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Bejarano G, Bluestein MA, Tackett AP, Duano J, Rawls S, Ahluwalia JS, Vandewater EA, Hébert ET. Factors Associated With Successful E-Cigarette Cessation Among a Convenience Sample of Adult Users. Subst Use Misuse 2024; 59:1126-1132. [PMID: 38503709 PMCID: PMC11017730 DOI: 10.1080/10826084.2024.2320395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Background: A growing body of literature suggests that many people who use e-cigarettes become dependent and have difficulty quitting. Most people who use e-cigarettes have interest in quitting, yet there is currently a lack of evidence to inform interventions for e-cigarette cessation. Objective: The purpose of this study was to identify factors associated with successful e-cigarette quit attempts among a large sample of people who use e-cigarettes. Methods: Participants (n=586) were people who use e-cigarettes who reported at least one lifetime attempt to quit their e-cigarette use. Adjusted logistic regression models were performed to examine differences in e-cigarette use characteristics and quit methods between people who currently use e-cigarettes and who quit e-cigarettes. Results: Most participants were people who currently use e-cigarettes and only 27.5% reported successfully quitting. Most participants (90.6%) used e-cigarettes that contained nicotine, and over half (54.0%) used closed-system e-cigarette devices with replaceable pre-filled pods or cartridges. The quit method most commonly used overall (63.1%) and for people who quit e-cigarettes (70.8%) was cold turkey. Past 30-day cigarette use and past 30-day other tobacco use was significantly associated with reduced odds of quitting, and there were no e-cigarette characteristics significantly associated with successful cessation. Nicotine replacement therapy was the only e-cigarette cessation method that was significantly associated with increased odds of quitting after adjusting for past 30-day cigarette and other tobacco use. Conclusions: These results suggests that cigarette use, other tobacco use, and quit method used may significantly influence the likelihood of e-cigarette cessation. Future research is needed to determine the effectiveness of interventions for e-cigarette cessation using nicotine replacement therapy.
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Affiliation(s)
- Geronimo Bejarano
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Alayna P. Tackett
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Jaimie Duano
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Shelby Rawls
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
- Legorreta Cancer Center at Brown University, Providence, Rhode Island
| | | | - Emily T. Hébert
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
- Department of Health Promotion and Behavioral Sciences, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
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Caponnetto P, Campagna D, Ahluwalia JS, Russell C, Maglia M, Riela PM, Longo CF, Busa B, Polosa R. Varenicline and counseling for vaping cessation: a double-blind, randomized, parallel-group, placebo-controlled trial. BMC Med 2023; 21:220. [PMID: 37403047 DOI: 10.1186/s12916-023-02919-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 06/01/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Vaping cessation is virtually unexplored. The efficacy and safety of varenicline for vaping cessation has not been studied and rigorous research is required to advance best practice and outcomes for people who use electronic cigarettes (EC) and want to quit. The objective is to evaluate the efficacy and safety of varenicline (1 mg BID, administered for 12 weeks, with follow-up to week 24) combined with vaping cessation counseling in exclusive daily EC users intending to quit vaping. METHODS Design: Double-blind, randomized, parallel-group, placebo-controlled trial. SETTING The study took place at a University-run smoking cessation center. PARTICIPANTS People who exclusively use ECs daily and intend to quit vaping. INTERVENTION A total of 140 subjects were randomized to either varenicline (1 mg, administered twice daily for 12 weeks) plus counseling or placebo treatment (administered twice daily, for 12 weeks) plus counseling. The trial consisted of a 12-week treatment phase followed by a 12-week follow-up, nontreatment phase. MAIN OUTCOMES AND MEASURES The primary efficacy endpoint of the study was biochemically validated continuous abstinence rate (CAR) at weeks 4 to 12. Secondary efficacy end points were CAR at weeks 4 to 24 and 7-day point prevalence of vaping abstinence at weeks 12 and 24. RESULTS CAR was significantly higher for varenicline vs placebo at each interval: weeks 4-12, 40.0% and 20.0%, respectively (OR = 2.67, 95% CI = [1.25-5.68], P = 0.011); weeks 4-24, 34.3% for varenicline with counseling and 17.2% for placebo with counseling (OR = 2.52, 95% CI = [1.14-5.58], P = 0.0224). The 7-day point prevalence of vaping abstinence was also higher for the varenicline than placebo at each time point. Serious adverse events were infrequent in both groups and not treatment-related. CONCLUSIONS The findings of the present RCT indicate that inclusion of varenicline in a vaping cessation program for people who use electronic cigarettes and intending to quit may result in prolonged abstinence. These positive findings establish a benchmark of intervention effectiveness, may support the use of varenicline combined with counseling in vaping cessation programs, and may also help guiding future recommendations by health authorities and healthcare providers. TRIAL REGISTRATION The study has been registered in EUDRACT with Trial registration ID: 2016-000339-42.
