Dual abstinence from nicotine vaping and cannabis use among young people: secondary analyses from two U.S.-based randomized controlled trials of vaping cessation

Abstract

Objective: To examine patterns of abstinence from nicotine vaping and cannabis use among adolescent and young adult (YA) e-cigarette users in two text message vaping cessation trials. Methods: Among adolescents with complete 7-month data (n = 1,016) at baseline, 25.4% were Exclusive E-cigarette Users (no past 30-day cannabis use) and 74.6% were Dual Users (past 30-day cannabis use). Among YAs with complete 7-month data (n = 1,829), 40.8% were Exclusive E-cigarette Users and 59.2% were Dual Users at baseline. Primary analyses examined the proportion of participants who were Dual Abstinent at 7-months by treatment arm differences. We also examined for interaction effects between baseline product use and vaping status at 7 months on cannabis use outcomes. Results: At 7-months, adolescent categories of use were: Dual Abstinent, 31.7% (95% CI: 28.8, 34.6); Exclusive E-cigarette Users, 18.2% (95% CI: 15.9, 20.7); Exclusive Cannabis Users, 15.1% (95% CI: 12.9, 17.4); Dual Users, 35.0% (95% CI: 32.1, 38.1). Among YAs: Dual Abstinent, 15.6% (95% CI: 13.9, 17.3); Exclusive E-cigarette Users, 29.4% (95% CI: 27.3, 31.6); Exclusive Cannabis Users, 12.8% (95% CI: 11.3, 14.5); Dual Users, 42.2% (95% CI: 39.9, 44.5). Intervention outperformed Control in promoting rates of Dual Abstinence among adolescents (38.5% vs. 25.0%, p < 0.0001) and YAs (17.9% vs. 13.3%, p = 0.007). A higher proportion of Exclusive E-cigarette Users compared to Dual Users were Dual Abstinent at follow-up (adolescents: 37.6% vs. 29.7%, p = 0.019; YAs: 25.8% vs. 8.5%, p < 0.001). Conclusion: A text message nicotine vaping cessation intervention promoted dual abstinence from e-cigarettes and cannabis among adolescents and YAs. Dual abstinence rates were higher among exclusive vapers than dual users, signaling the need to optimize cessation programs for dual users. Trial Registration: Studies included were registered on ClinicalTrials.gov (NCT04251273, registered on January 31, 2020; NCT04919590, registered on June 9, 2021)