E-cigarettes Users' Quit Methods and Interventions that may Facilitate Quitting

Purpose: Empirical studies suggest that the best cessation techniques for cigarette smokers is a combination of counseling and medications, such as varenicline and bupropion, followed by Nicotine Replacement Therapies (NRT), such as nicotine gums, patches, and lozenges, whereas abrupt cessation (‘cold-turkey’) method is the least effective method with about 95% failure and relapse rate. However, the extent of which those techniques are applicable to Electronic Nicotine Delivery Systems (ENDS) users are still unclear. The purpose of this study is to examine ENDS users’ vaping behaviors, preferred quit methods, and their interest in interventions that assist quitting.

Method: Cross-sectional design, convenience sampling method, and Qualtrics survey platform were used to survey undergraduate students in a Midwestern campus (N=101). Being a current vaper was the eligibility criterion. Current vapers were asked about their demographics, vaping behaviors, attempted quitting methods, and their interest in a device that slowly weans them off their nicotine dependency by restricting how many puffs are allowed for each day. Data were analyzed using SPSS. Pearson correlation and chi-square test were utilized to detect associations at 0.05 significance level.

Results: Among the 81 current vapers with complete responses, 81% had thought of quitting before, 58% had attempted quitting, and 78% are planning to quit in the future. However, none of these was associated with their interest in a device that assists quitting. Only 70% who thought of quitting attempted it, but almost 90% of those who attempted are planning to quit in the future. Of those who attempted quitting before, 83% used abrupt cessation as their quit method, while 15% used NRT, and none tried counseling or medication. Compared to males, females were significantly more interested in an assistive device for quitting (68% vs 44%; chi-square=4.07; df=1; p=0.04). Average days vaped per month was significantly correlated with interest in attempting an assistive device (r=0.23; p=0.04). However, average number of puffs per day, perceived user status (‘almost a non-user’ through ‘a problem user’), type of vaping device used (disposables, mods, cartridges), places of vaping (e.g., work, restaurant, home) were not associated with interest in an assistive device significantly.

Conclusions: If the majority of current vapers want to quit and abrupt cessation is the primary quit method despite it’s very low success rate, then it suggests that: 1) new vaper-specific intervention methods are critically needed, 2) better public-health marketing communications are required to inform the public about the effectiveness of NRT, counseling and medication. A majority of current vapers (53%) were interested in a device that assists them in quitting. A personalized, automated feedback system, derived from concepts of behavioral counseling, such as Motivational Interviewing, can be incorporated in such intervention. Along with the need for better nicotine cessation innovations and public-health awareness campaigns, more research is needed on the effectiveness of interventions that replace the abrupt cessation method for specifically ENDS, and to understand why vapers disregard NRT, counseling, and medication.

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