Top

BMC Public Health

Published in:

Open Access 01-12-2022 | Study protocol

Delivering vaping cessation interventions to adolescents and young adults on Instagram: protocol for a randomized controlled trial

Authors: Joanne Chen Lyu, Sarah S. Olson, Danielle E. Ramo, Pamela M. Ling

Published in: BMC Public Health | Issue 1/2022

Abstract

Background

Adolescent and young adult use of electronic nicotine delivery systems (“vaping”) has increased rapidly since 2018. There is a dearth of evidence-based vaping cessation interventions for this vulnerable population. Social media use is common among young people, and smoking cessation groups on social media have shown efficacy in the past. The objective of this study is to describe the protocol for a randomized controlled trial (RCT) testing the efficacy of an Instagram-based vaping cessation intervention for adolescents and young adults.

Methods

Adolescents and young adults aged 13–21 residing in California who have vaped at least once per week in the past 30 days will be recruited through social media ads, community partners, and youth serving organizations. Participants will be randomly assigned to intervention or control conditions: the intervention group takes place on Instagram, where participants receive up to 3 posts per weekday for 25 days over 5 weeks; the control group will be directed to kickitca.org, a website offering links to chatline and texting cessation services operated by the California Smokers' Helpline. The primary outcome is biochemically verified 7-day point prevalence abstinence for nicotine vaping; secondary outcomes are vaping reduction by 50% or more, vaping quit attempts, readiness to quit vaping, confidence in ability to quit, desire to quit, commitment to abstinence, and use of evidence-based cessation strategies. Both the primary outcome and secondary outcomes will be assessed immediately, 3 months, and 6 months after the treatment.

Discussion

This is the first RCT to test a vaping cessation intervention delivered through Instagram. If effective, it will be one of the first evidence-based interventions to address vaping among adolescents and young adults and add to the evidence base for social media interventions for this population.

Trial registration

ClinicalTrials.gov: NCT04707911, registered on January 13, 2021.

Available only for authorised users

Mays D, Arrazola RA, Tworek C, Rolle IV, Neff LJ, Portnoy DB. Openness to using non-cigarette tobacco products among U.S. young adults. Am J Prev Med. 2016;50(4):528–34. https://doi.org/10.1016/j.amepre.2015.08.015.

Rath JM, Villanti AC, Abrams DB, Vallone DM. Patterns of tobacco use and dual use in US young adults: the missing link between youth prevention and adult cessation. J Environ Public Health. 2012;2012:679134.CrossRef

Green MP, McCausland KL, Xiao H, Duke JC, Vallone DM, Healton CG. A closer look at smoking among young adults: where tobacco control should focus its attention. Am J Public Health. 2007;97:1427–33.CrossRef

Foldes SS, An LC, Rode P, Schillo BA, Davern M, Alesci NL, et al. The prevalence of unrecognized tobacco use among young adults. Am J Health Behav. 2010;34:309–21.CrossRef

Fix BV, O’Connor RJ, Vogl L, Smith D, Bansal-Travers M, Conway KP, et al. Patterns and correlates of polytobacco use in the United States over a decade: NSDUH 2002–2011. Addict Behav. 2014;39:768–81.CrossRef

Lee YO, Hebert CJ, Nonnemaker JM, Kim AE. Multiple tobacco product use among adults in the United States: cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus. Prev Med. 2014;62:14–9.CrossRef

Arrazola RA, Neff LJ, Kennedy SM, Holder-Hayes E, Jones CD. Tobacco use among middle and high school students–United States, 2013. MMWR Morb Mortal Wkly Rep. 2014;63:1021–6.

Gentzke AS, Creamer M, Cullen KA, Ambrose BK, Willis G, Jamal A, et al. Vital signs: tobacco product use among middle and high school students - United States, 2011–2018. MMWR Morb Mortal Wkly Rep. 2019;68:157–64.CrossRef

Vallone DM, Bennett M, Xiao H, Pitzer L, Hair EC. Prevalence and correlates of JUUL use among a national sample of youth and young adults. Tob Control. 2019;28:603–9.CrossRef

10.

