Study of adult e-cigarette users' attempts and experiences of quitting

Many e-cigarette (vape) users intend to quit, but there are few evidence-based interventions to help them do so. Due to this lack of interventions for e-cigarette cessation, researchers in the United States studied how and why users attempt to quit independently. The study, published in the journal Environmental Research and Public Health, analyzed both barriers and facilitators to quitting e-cigarettes.

Study: E-Cigarette Quit Attempts and Experiences in a Convenience Sample of Adult Users. ​​​​​​​Image Credit: e-cigarettes / Shutterstock

Background

The current prevalence of e-cigarette usage among adults aged 18 years and above has been estimated to be 5.1% in the United States. Although e-cigarettes are considered less harmful than conventional cigarettes, regular vaping of nicotine-containing e-cigarettes could expose the users to nicotine levels proportional to traditional cigarettes.

Many studies have reported that e-cigarette users frequently plan to quit vaping because of health concerns, financial reasons, or to avoid addiction. Studies conducted on nicotine users who want to quit have highlighted that the experiences associated with e-cigarette quitting are somewhat similar to that associated with conventional cigarette quitting. The study's primary purpose is to identify factors contributing to successful interventions for e-cigarette quitting.

Study design

The study was conducted on 787 adults who used e-cigarettes at some point in their life and had made at least one attempt to quit vaping. They were recruited through an online crowdsourcing platform.

Information on the overall frequency of vaping, daily frequency, and timing of last e-cigarette use was collected from the participants. In addition, the participants were asked how soon they used e-cigarettes after waking up and how often they woke up at night to use an e-cigarette. Participants were also asked about the type of e-cigarette device as well as the concentration of nicotine they use.

Regarding e-cigarette quitting, participants were asked about the reasons for quitting, methods tried, and experiences during quit attempts. In addition, participants were provided with two optional questions, i.e., "What advice would you have for someone trying to quit vaping?" and "What resources do you wish you had to help you quit vaping."

Important observations

The analysis of participants' responses revealed that about 72% had used an e-cigarette within the last 30 days, and 42% had stopped entirely using e-cigarettes. Among participants who reported quitting vaping, about 18% mentioned vaping in the previous 30 days, and 21% reported currently vaping every day or some days.

These discrepancies in self-reported information indicate that participants may be considering "complete quitting" as an episodic rather than a permanent state. Participants may also consider themselves as quitters even though they stop vaping for a short period of time.

About 77% of participants reported using an e-cigarette every day or some days, and 67% reported vaping within 30 minutes of waking. Vaping nicotine-containing e-cigarettes was reported by about 89% of participants.

Although many participants reported not knowing the concentration of nicotine they use, some reported vaping a relatively low amount of nicotine. Since there is a significant association between nicotine concentration and the ability to quit vaping, careful examination of nicotine concentration in e-cigarettes is needed in future studies.

E-cigarette quitting responses   

About 83% of participants reported attempting to quit vaping at least once in the past year. Regarding the reasons for quitting, about 42% of participants reported health concerns. Regarding methods tried for quitting e-cigarettes, about 56% said cold turkey (abrupt cessation of an addictive substance) as a preferred method.

Regarding quitting experiences, about 41% reported intense craving as a side-effect, 53% said stress as a trigger to resume vaping, 67% reported distraction as a method to avoid triggers, 22% reported relying on online resources for quitting, and 54% reported not using any resources.

Regarding participants' advice for those wanting to quit vaping, the most commonly reported recommendations were distractions, hobbies, or alternative activities. Other reported recommendations were reducing nicotine use, using nicotine replacement therapy, advice from peers or support groups, professional help, and online resources. Moreover, about 21% of participants reported commitment, motivation, or willpower as strategies for quitting vaping.

Study significance

This study finding provides valuable information for developing effective interventions for people who want to quit vaping. Until now, most of what we know about harm reduction came from samples of tobacco users who use e-cigarettes to quit using smoking traditional cigarettes. Younger cohorts, however, indicate that more young adults are using e-cigarettes exclusively, have become addicted, and desire to quit. Therefore, there is a need for descriptive information regarding demographics, e-cigarette use, device characteristics, reasons, methods, resources available to quit e-cigarettes, and users' experiences during a quit attempt (cravings, withdrawal symptoms, and triggers). Finally, an essential first step in developing effective interventions for people wishing to stop using e-cigarettes is understanding what motivates them.

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.