For young people who want to quit vaping, simple interventions such as hotlines, informational text messages and nicotine replacement are helpful tools for quitting smoking, a new study has found.
The research, published Wednesday (Dec. 11) in the American Journal of Preventive Medicine, explored these interventions in helping young people aged 18 to 25 quit vaping, and it reported surprisingly positive results.
Researchers at Ohio State University (OSU) placed 508 young adults, all of whom were interested in quitting vaping, into four treatment groups. These volunteers received various combinations of over-the-phone coaching, nicotine replacement therapy (NRT) and mobile health support via text messages and online informational materials.
After three months, more than 40% of participants in each group had stayed without vaping for at least one week. Those who received two interventions — namely, phone calls and NRT — or all three interventions performed best, with a 48% quit rate.
“Unfortunately or fortunately, we’ve been very effective in vaping — fortunately, because it’s generally difficult to help people quit, and unfortunately, because the uniformly high recidivism rates raised questions about which interventions were the most effective that were tested,” said study co-author Liz Klein, who chairs OSU’s Department of Health Behavior and Health Promotion.
“We really have to do more work to understand the different aspects,” Klein told Live Science.
The best ways to help people, particularly teens and young adults, quit smoking remain uncertain. “Many people assume that quitting vaping will be the same as quitting smoking, and we don’t have evidence that they can be replaced,” Klein said.
But the issue is gaining attention. In 2018, the U.S. Surgeon General declared e-cigarette use by teens and young adults an epidemic. In addition to the many unknowns about the potential long-term harms of vaping, Klein said that Nicotine addiction can alter young people’s brain development, potentially changing their ability to concentrate and their responses to other drugs of abuse.
For the new study, people who vaped but did not smoke cigarettes were recruited through social media. They were all coached through telephone calls — commonly known as quitlines, an established support tool for people wanting to quit smoking. Klein said that “ethically, we didn’t feel comfortable” including a control group that received no help for comparison.
One group was given only these calls. The second group was also given NRT, and were sent nicotine patches and gum or lozenges. The third group received support through quitline calls and text messages, with videos and other informational material shared online. The fourth and final group received calls, NRT and mobile support.
Quitline rates were 41% for quitline calls only, 43% for calls and mobile assistance, 48% for calls and NRT, and 48% for all three interventions.
So the study supports NRT as an aid to quitting vaping, but it raises questions about mobile assistance. Although a previous trial found that text messages boosted quit rates, here, they appeared to add negligible benefit. “We need to understand a little more deeply” about why this might be, Klein said.
But the surprisingly high cessations seen across all groups suggest that quitlines can help young adults quit vaping.
“This study is only the third randomized trial of a vaping cessation program for young people,” said Amanda Graham, chief health officer at the Truth Initiative, a charity dedicated to preventing nicotine addiction in young people, who was not involved in the study. “It’s exciting to see this neglected field growing,” she said.
While the results are promising, Graham said that since the study lacked a control group without quitline support, it can’t yet be concluded how effective the phone coaching was. She would also like to see longer follow-up than the week of abstinence at the three-month mark used in this study.
Klein and his colleagues are now deciding which interventions to test in larger, longer trials that will also look at people who both vape and smoke.
Klein said there was a lot of demand to be included in this study, and both he and Graham noted that, in recent large surveys, the majority of young people who vape say they want to quit. This is different from previous generations of young people who smoked cigarettes and often considered it something to do later in life.
“With traditional cigarette smoking, young people weren’t banging on the door to say, ‘I need services and I’m not getting them,’” Klein said. “I think we’re finding higher rates of interest and engagement.”
