For young people who want to give up vaping, simple interventions — like hotlines, informational text messages and nicotine replacement — are helpful tools for quitting, a new study finds.
The research, published Wednesday (Dec. 11) in the American Journal of Preventive Medicine, explored these interventions to help 18- to 25-year-olds quit vaping, and it reported strikingly positive results.
Researchers at The Ohio State University (OSU) assigned the 508 young adults, who were all keen to give up vaping, to four treatment groups. These volunteers received various combinations of coaching over the phone, nicotine replacement therapy (NRT) and mobile health support via text messages and online informational content.
After three months, over 40% of the participants in each group had gone at least a week without vaping. Those who got two interventions — namely, phone calls and NRT — or all three interventions fared the best, with a 48% quit rate.
"Unfortunately or fortunately, we were very effective in producing cessation," said study co-author Liz Klein, chair of OSU's Division of Health Behavior and Health Promotion — fortunately, because it's normally difficult to help people to stop vaping, and unfortunately, because the uniformly high rates left questions about which was the most effective intervention tested.
"We have to really do more work to understand the various pieces," Klein told Live Science.
Related: Is vaping healthier than smoking?
The best ways to help people, especially teens and young adults, stop vaping remains uncertain. "A lot of folks assume that quitting vaping is going to be identical to quitting smoking, and we just don't have evidence that they're exchangeable," Klein said.
But the issue is gaining attention. In 2018, the U.S. Surgeon General declared e-cigarette use by teens and young adults to be an epidemic. Atop many unknowns about the potential long-term harms of vaping, Klein said nicotine addiction may change young people's brain development, potentially altering 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 via social media. They all received coaching via telephone calls — commonly known as a quitline, which is an established support tool for people seeking to stop smoking. "Ethically, we didn't feel comfortable" including a control group who received no help, for comparison, Klein noted.
One group was given only these calls. A second group received NRT, too, and were sent nicotine patches and either gum or lozenges. The third group received quitline calls and support via text messages, which shared online videos and other informational content. A fourth and final group received calls, NRT and mobile support.
The quit rates were 41% for quitline calls only, 43% for calls plus mobile support, 48% for calls and NRT, and 48% for all three interventions.
The study therefore supports NRT as a vape-quitting aid, but it poses questions about mobile support. Although a previous trial found that text messages boosted quit rates, here, they seemed to add negligible benefits. "We need to drill down and understand a little bit more" why that might be, Klein said.
But the surprisingly high cessation seen across all of the groups suggests quitlines could help young adults kick vaping.
"This study is only the third randomized trial of a vaping cessation program for young people to be published," 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 added.
However, suggestive as the results are, Graham said that because the study lacked a control group without quitline support, it can't yet be concluded exactly 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 her colleagues are now deciding which interventions to test in larger, longer trials, which will also look at people who both vape and smoke.
There was considerable demand to join this study, Klein said, and both she and Graham noted that, in recent large surveys, a majority of young people who vape say they want to stop. This contrasts with previous generations of young people who smoked cigarettes and often viewed quitting as something to do later in life.
"With traditional cigarette smoking, young people weren't beating down the door to say, 'I need services and I'm not getting them,'" Klein said. "I do think we're detecting a higher rate of interest and engagement."
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