First-of-its-kind randomized clinical trial shows teens 35% more likely to quit vaping nicotine with an interactive, tailored text message program.
WASHINGTON, D.C. (August 7, 2024) – A groundbreaking new study published today in the Journal of the American Medical Association (JAMA) demonstrates the effectiveness of an interactive and tailored text message program in helping adolescents quit vaping nicotine. This study is the first published randomized clinical trial of a quit vaping program among teens, filling an important gap in the scientific literature and providing much needed evidence for pediatricians, school administrators, and public health agencies.
Conducted from October 2021 to October 2023, the study involved 1,503 adolescents ages 13-17 from across the United States who reported past 30-day e-cigarette use and were interested in quitting. Compared to a control group, participants who received the interactive text message program were 35% more likely to report not using nicotine at the 7-month study endpoint. Quit rates were 37.8% in the intervention groups compared to 28% in the control group.
“For many years, healthcare providers, teachers, and parents have been asking how to help teens quit vaping,” said Dr. Amanda Graham, Chief Health Officer at Truth Initiative and principal investigator of the study. “Until today, we haven’t had data to tell us what works. This study is a critical breakthrough that demonstrates the power of a relatively simple technology in changing behavior. Text messages serve as powerful reminders of an initial commitment to quit and can deliver proven behavior change support right to a young person’s phone.”
Importantly, the researchers found strong evidence of the program’s effectiveness among key subgroups defined by race, ethnicity, gender, higher levels of nicotine dependence, smoking and other substance use, mental health challenges, and household dysfunction.
These findings are especially important given the recent youth mental health crisis documented by the U.S. Surgeon General. Adolescents in this study were characterized by high severity of past-year problems with depression, sleep, anxiety, trauma, and substance use. In addition, moderate to high levels of nicotine dependence were observed across multiple measures, with more than three-quarters (76.2%) of teens vaping within 30 minutes of waking — a common way to measure addiction.
The text message intervention tested in this study is called This is Quitting, now part of the EX Program from Truth Initiative. Since This is Quitting launched as a text message program in 2019, more than 750,000 young people have enrolled from across the U.S. Grounded in clinical guidelines for treating tobacco dependence, This is Quitting incorporates powerful messages from other young e-cigarette users who have offered their advice about how to quit. Teens and young adults can text DITCHVAPE to 88709 to receive free quit vaping support from the program.
There is no safe level of nicotine use among adolescents, and yet e-cigarettes remain the most commonly used tobacco product among young people, according to the CDC. In 2023, more than 2.1 million adolescents reported current e-cigarette use (4.6% of middle school students and 10% of high school students), with many of them doing so frequently, according to the National Youth Tobacco Survey. Interest in quitting vaping also remains high: 67% of 15- to 24-year-old e-cigarette users said they were considering quitting as a New Year’s resolution, according to a 2023 Truth Initiative survey.
“We also did not see evidence that teens who quit vaping transitioned to smoking,” added Graham. “Additional analyses requested by the JAMA editorial team focused on use of combustible tobacco products since there is often a concern about transition between vaping and smoking. Even though This is Quitting does not explicitly address smoking, it was effective in reducing dual use (smoking and vaping) and keeping teens in this study from starting to smoke.”
This study builds on the findings of an earlier randomized clinical trial of This is Quitting conducted among roughly 2,600 young adults ages 18 to 24. Taken together, the studies provide strong evidence that an interactive, tailored text message program can help teens and their older peers break free from nicotine addiction.
For more information about Truth Initiative, please visit truthinitiative.org. For more information about This is Quitting and the EX Program please visit truthinitiative.org/exprogram.
Background
The clinical trial was conducted by Truth Initiative with oversight from Advarra Institutional Review Board. All branding was removed in the trial to eliminate potential bias. Participants were recruited via social media ads. All participants received incentivized text message assessments regarding e-cigarette use and abstinence at 14 days post-randomization and monthly thereafter through 6 months. All participants were compensated $5 via digital card per response (7 assessments total, maximum $35). These assessments were designed solely to maximize retention; they were not analyzed as outcomes.
This trial was funded by Truth Initiative.
About Truth Initiative®
Truth Initiative is a national nonprofit public health organization committed to a future free from lifelong addiction, fostering healthier lives and a more resilient nation. Our mission is to prevent youth and young adult nicotine addiction and empower quitting for all. Through our evidence-based, market-leading cessation EX Program and the nationally recognized truth® public education campaign, we are leading the fight against youth and young adult tobacco use, which threatens to put a new generation at risk of nicotine addiction. Our first-of-its-kind text message quit vaping program, This Is Quitting, has enrolled over 750,000 young people across the country, and our youth e-cigarette prevention curriculum, Vaping: Know the truth®, is currently implemented in over 9,000 schools nationwide, reaching a total of over one million students thus far. Our rigorous scientific research and policy studies, community and youth engagement programs supporting populations at high risk of using tobacco, and innovation in tobacco dependence treatment continue to contribute to ending one of the most critical public health battles of our time. Based in Washington, D.C., our organization was established and funded through the 1998 Master Settlement Agreement between attorneys general from 46 states, five U.S. territories, and the tobacco industry. To learn more, visit truthinitiative.org.