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Affiliation(s)
- Pasquale Caponnetto
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Science of Education, Section of Psychology, University of Catania, Catania, Italy
| | - Davide Campagna
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
- UOC MCAU, University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy
| | - Jasjit S Ahluwalia
- Brown University School of Public Health and Alpert School of Medicine, RI, Providence, USA
| | | | - Marilena Maglia
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Paolo Marco Riela
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - Carmelo Fabio Longo
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - Barbara Busa
- UOC Farmacia Ospedaliera, ARNAS Hospital "Garibaldi", Catania, Italy
| | - Riccardo Polosa
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy.
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy.
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy.
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Bluestein MA, Bejarano G, Tackett AP, Duano JC, Rawls SG, Vandewater EA, Ahluwalia JS, Hébert ET. E-Cigarette Quit Attempts and Experiences in a Convenience Sample of Adult Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2332. [PMID: 36767698 PMCID: PMC9916273 DOI: 10.3390/ijerph20032332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/10/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Most e-cigarette users report planning to quit, but there is a paucity of evidence-based interventions for e-cigarette cessation. In the absence of interventions for e-cigarette cessation, we sought to understand how and why e-cigarette users attempt to quit on their own. Participants were recruited from Amazon Mechanical Turk, an online crowdsourcing platform. Those who reported they had ever used e-cigarettes regularly and had attempted to quit e-cigarette use were eligible for participation. Measures included demographic characteristics, other tobacco product use, e-cigarette device characteristics, barriers to quitting e-cigarettes, and facilitators to quitting e-cigarettes. A content analysis was conducted on twotwo open-ended questions that asked about advice respondents had for others trying to quit vaping and resources they wished they had during their quit attempt. Descriptive analyses were performed (means/standard errors; frequencies/proportions). A total of 89.0% reported using an e-cigarette with nicotine, 20.2% reported a nicotine concentration of 4-6 mg/mL%, 32.8% reported using multiple flavors, and 77.7% reported using their e-cigarette every day or some days. The primary reason reported for wanting to quit e-cigarettes was health concerns (42.2%), and 56.7% reported trying to quit "cold turkey". During quit attempts, 41.0% reported intense cravings and 53.1% reported stress as a trigger. From the content analysis, the most commonly cited suggestion for those wanting to quit e-cigarettes was distractions/hobbies (19.9%), followed by reducing/tapering down nicotine (16.9%). Descriptive information on demographics, e-cigarette use, device characteristics, barriers, facilitators, and quit methods provides a first step in identifying factors that contribute to successful interventions designed for e-cigarette cessation.
