and 7 months after randomization, conducted from October 1, 2021 to October 18, 2023.¹

Study participants were recruited through social media ads. Interventions, delivered via text message, were completed online or by phone. To be eligible, participants were US-residents aged 13 to 17 years who reported past 30-day e-cigarette use, were interested in quitting within 30 days, and owned a mobile phone with an active texting plan. All study participants received monthly assessments via text about e-cigarette use.¹

"Assessment-only controls (n = 744) received only study retention text messages. Intervention participants (n = 759) also received an automated, interactive text message program for vaping cessation that delivers cognitive and behavioral coping skills training and social support," stated the authors.

The average age of the 1503 adolescents who were randomized was 16.4 years. Of the sample¹:

• 50.6% were female
• 42.1% were male
• 7.4% were nonbinary/other
• 10.2 were Black/African American
• 62.6% were White
• 18.5% were multiracial
• 8.7% were another race
• 16.2% were Hispanic
• 42.5% were sexual minority
• 76.2% vaped within 30 minutes of waking

With a 7-month follow-up rate of 70.8%, point-prevalence abstinence rates were 37.8% (95% CI, 34.4%-41.3%) for intervention participants and 28.0% (95% CI, 24.9%-31.3%) for control participants, with a relative risk of 1.35 (95% CI, 1.17-1.57 [P < .001]).¹

The authors noted that no baseline variables moderated the treatment-outcome relationship, and there was no evidence that adolescents who quit vaping switched to combustible tobacco products.¹

Conclusion

Patients who were randomized to the This is Quitting automated, tailored, and interactive text message program for vaping cessation were 35% more likely to quit vaping at 7 months compared to assessment-only control participants.¹

The investigative team concluded, "A tailored, interactive text message intervention increased self-reported vaping cessation rates among adolescents recruited via social media channels."¹

References:

1. Graham AL, Cha S, Jacobs MA, et al. A Vaping Cessation Text Message Program for Adolescent E-Cigarette Users: A Randomized Clinical Trial. JAMA. Published online August 07, 2024. doi:10.1001/jama.2024.11057.
2. E-cigarette use among youth. Centers for Disease Control and Prevention. Updated May 15, 2024. Accessed August 14, 2024. https://www.cdc.gov/tobacco/e-cigarettes/youth.html?s_cid=OSH_emg_GL0001&gad_source=1&gclid=Cj0KCQjwq_G1BhCSARIsACc7NxppKMkAXCKjSIWv3R1AeSU_BTb09AZgVFAPahax86PHrG6nZaBh2YoaAjGAEALw_wcB