Barrington-Trimis JL, Urman R, Leventhal AM, Gauderman WJ, Cruz TB, Gilreath TD, et al. E-cigarettes, cigarettes, and the prevalence of adolescent tobacco use. Pediatr. 2016;138:e20153983.CrossRef

11.

Dutra LM, Glantz SA. E-cigarettes and national adolescent cigarette use. Pediatr. 2017;139:20162450.CrossRef

12.

Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the field: use of electronic cigarettes and any tobacco product among middle and high school students - United States, 2011–2018. MMWR Morb Mortal Wkly Rep. 2018;67:1276–7.CrossRef

13.

Cullen KA, Gentzke AS, Sawdey MD, Chang JT, Anic GM, Wang TW, et al. E-cigarette use among youth in the United States, 2019. Jama. 2019;322:2095.CrossRef

14.

Gaiha SM, Lempert LK, Halpern-Felsher B. Underage youth and young adult e-cigarette use and access before and during the coronavirus disease 2019 pandemic. JAMA Network Open. 2020;3:e2027572-e.CrossRef

15.

Gentzke AS, Wang TW, Cornelius M, Park-Lee E, Ren C, Sawdey MD, et al. Tobacco product use and associated factors among middle and high school students - national youth tobacco survey, United States, 2021. MMWR Surveill Summ. 2022;71:1–29.CrossRef

16.

National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. E-Cigarette use among youth and young adults: a report of the Surgeon General. Atlanta: Centers for Disease Control and Prevention (US); 2016. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538680/.

17.

Centers for Disease Control and Prevention (CDC). Talking to Youth and Young Adults to Prevent E-cigarette Use. [updated August 20, 2021; cited 2022 June 17]; Available from: https://www.cdc.gov/tobacco/features/back-to-school/index.html.

18.

Voos N, Goniewicz ML, Eissenberg T. What is the nicotine delivery profile of electronic cigarettes? Expert Opin Drug Deliv. 2019;16:1193–203.CrossRef

19.

Stanford Medicine. Tobacco Prevention Toolkit. 2020 [cited 2020 January 22]; Available from: https://med.stanford.edu/tobaccopreventiontoolkit.html.

20.

Catch Global Foundation. Be Vape Free - A new initiative from CATCH, Discover Education, and the CVS Health Foundation 2019 [updated Dec 17, 2019; cited 2020 January 22]; Available from: https://catchinfo.org/be-vape-free-announcement/.

21.

National Jewish Health. National Jewish Health Launches Vaping and Tobacco Cessation Program to Help with Youth Vaping Epidemic. 2019 [cited 2022 March 7]; Available from: https://www.nationaljewish.org/about/news/press-releases/2019/njh-launches-vaping-and-tobacco-cessation-program-to-help-vaping-epidemic#:~:text=On%20July%201%2C%202019%2C%20National,including%20electronic%20cigarettes%20and%20vapes.

22.

U. S. Department of Health and Human Services. Smokefree Teen. Quit Vaping. 2019; Available from: https://teen.smokefree.gov/quit-vaping.

23.

Graham AL, Amato MS, Cha S, Jacobs MA, Bottcher MM, Papandonatos GD. Effectiveness of a vaping cessation text message program among young adult e-cigarette users: a randomized clinical trial. JAMA Intern Med. 2021;181:923.CrossRef

24.

Auxier B, Anderson M. Social media use in 2021: Pew Research Center; 2021. Available from: https://www.pewresearch.org/internet/2021/04/07/social-media-use-in-2021/.

25.

Vogel EA, Gelles-Watnick R, Mssarat N. Teens, Social Media and Technology 2022. Pew Research Center; 2022 [cited 2022 September 5]; Available from: https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/.

26.

Hansen J, Hanewinkel R, Morgenstern M. Electronic cigarette advertising and teen smoking initiation. Addict Behav. 2020;103:106243.CrossRef

27.

