E-cigarettes contribute to unsuccessful nicotine quit attempts by adolescents

A new study published in JAMA highlights the prevalence of unsuccessful quit attempts among adolescents who use either e-cigarettes or cigarettes over the past 13 years.

The reported prevalence of an unsuccessful cigarette quit attempt by adolescents declined from 1997 to 2020. However, in 2020, the reported prevalence of unsuccessful quit attempts among adolescents who used either cigarettes or e-cigarettes was higher than the prevalence of unsuccessful cigarette quit attempts from 1997 to 2020, researchers reported.

“The contribution of e-cigarettes to unsuccessful nicotine quit attempts among adolescents is substantial and warrants consideration as the U.S. formulates policies to regulate e-cigarettes,” Richard Allen Miech, PhD, co-investigator of the Monitoring the Future study in the Survey Research Center at the Institute for Social Research at the University of Michigan, Ann Arbor, and colleagues wrote.

Researchers surveyed 815,690 respondents from the 1997-2020 Monitoring the Future study, which included nationally representative samples of eighth, 10th and 12th grade students surveyed each year. Respondents answered “yes” or “no” to questions about smoking cessation attempts in the past with no success and, for e-cigarette users in 2020, nicotine vaping cessation attempts with no success. Based on responses, researchers designed a variable identifying failed smoking cessation attempts for combustible cigarettes or e-cigarettes.

“An unsuccessful attempt to stop using nicotine is a central measure of nicotine addiction because it indicates loss of autonomy, a defining characteristic of addiction to any substance, and is also a risk factor for long-term chronic substance use trajectories, distress and impairment,” Miech and colleagues wrote. “E-cigarette and combustible cigarette users may be similarly likely to experience an unsuccessful quit attempt because both products deliver similar levels of nicotine with similar addiction potential.”

Overall, 249,663 respondents reported lifetime cigarette use from 1997 to 2020 and, in 2020 only, 3,050 respondents reported lifetime e-cigarette use.

Among these lifetime users, 35,191 respondents reported at least one unsuccessful cigarette cessation attempt and, in 2020 only, 365 respondents reported at least one unsuccessful e-cigarette cessation attempt.

The percentage of adolescents who reported an unsuccessful cessation attempt for cigarettes declined from 9.82% in 1997 to 2.23% in 2020 (P < .001). The percentage of adolescents who reported an unsuccessful cessation attempt for e-cigarettes was 4.12% in 2020. For combustible cigarettes or e-cigarettes, the percentage of adolescents who reported an unsuccessful cessation attempt was 5.74% in 2020.

Researchers reported a significantly higher percentage of unsuccessful cigarette cessation attempts during each year from 1997 to 2001 (9.82% to 7.47%), was not significantly different from 2002 to 2006 (6.61% to 4.86%) and then was significantly lower each following year from 2007 to 2020 (3.96% to 2.23%).