基于戒烟热线的青年电子烟戒烟：一项检验尼古丁替代疗法和移动健康的随机临床试验

Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth.

作者信息

Vickerman Katrina A, Carpenter Kelly M, Mullis Kristina, Shoben Abigail B, Nemeth Julianna, Mayers Elizabeth, Klein Elizabeth G

机构信息

RVO Health, Center for Wellbeing Research, Fort Mill, South Carolina.

出版信息

Am J Prev Med. 2025 Feb;68(2):366-376. doi: 10.1016/j.amepre.2024.10.019. Epub 2024 Dec 11.

DOI:10.1016/j.amepre.2024.10.019

PMID:39665734

Abstract

INTRODUCTION

Broad-reaching, effective e-cigarette cessation interventions are needed.

STUDY DESIGN

This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.

SETTING/PARTICIPANTS: Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18-24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.

INTERVENTION

All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).

MAIN OUTCOME MEASURES

Self-reported 7-day point prevalence vaping abstinence at 3 months.

RESULTS

A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; p=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; p=0.84).

CONCLUSIONS

This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.

TRIAL REGISTRATION

clinicaltrials.gov NCT04974580.

摘要

引言

需要广泛有效的电子烟戒烟干预措施。

研究设计

这项远程随机临床试验测试了一项移动健康计划和尼古丁替代疗法（NRT）对年轻成人电子烟戒烟的效果。

设置/参与者：2021年至2022年利用社交媒体招募了508名美国年轻成人（年龄在18 - 24岁之间），他们仅定期（过去30天内20天以上）使用电子烟且有戒烟意愿。

干预措施

所有参与者都获得了2次辅导电话，且需要完成第一次电话以正式纳入研究。参与者按2×2设计随机分为4组：邮寄NRT（8周或无）和/或移动健康计划（有或无；独立的文本计划，包括视频和在线内容链接）。

主要结局指标

3个月时自我报告的7天点患病率电子烟戒断情况。

结果

共有981名参与者符合条件并被随机分组；508名（52%）通过完成第一次电话正式纳入研究。纳入的参与者71%为女性，31%为非白人，78%每天使用电子烟。总体而言，74%的参与者完成了3个月的调查。总体而言，邮寄NRT组中83%的人以及未邮寄NRT组中24%的人自我报告使用了NRT。意向性分析7天点患病率戒断率（缺失值假定为仍在使用电子烟）仅辅导电话组为41%，辅导电话 + 移动健康计划组为43%，辅导电话 + NRT组为48%，辅导电话 + NRT + 移动健康计划组为48%。邮寄NRT（与未邮寄NRT相比；OR = 1.3；95% CI = 0.91, 1.84；p = 0.14）或移动健康计划（与无移动健康计划相比；OR = 1.04；95% CI = 0.73, 1.47；p = 0.84）之间无统计学显著差异。