Truth Initiative. Behind the explosive growth of JUUL. 2019 [updated January 3; cited 2022 January 24]; Available from: https://truthinitiative.org/research-resources/emerging-tobacco-products/behind-explosive-growth-juul.

28.

Thrul J, Tormohlen KN, Meacham MC. Social media for tobacco smoking cessation intervention: a review of the literature. Curr Addict Rep. 2019;6:126–38.CrossRef

29.

Naslund JA, Kim SJ, Aschbrenner KA, McCulloch LJ, Brunette MF, Dallery J, et al. Systematic review of social media interventions for smoking cessation. Addict Behav. 2017;73:81–93.CrossRef

30.

Fanshawe TR, Halliwell W, Lindson N, Aveyard P, Livingstone-Banks J, Hartmann-Boyce J. Tobacco cessation interventions for young people. Cochrane Database Syst Rev. 2017;11:Cd003289.

31.

Ramo DE, Thrul J, Delucchi KL, Hall S, Ling PM, Belohlavek A, et al. A randomized controlled evaluation of the tobacco status project, a Facebook intervention for young adults. Addiction. 2018. https://doi.org/10.1111/add.14245.

32.

Sussman S, Sun P, Dent CW. A meta-analysis of teen cigarette smoking cessation. Health Psychol. 2006;25:549–57.CrossRef

33.

Ramo DE, Thrul J, Chavez K, Delucchi KL, Prochaska JJ. Feasibility and quit rates of the tobacco status project: a facebook smoking cessation intervention for young adults. J Med Internet Res. 2015;17:e291.CrossRef

34.

Ramo DE, Thrul J, Delucchi KL, Ling PM, Hall SM, Prochaska JJ. The Tobacco Status Project (TSP): Study protocol for a randomized controlled trial of a Facebook smoking cessation intervention for young adults. BMC Public Health. 2015;15:897.CrossRef

35.

Meacham MC, Lang OS, Zhao M, Yang CC, Thrul J, Ramo DE. Connectedness based on shared engagement predicts remote biochemically verified quit status within smoking cessation treatment groups on Facebook. Nicotine Tob Res. 2021;23(1):71–6.CrossRef

36.

Anderson M, Jiang J. Teens, social media & technology 2018: Pew Research Center; 2018. Available from: https://www.pewresearch.org/internet/2018/05/31/teens-social-media-technology-2018/.

37.

Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200–7.CrossRef

38.

Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. British Med J. 2013;346:e7586.CrossRef

39.

Federal Trade Commission. Children's Online Privacy Protection Rule. 2013; Available from: https://www.ftc.gov/legal-library/browse/rules/childrens-online-privacy-protection-rule-coppa.

40.

Hintze J. NCSS PASS 2008. 2008 ed. Kaysville, Utah: NCSS Statistical Software; 2008.

41.

Ramo DE, Rodriguez TM, Chavez K, Sommer MJ, Prochaska JJ. Facebook recruitment of young adult smokers for a cessation trial: methods, metrics, and lessons learned. Internet Interv. 2014;1:58–64.CrossRef

42.

Teen Health Law. California Minor Consent and Confidentiality Laws. 2019 [cited 2022 March 19]; Available from: http://teenhealthlaw.org/consent/.

43.

Tobacco Use and Dependence Guideline Panel. Treating tobacco use and dependence: 2008 update. Rockville: US Department of Health and Human Services; 2008. Available from: https://www.ncbi.nlm.nih.gov/books/NBK63952/.

44.

Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51:390–5.CrossRef

45.

DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991;59:295–304.CrossRef

46.

Vogel EA, Ramo DE, Meacham MC, Prochaska JJ, Delucchi KL, Humfleet GL. The Put It Out Project (POP) facebook intervention for young sexual and gender minority smokers: outcomes of a pilot, randomized, controlled trial. Nicotine & Tob Res. 2020;22(9):1614–21.CrossRef

47.

