Social Media Support Groups for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial

Ling PM, Joanne Lyu C, Lisha NE, Nhung Nguyen, Valerie Gribben, Danielle Ramo.
Social Media Support Groups for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial
Am J Prev Med. 2026 Feb 20:108314. doi: 10.1016/j.amepre.2026.108314. Epub ahead of print. PMID: 41724253.

Introduction: E-cigarettes are the most frequently used tobacco product among adolescents and young adults. Over 40% of adolescents who used e-cigarettes tried quitting in 2023, but few programs support them, particularly on social media.

Objective: Test the efficacy of e-cigarette cessation support groups on Instagram in a randomized controlled trial.

Study design: 500 participants were randomized to intervention or active control with baseline, 5 week (end of program), 3 and 6 month follow up surveys in 2022-2024.

Setting: Healthy volunteers in California were recruited via social media advertisements.

Participants: Participants reported age 13-21 years, English literacy, using social media at least 4 days per week, using e-cigarettes at least weekly, access to device with photo capability, considering quitting within 6 months.

Interventions: Instagram direct message support groups for 5 weeks provided motivational interviewing, social support, skill building, and group quit attempts. Controls were referred to state quitline resources including telephone, online, texting or mobile app.

Main outcome: 7-day point prevalence abstinence from e-cigarette use.

Results: Data was analyzed in 2024-2025. Mean age was 18.9 years, 39.8% female, 51.2% male; 41.1% non-Hispanic white, 17.2% Hispanic, and 27.4% multiracial; 35.1% sexual minority. 70.4% used e-cigarettes daily, and 78.2% within 30 minutes of waking. Retention rates were 43.6% at 5 weeks, 23.0% at 3 months and 28.0% at 6 months. Generalized linear mixed models (GLMM) in a time-averaged difference examined 7-day point prevalence abstinence accounting for repeated measures and clustering effects. Intention to treat analysis counting missing as vaping found greater abstinence in the intervention group (18.2% vs 11.8%) (OR = 2.15, 95% CI = 1.1, 4.2, p=0.025). Complete case analysis also found greater abstinence over 6 months for intervention (53.9%) compared to control (40.4%) (OR = 2.07, 95%CI = 1.21, 3.52, p=0.008). There were no differences in vaping reduction, attitudes, or use of evidence-based methods. Intervention participants reported higher social support with no difference in overall program evaluation.

Conclusions: Social media support groups were acceptable to diverse young people and improved abstinence rates on average over 6 months compared to quitline referral.

Trial registration: Clinicaltrials.gov (protocol # NCT04707911).