Challenges faced by young adult users

High stress, high dependence, and mental health issues shape the smoking cessation journey of young adult e-cigarette users, highlighting the need for targeted interventions and support.

Study: A randomized clinical trial of a vaping cessation intervention: baseline characteristics of young adult exclusive e-cigarette users seeking treatment. Image credit: xyfen/Shutterstock.com

A recent study published in the International Journal of Environmental Research and Public Health The study examines the characteristics of young adults (YAs) who were exclusive e-cigarette (EC) users and seeking treatment.

Tailored stop for young adults e-cigarettes

Current estimates indicate that the prevalence of EC use among youth ages 18 to 24 in the United States is between 11% and 26.2%. Several young people have tried to stop using EC; however, few options are specifically aimed at YA EC users.

Additionally, it remains unclear what is the most effective approach to engaging YA EC users with effective cessation resources. Despite similarities in reasons for quitting vaping or smoking, there are unique facilitators and barriers to quitting vaping within the YA population.

Thus, further research is needed to determine effective smoking cessation methods for EC users wishing to quit smoking, by understanding the characteristics of those seeking treatment.

About the study

Data on treatment-seeking YAs who completed a randomized clinical trial baseline survey were included in the present study. The trial involved remote delivery of an intervention to support EC cessation.

Study participants were randomized into one of four groups: those who did and did not receive the mHealth intervention, those who received nicotine replacement therapy (NRT) for eight weeks with or without the mHealth intervention and controls.

A total of 981 participants completed the baseline survey, which included information on demographic factors, education level, employment status, chronic illnesses, smoking behaviors, and measures of depression, anxiety and stress. The key objective of the current study was to characterize treatment-seeking YAs who exclusively use EC and explore differences between those who are willing to talk on the phone and those who do not.

Study results

More than 72% of YA EC users were female, with a similar proportion of 70% identifying as white. Approximately 57% of the study cohort reported some college or professional education, with most of these characteristics similar among participants and nonparticipants. The largest difference was in age, with 52.2% of non-participants slightly older than those enrolled in the study.

Approximately 78% of study participants used ECs daily, including 87% for at least a year. The use of disposable ECs was slightly higher. According to the Pennsylvania State E-Cigarette Addiction Index, most were classified as heavily addicted.

Some of the different reasons why study participants wanted to quit smoking included health concerns, lack of addiction, cost, and more. About 88% of them have already tried to quit smoking, and about 30% reported their longest period of abstinence from EC, ranging from one to six days.

More than 31% of people wanting to quit smoking previously used a quit smoking medication, the most common being NRT in the form of a lozenge, gum or patch. At the time of the baseline survey, NRT use was higher among non-participants.

In the total sample, behavioral health concerns were high, with 44.8%, 55.4%, and 73.1% scoring positive for depression, anxiety, and high stress, respectively. The incidence of anxiety and depression was higher among non-participants.

Additionally, 57.4% of the study cohort reported consuming alcohol at least once a month, while approximately 89% and 60% reported consuming alcohol and cannabis during the month. previous, respectively. The prevalence of these habits was similar between nonparticipants and participants.

Limitations of the study

A key limitation of the current study is the lack of diversity in the study cohort, which was not representative of the US population. Additionally, because announcements of study participation were posted on specific social media platforms, only YAs who were engaged and active on these websites could be recruited.

The overlap of the intervention period with the coronavirus disease 2019 (COVID-19) pandemic may have influenced participant characteristics, including stress levels. Additionally, the potential presence of fraudulent participants due to the fully remote design and online recruitment approach cannot be excluded.

Although the study considered several psychosocial, behavioral, smoking-related, and demographic factors, unknown external factors may also have influenced the differences among those who responded to a coach’s calls to quit smoking.

Future direction

Additional research is needed to identify better ways to engage with YAs seeking treatment for EC use and whether these treatments can be improved by considering behavioral health concerns in this population. Future studies should also examine cognitive barriers and smoking cessation intervention preferences to better understand why YAs may or may not be willing to participate in one-on-one telephone coaching.