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Affiliation(s)
- Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Geronimo Bejarano
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Alayna P. Tackett
- Center for Tobacco Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Internal Medicine, Division of Medical Oncology, The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Jaimie C. Duano
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Shelby Grace Rawls
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Elizabeth A. Vandewater
- Population Research Center, University of Texas at Austin, Austin, TX 78701, USA
- Department of Health Promotion and Behavioral Sciences, Austin Campus, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
- Legorreta Cancer Center, Brown University, Providence, RI 02912, USA
| | - Emily T. Hébert
- Michael & Susan Dell Center for Healthy Living, Austin Campus, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
- Department of Health Promotion and Behavioral Sciences, Austin Campus, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
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Krishnan N, Berg CJ, Elmi A, Klemperer EM, Sherman SE, Abroms LC. Predictors of electronic nicotine product quit attempts and cessation: Analysis of waves 3 and 4 of the PATH study. Addict Behav 2022; 134:107419. [PMID: 35810644 DOI: 10.1016/j.addbeh.2022.107419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Identifying theory-based predictors of electronic nicotine product (ENP) quit attempts and cessation can guide the development of effective vaping cessation interventions, which are currently limited. This study examined predictors of ENP quit attempts and cessation among adult ENP users. METHODS Using data from wave 3 (W3; 2015-2016) current established ENP users in the Population Assessment of Tobacco and Health study, we used multivariable logistic regression to identify predictors of (i) wave 4 (W4; 2016-2018) quit attempts (unweighted n = 1,135); and (ii) W4 cessation among those who made a quit attempt (unweighted n = 610). Predictors included Social Cognitive Theory (SCT)-based cognitive (interest in quitting, self-efficacy to quit, outcome expectancies, risk perception), behavioral (smoking status, and use of combustibles, non-combustibles, cannabis, and alcohol), and socio-environmental (perceived disapproval, household rules, exposure to advertising) factors. RESULTS Between W3 and W4, 51.7% of W3 ENP users made a quit attempt. Among those who tried quitting, 68.4% stopped using ENPs. SCT-based predictors of ENP quit attempts included higher interest in quitting ENPs (aOR = 1.18), greater self-efficacy to quit ENPs (aOR = 1.31), and currently using cigarettes (vs non-smoker; aOR = 1.71), non-combustibles (aOR = 2.25), and cannabis (aOR = 1.80). Predictors of ENP cessation included greater self-efficacy to quit ENPs (aOR = 1.33), greater perceived risk of ENPs (aOR = 1.35), and being a current smoker (vs non-smoker; aOR = 3.28). CONCLUSIONS ENP cessation interventions should address cognitive factors, particularly self-efficacy, as it predicted quit attempts and cessation. Cigarette smoking among dual users should be monitored and addressed to ensure that those who quit using ENPs do not maintain cigarette use.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Angelo Elmi
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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Palmer AM, Price SN, Foster MG, Sanford BT, Fucito LM, Toll BA. Urgent Need for Novel Investigations of Treatments to Quit E-cigarettes: Findings from a Systematic Review. Cancer Prev Res (Phila) 2022; 15:569-580. [PMID: 35816038 PMCID: PMC9444997 DOI: 10.1158/1940-6207.capr-22-0172] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/01/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022]
Abstract
E-cigarette use has been increasing globally over the past decade. Many use e-cigarettes as an alternative or method to quit cigarette smoking, whereas others use these products recreationally. As technology has advanced, many individuals have reported symptoms of dependence on these products and continue to use them beyond achieving abstinence from smoking. Despite individuals reporting interest in quitting, little is known about e-cigarette cessation. This systematic review sought to identify and evaluate all human subjects literature published on the outcome of e-cigarette cessation through September 2021. Of the 79 articles identified, 56 were cross-sectional, 6 were qualitative, 5 were cohort studies, 3 were experimental, 2 were mixed methods, and 7 reported intervention or case studies of e-cigarette cessation. Results showed youth generally had high intent to quit e-cigarettes, whereas results were mixed with adult samples. Youth were motivated to quit e-cigarettes by health concerns, whereas adults were motivated to quit e-cigarettes by cost, lack of satisfaction, and psychologic factors. Adults were more likely to report past e-cigarette quit attempts, most commonly "cold turkey." Few interventions tested strategies for e-cigarette cessation, with a majority targeted for youth. Given the lack of information on e-cigarette cessation, recommendations for future studies are outlined.
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah N. Price
- Department of Psychology, University of Arizona, Tucson, AZ, USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Madeline G. Foster
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Brandon T. Sanford
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Family Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Lisa M. Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT USA,Yale Cancer Center, New Haven, CT USA
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA,Department of Psychiatry, Yale School of Medicine, New Haven, CT USA
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