More Than Half of Teen e-Cigarette Users Report Cessation Intention

By Lisa Rapaport

August 19, 2021

(Reuters Health) - The majority of adolescents who use e-cigarettes report cessation intention and quit attempts in the previous year, particularly when they tried vaping only out of curiosity, a new study suggests.

Researchers examined data from 1,660 current e-cigarette users aged 11-18 who participated in the 2020 National Youth Tobacco Survey. Overall, 53.4% of e-cigarette users reported an intention to quit and 67.4% reported an actual quit attempt over the past year, with a mean of 5.3 attempts.

"Perceived harm of e-cigarette use is strongly associated with both intention to quit vaping and past-year quit attempts," said study author Hongying Dai of the College of Public Health at the University of Nebraska Medical Center in Omaha.

But the study found that 44.5% of youth said they thought there was little or no harm to using e-cigarettes, according to the results reported in Pediatrics.

"Therefore, clinicians should emphasize the adverse health outcomes of vaping and deliver the message that e-cigarettes, just like cigarettes, will increase the risks of nicotine addiction, respiratory injury, cardiovascular illnesses, and other tobacco-related diseases," Dai said.

Only 7% of youth said they were using e-cigarettes in an effort to stop smoking traditional cigarettes, the study also found.

Other reasons youth cited for using e-cigarettes included having a friend that vaped (35.7%), being able to use without detection at home or school (17.5%), and curiosity (42.2%).

Compared to youth not motivated by curiosity, those who did cite this as a reason for vaping were significantly more likely to report an intent to quit (adjusted odds ratio 1.2). Youth who said curiosity played a role in vaping were also significantly more likely to make a quit attempt (aOR 1.4).

By contrast, youth who said they vaped to evade detection at home or at school were significantly less likely to report an intention to quit (aOR 0.4) or an attempt to quit (aOR 0.7).

One limitation of the study is that intention and attempts to quit were self-reported, and adolescents are particularly susceptible to social desirability bias, the authors note. And because many young users don't have a daily vaping habit, the results might inflate efforts to quit, based on cessation of at least one day. Data on some potential confounders, such as parental education and income, and household socioeconomic status, also were not available.

More broadly, the measure of intentions around cessation doesn't actually ask about committed intention, or likelihood of future use, or making concrete plans to quit, said Thomas Wills, a professor and director of the Cancer Prevention in the Pacific Program at the University of Hawaii Cancer Center in Honolulu. There's a big difference between thinking about quitting and making a plan or an attempt to do so, Wills, who wasn't involved in the study, said by email.

The question about cessation attempts also doesn't necessarily reflect the realities of teen tobacco use, Wills added.

"Because much adolescent e-cigarette use is episodic, this could be answered affirmatively by a considerable part of the user population, irrespective of quitting motivation," Wills said.

SOURCE: Pediatrics, online August 18, 2021.