A pilot feasibility study of a behavioral intervention for nicotine vaping cessation among young adults delivered via telehealth

Amanda M Palmer, Rachel L Tomko, Lindsay M Squeglia, Kevin M Gray, Matthew J Carpenter, Tracy T Smith, Jennifer Dahne, Benjamin A Toll, Erin A McClure, Amanda M Palmer, Rachel L Tomko, Lindsay M Squeglia, Kevin M Gray, Matthew J Carpenter, Tracy T Smith, Jennifer Dahne, Benjamin A Toll, Erin A McClure

Abstract

Background: Nicotine vaping among youth has increased, warranting concern from tobacco control proponents. Many youth who vape indicate interest in quitting; however, few empirically supported vaping cessation interventions exist. This pilot feasibility study adapted an established behavioral intervention, contingency management (CM), delivered via telehealth to promote vaping cessation among young adults.

Methods: Participants (N = 27; ages 17-21) vaping nicotine regularly were recruited via social media and digital advertisements from across the US (June 2020-January 2021). Participants were randomized at approximately 4:1 to CM or Monitoring control (22:5). CM was delivered through DynamiCare Health's smartphone app for 4 weeks, in which financial incentives were delivered contingent on abstinent cotinine samples after the quit day until the end of treatment (EOT; Days 7-28; 10 expected submissions). Control participants earned incentives for submitting cotinine, regardless of abstinence. Feasibility, acceptability, and abstinence was collected throughout treatment, at EOT, and at 1-month follow-up.

Results: The majority of enrolled participants completed treatment (Monitoring: 5/5; CM: 20/22), and intervention components were rated favorably overall (> 80%). CM participants submitted 112/220 (55%) abstinent cotinine samples throughout the quit attempt, while the Monitoring group submitted 4/50 (8%) negative samples. There were no differences in abstinence between groups at EOT or follow-up.

Conclusion: This pilot study of a telehealth-based youth vaping cessation intervention demonstrated preliminary feasibility and acceptability. These results suggest that CM for young adult vaping cessation, delivered remotely, is a promising direction for future work and fully powered trials are warranted to assess intervention efficacy.

Keywords: Contingency management; Electronic cigarettes; Telehealth; Treatment; Vaping; Youth.

Conflict of interest statement

Declarations of Interest: Drs. Carpenter, Gray, and Toll have consulted to Pfizer for advisory boards. Dr. Toll testifies as expert witnesses on behalf of plaintiffs who filed litigation against the tobacco industry. Dr. Carpenter received consulting honoraria from Frutarom Pharmaceuticals. Dr. Tomko provides consultation to the American Society of Addiction Medicine. Dr. Dahne is co-owner of Behavioral Activation Tech LLC, a small business that develops digital interventions for the treatment of depression and common comorbidities. No other authors have conflicts of interest to declare.

Copyright © 2022 Elsevier B.V. All rights reserved.

Figures

Figure 1.
Figure 1.
Study design and procedures.

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