United States: Text messaging service effective in helping young people quit vaping nicotine

According to a study published in the Journal of the American Medical Association[1], adolescents randomized to the arm receiving the Truth Initiative's text-based e-cigarette cessation program (This is Quitting) were 35% more likely to quit vaping nicotine within seven months than those randomized to the control arm.

The Truth Initiative Vaping Quit Program is part of its national prevention campaign; it is a free, anonymous text messaging (SMS) program designed to help young people quit vaping. Since This is Quitting was launched in 2019, more than 750,000 young people have registered for the program. This is Quitting includes messages designed to build confidence and skills to quit vaping, including cognitive and behavioral coping strategies, social support, and information about cessation medications. It draws on best practices from youth smoking/nicotine cessation research, formative research among youth, and experience with digital interventions for smoking cessation.

Conducted from October 2021 to October 2023, the study involved 1,503 adolescents ages 13 to 17 from across the United States who reported using e-cigarettes in the past 30 days and who wanted to quit vaping. About three-quarters of participants reported using e-cigarettes within 30 minutes of waking up—a common measure of nicotine dependence—and 9/10 reported feeling somewhat or very dependent on vaporized nicotine. Of these, 87 % had tried to quit vaping in the past year, and 53 % had made three or more quit attempts. A majority of adolescents surveyed reported issues with depression, sleep, anxiety, trauma, and polysubstance use (cannabis and/or tobacco).

An effective program to help teens quit vaping

Compared with the control group, participants who received the interactive SMS program were 35% more likely to report no nicotine use at the end of the seven-month study: vaping cessation rates were 37.8% in the intervention group, compared with 28% in the control group. It should be noted that there was no evidence of a possible shift in consumption towards smoked tobacco among vapers who had stopped.

Of note, among dual-user adolescents (vaping and smoking tobacco), 51% of participants who received the SMS program reported no longer vaping or smoking after seven months, compared to 30 % in the control group. Although the intervention was not focused on stopping tobacco products, the authors suggest that this program could also be effective for smoking cessation among adolescents.

Finally, the study showed that this program was also effective in adolescents with both high nicotine dependence and mental health problems.

E-cigarettes are the most common method of nicotine consumption among American adolescents

For nearly a decade, e-cigarettes have been the most commonly used nicotine consumption product among adolescents in the United States. In 2023, more than 2.1 million adolescents reported regular e-cigarette use (10 % of high school students, 4.6 % of middle school students). Thus, the development of interventions to help vaping stop has become a public health imperative in this country, given that more than one-third of them vape frequently (≥20 days/month). In addition, recent studies[2]-[3] have shown that young e-cigarette users want to quit, mainly for health and social reasons, and a majority of them try to quit each year, mostly without help or using methods that have not been proven to work.

The authors believe that text messaging is a scalable, effective, and cost-effective approach that can help youth quit nicotine vaping. This widely accessible approach could significantly reduce the prevalence of vaping among adolescents and improve their health.

©Generation Without Tobacco

AE

[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] Smith TT, Nahhas GJ, Carpenter MJ, et al. Intention to quit vaping among United States adolescents.   JAMA Pediatr. 2021;175(1):97-99. doi:10.1001/jamapediatrics.2020.2348

[3] Cha S, Amato MS, Papandonatos GD, et al. Changes over time in reasons for quitting vaping among treatment-seeking young people from 2019 to 2022.   Addict Behav Rep. 2023;19:100521. doi:10.1016/j.abrep.2023.100521