E-cigarette Quit Attempts in Emerging Adults: Motivations for Attempts and Predictors of Cessation Barriers

Abstract

Introduction Although young adults use electronic nicotine delivery systems (ENDS) more often than any other demographic group, most are interested in cessation; however, little is known about their cessation experiences. The present study examined characteristics associated with quit attempts, reasons for quitting and resources utilized, and psychological symptoms [i.e., depression, anxiety, anxiety sensitivity, attention-deficit/hyperactivity disorder (ADHD)] associated with cessation barriers. Method College-attending adults from six U.S. institutions who endorsed lifetime ENDS use (N=2007; 75% female) completed a one-hour online survey between Fall 2022-Spring 2023. Results More than half of participants (53%) made a cessation attempt; of those participants, more than half (53%) made multiple attempts. Male sex; college region; earlier ENDS initiation; higher ENDS dependence; disposable or pod device use; and past 30-day combustible use were associated with cessation attempts. Health concerns motivated many quit attempts (44%), although participants identified a range of reasons that converged with prior research. Unassisted cessation methods were most common [e.g., cold turkey (68%), willpower (53%)]. Although utilized far less often, replacing vaping with another activity, support from family/friends, nicotine replacement, and prescription cessation medications were perceived to be helpful. Anxiety sensitivity and ADHD symptoms were associated with more barriers to cessation, particularly with affect management and withdrawal. Conclusions ENDS quit attempts are common among young adults, particularly males and those with higher dependence, but largely are unassisted. Encouraging the use of multiple interventions and tailoring interventions to those with psychological vulnerabilities are critical next steps to improving young adults’ success with ENDS cessation. Implications Young adults are motivated to quit ENDS for a wide range of intra- and interpersonal reasons. However, their limited uptake of ENDS cessation resources suggests an opportunity to better publicize and increase access to these resources, particularly to digital resources, nicotine replacement therapy, and prescription cessation medications. To be maximally effective, cessation interventions should be multipronged and address the unique challenges faced by individuals with greater anxiety sensitivity and ADHD symptoms, prominent issues in this developmental stage.