Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth.

Abstract

Broad-reaching, effective e-cigarette cessation interventions are needed. This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation. Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18-24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting. All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content). Self-reported 7-day point prevalence vaping abstinence at 3 months. A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; p=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; p=0.84). This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial. clinicaltrials.gov NCT04974580.