Effectiveness of a Vaping Cessation Text Message Program among Young Adult E-cigarette Users: A Rand
Saturday, June 19, 2021
Posted by: Natalia Gromov
Graham
AL, Amato MS, Cha S, Jacobs MA, Bottcher MM, Papandonatos GD.
Effectiveness of a Vaping
Cessation Text Message Program among Young Adult E-cigarette Users: A
Randomized Clinical Trial.
JAMA Intern Med. Published online May 17, 2021.
doi:10.1001/jamainternmed.2021.1793
Importance.
e-Cigarettes are the most commonly used tobacco product among young adults
(YAs). Despite the harms of nicotine exposure among YAs, there are few, if any,
empirically tested vaping cessation interventions available.
Objective.
To determine the effectiveness of a text message program for vaping cessation
among YAs vs assessment-only control.
Design, Setting, and
Participants. A parallel, 2-group, double-blind, individually
randomized clinical trial was conducted from December 2019 to November 2020
among YA e-cigarette users. Eligible individuals were US residents aged 18 to
24 years who owned a mobile phone with an active text message plan, reported
past 30-day e-cigarette use, and were interested in quitting in the next 30
days. Participants were recruited via social media ads, the intervention was
delivered via text message, and assessments were completed via website or
mobile phone. Follow-up was conducted at 1 and 7 months postrandomization;
follow-up data collection began January 2020 and ended in November 2020. The
study was prespecified in the trial protocol.
Interventions.
All participants received monthly assessments via text message about
e-cigarette use. The assessment-only control arm (n = 1284) received no
additional intervention. The active intervention arm (n = 1304) also received
This is Quitting, a fully automated text message program for vaping cessation
that delivers social support and cognitive and behavioral coping skills
training.
Main Outcomes and Measures.
The primary outcome was self-reported 30-day point prevalence abstinence (ppa)
at 7 months analyzed under intention-to-treat analysis, which counted
nonresponders as vaping. Secondary outcomes were 7-day ppa under
intention-to-treat analysis and retention weighted complete case analysis of
30-day and 7-day ppa.
Results. Of
the 2588 YA e-cigarette users included in the trial, the mean (SD) age was 20.4
(1.7) years, 1253 (48.4%) were male, 2159 (83.4%) were White, 275 (10.6%) were
Hispanic, and 493 (19.0%) were a sexual minority. Most participants (n = 2129;
82.3%) vaped within 30 minutes of waking. The 7-month follow-up rate was 76.0%
(n = 1967), with no differential attrition. Abstinence rates were 24.1% (95%
CI, 21.8%-26.5%) among intervention participants and 18.6% (95% CI,
16.7%-20.8%) among control participants (odds ratio, 1.39; 95% CI, 1.15-1.68;
P < .001). No baseline variables moderated the treatment-outcome
relationship, including nicotine dependence.
Conclusions and Relevance.
Results of this randomized clinical trial demonstrated that a tailored and
interactive text message intervention was effective in promoting vaping
cessation among YAs. These results establish a benchmark of intervention effectiveness.
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