Targeted intervention could help promote smoking cessation in dual users

There are many concerns about electronic cigarettes, especially when it comes to vaping by young people. However, new evidence suggests that e-cigarettes can be a useful tool to quit smoking. Researchers at the Moffitt Cancer Center’s Tobacco Research and Intervention Program wanted to build on this evidence by testing whether it could help dual users, people who use both combustible cigarettes and e-cigarettes. , to quit smoking.

In a new article published in Lancet Public Health, they report the results of a one-of-a-kind national study evaluating a targeted intervention to transform dual-user e-cigarettes from a product that could maintain smoking into a tool that can be used to help quit smoking.

An estimated 8 million adults in the United States use e-cigarettes, often for the purpose of quitting or reducing smoking. Almost 41% are dual users, a practice that maintains, and in some cases could increase, both nicotine addiction and exposure to toxins.

We were concerned that smokers who started vaping to quit smoking often ended up using both products. This prompted our team to develop an easy-to-distribute intervention that could improve the smoking cessation efforts of dual users and maintain smoking abstinence. “

Thomas Brandon, Ph.D., Chairman of the Health Outcomes & Behavior Department and Director of the Tobacco Research and Intervention Program, Moffitt Cancer Center

The research team, which included collaborators from Virginia Commonwealth University; Eastern Virginia School of Medicine; and the University of Auckland, New Zealand, interviewed vapers who were and could not quit smoking. Based on what they learned, they developed a series of “If You Vape” booklets that include smoking cessation tips specially designed for dual users.

To test their intervention, Moffitt’s team launched a nationwide trial with nearly 2,900 dual users. The participants were randomly divided into three groups: an evaluation group receiving no intervention, a generic support group receiving standard smoking cessation materials and the targeted intervention group receiving the new “If You Vape” booklets. Participants completed surveys every three months for two years to report their current smoking and vaping.

The results showed that the targeted intervention produced smoking abstinence rates about 5-10 percentage points higher than the assessment group over the 18 months of treatment. The generic intervention produced abstinence rates between the other two arms. The researchers noted that while those who reported little or no addiction to combustible cigarettes had better overall success in quitting, the more addicted smokers benefited the most from the new intervention. For example, among addicted smokers who received the booklets, about 20% had quit after six months, compared to 13% of those in the evaluation group.

“Our study indicates that dual users could benefit from specific interventions that benefit from their continued use of electronic cigarettes, which in turn could increase the public health potential of electronic cigarettes,” Brandon said. “I think it’s important to note that while our documents didn’t endorse initiation of vaping, neither did they demonize use. We treated vapers with respect and passed on information to help them achieve their goal of quitting smoking. “

Although the booklets suggest that participants might consider giving up all nicotine, the researchers found no difference in vaping between the groups.

The research team wants to expand its efforts to include testing alternative intervention modalities such as a mobile app, improving long-term smoking cessation, and testing the intervention in a clinical setting.


Journal reference:

Martinez, U., et al. (2021) Targeted smoking cessation for dual fuel and electronic cigarette users: a randomized controlled trial. Lancet Public Health.

About Margaret Shaw

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