Resnicow K, Baranowski T, Ahluwalia JS, Braithwaite RL. Cultural sensitivity in public health: defined and demystified. Ethn Dis. 1999;9:10–21.

48.

Hall SM, Humfleet GL, Muñoz RF, Reus VI, Prochaska JJ, Robbins JA. Using extended cognitive behavioral treatment and medication to treat dependent smokers. Am J Public Health. 2011;101:2349–56.CrossRef

49.

Hall SM, Havassy BE, Wasserman DA. Commitment to abstinence and acute stress in relapse to alcohol, opiates, and nicotine. J Consult Clin Psychol. 1990;58:175–81.CrossRef

50.

Scott CK. A replicable model for achieving over 90% follow-up rates in longitudinal studies of substance abusers. Drug Alcohol Depend. 2004;74:21–36.CrossRef

51.

Cantrell J, Bennett M, Thomas RK, Rath J, Hair E, Vallone D. It’s getting late: improving completion rates in a hard-to-reach sample. Surv Pract. 2018;11:(2). https://www.surveypractice.org/article/2711-it-s-getting-late-improving-completion-rates-in-a-hard-to-reach-sample.

52.

Crosnoe R, Johnson MK. Research on adolescence in the twenty-first century. Ann Rev Sociol. 2011;37:439–60.CrossRef

53.

Ary DV, Tildesley E, Hops H, Andrews J. The influence of parent, sibling, and peer modeling and attitudes on adolescent use of alcohol. Int J Addict. 1993;28:853–80.CrossRef

54.

Pentz MA, Shin H, Riggs N, Unger JB, Collison KL, Chou CP. Parent, peer, and executive function relationships to early adolescent e-cigarette use: a substance use pathway? Addict Behav. 2015;42:73–8.CrossRef

55.

Moreno MA, Parks M, Richardson LP. What are adolescents showing the world about their health risk behaviors on MySpace? MedGenMed. 2007;9:9.

56.

Dunlop SM, More E, Romer D. Where do youth learn about suicides on the Internet, and what influence does this have on suicidal ideation? J Child Psychol Psychiatry. 2011;52:1073–80.CrossRef

57.

Ybarra ML, Mitchell KJ, Wolak J, Finkelhor D. Examining characteristics and associated distress related to internet harassment: findings from the second youth internet safety survey. Pediatr. 2006;118:e1169–77.CrossRef

58.

Ybarra ML, Mitchell KJ. How risky are social networking sites? A comparison of places online where youth sexual solicitation and harassment occurs. Pediatrics. 2008;121:e350–7.CrossRef

59.

Pantic I, Damjanovic A, Todorovic J, Topalovic D, Bojovic-Jovic D, Ristic S, et al. Association between online social networking and depression in high school students: behavioral physiology viewpoint. Psychiatr Danub. 2012;24:90–3.

60.

O’Dea B, Campbell A. Healthy connections: online social networks and their potential for peer support. Stud Health Technol Inform. 2011;168:133–40.

Title: Delivering vaping cessation interventions to adolescents and young adults on Instagram: protocol for a randomized controlled trial
Authors: Joanne Chen Lyu
Sarah S. Olson
Danielle E. Ramo
Pamela M. Ling
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-022-14606-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Delivering vaping cessation interventions to adolescents and young adults on Instagram: protocol for a randomized controlled trial

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2022

The power of local research to inform adverse childhood experiences in substance use prevention in adolescents and adults

Explanatory models of hypertension in Guatemala: recognizing the perspectives of patients, family members, health care providers and administrators, and national-level health system stakeholders

Protocol of the Luebeck longitudinal investigation of SARS-CoV-2 infection (ELISA) study – a prospective population-based cohort study

Operationalizing the distribution of oral HIV self-testing kits to men who have sex with men (MSM) in a highly homophobic environment: the Nigerian experience

Acceptability of a real-time notification of stress and access to self-help therapies among law enforcement officers

Association between social media use and the acceptance of COVID-19 vaccination among the general population in Saudi Arabia – a cross-sectional study