New data highlights key motivators of cessation attempts in young people and the methods being used.
While nearly two-thirds of young adults who vape have tried to quit, fewer than one in five successfully stop, new research shows.
Concerningly, researchers found that the only method in the cohort statistically associated with successful vaping cessation was switching to cigarettes.
Nearly 40% who quit vaping this way had never previously smoked, and more than 90% were still smokers a year later.
Using nationally representative data from the US Population Assessment of Tobacco and Health (PATH) study – one of the largest longitudinal tobacco-use studies – researchers found that vaping cessation attempts were common among young adults but were unable to identify any truly effective quitting strategies.
Data from Wave 6 (2021) and Wave 7 (2022–2023) of the ongoing PATH study showed that around 13.5% of the population aged 18–24 years used electronic nicotine products (ENPs) regularly, 61% of whom reported vaping every day.
This latest study focussed on 963 participants who reported regular use in 2021 and completed follow-up surveys around one year later. Of this cohort, 62.4% had made at least one genuine attempt to quit during the study period, with 18.6% successfully stopping by the follow-up survey.
“These data are strikingly similar to cigarette cessation data in young adults,” the authors wrote, raising concerns that vaping may produce levels of nicotine dependence comparable to tobacco products.
Among participants who either attempted to quit or successfully quit, the cessation rate was around 29%. More than half of continuing vapers reported making at least one unsuccessful quit attempt during the study period.
Researchers looked at factors associated with quitting such as support from family and friends, behavioural interventions, quitting apps, nicotine replacement therapy (NRT), prescription medications, and substitution with tobacco.
Overall, use of evidence-based cessation aids was low. Only 6.2% of participants reported using NRT during their most recent quit attempt, while just 1.5% used prescription medications such as varenicline or bupropion. None were associated with successful vaping cessation in the cohort.
Use of apps to quit was also uncommon, reported by 7.9% of participants, and was associated with lower odds of quitting in adjusted analyses (aOR 0.30).
Social support from family and friends was the most commonly used cessation aid, reported by 30.6% of participants, although it was not independently associated with successful cessation after adjustment for other factors (aOR 0.99).
The only method associated with significantly higher odds of successfully stopping vaping was substituting vapes with cigarettes (OR 2.61). Of those who quit vaping this way, 37.1% had never previously been cigarette smokers and 91.3% remained smokers at follow-up.
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But it’s not all bad news.
One of the study’s key findings was that perceptions of harm and social influences played a major role in quit attempts, highlighting these as important targets for intervention.
Young adults who believed vaping was harmful were significantly more likely to attempt quitting (OR 1.44), as were those who perceived dangers associated with nicotine itself (OR 1.35).
Disapproval from close friends and/or family was one of the strongest predictors of quit attempts, with 153% higher odds of trying to quit among participants who reported this. However, this apparent motivator to quit did not translate into successful cessation (43–57% lower odds of quitting).
Living in environments where vaping or smoking was permitted indoors was associated with 22-28% lower odds of making a quit attempt (OR 0.78 and 0.72, respectively). Antitobacco campaign exposure showed little association with quit attempts (OR 0.96).
While only 14.4% of the cohort reported receiving cessation advice from healthcare professionals in the past 12 months, those who did had 21% higher odds of making a quit attempt compared to those who were not.
However, this too did not translate into successful cessation (53-67% lower odds of quitting), likely reflecting confounding by indication (i.e., advice being more common among higher-dependence users).
“The low rates of quit method use and lack of specific methods leading to cessation highlights the ongoing need for ENP cessation treatments that are evidence-based and appealing to young people,” the authors wrote.
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