Social Media Support Groups for Youth Nicotine Vaping Cessation: An RCT.

Abstract

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. The aim of this study was to test the efficacy of E-cigarette cessation support groups on Instagram in an RCT. A total of 500 participants were randomized to intervention or active control with baseline, 5-week (end of program), and 3- and 6-month follow-up surveys in 2022-2024. Healthy volunteers in California were recruited through social media advertisements. Participants reported the age of 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, and considering quitting within 6 months. 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. A 7-day point prevalence abstinence from E-cigarette use. Data were analyzed in 2024-2025. Mean age was 18.9 years, 39.8% were female, and 51.2% were male; 41.1% were White, 17.2% were Hispanic, and 27.4% were multiracial; 35.1% were sexual minority. A total of 70.4% used E-cigarettes daily, and 78.2% used 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 in a time-averaged difference approach examined 7-day point prevalence abstinence accounting for repeated measures and clustering effects. Intention-to-treat (ITT) 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%) than for 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. Social media support groups were acceptable to diverse young people and improved abstinence rates on average over 6 months compared with quitline referral. This study is registered at Clinicaltrials.gov (Protocol Number NCT04707911).