Adverse Childhood Experiences are Associated With e-Cigarette Abstinence in a Vaping Cessation Randomized Clinical...

Adverse childhood experiences (ACEs) are linked to e-cigarette use. To date, no studies have examined the association between ACEs and e-cigarette cessation. This study examined the relationship between ACEs and vaping cessation outcomes among adolescent e-cigarette users.

Participants were n = 1,248 adolescent (13-17 years) e-cigarette users recruited nationally to a randomized clinical trial of vaping cessation who completed the PEdiatric ACEs and Related Life Events Screener at baseline. The primary outcome was 30-day point prevalence abstinence from nicotine vaping at 7 months (missingness = vaping). Analyses examined associations between vaping cessation and individual ACEs items, risk strata (low: 0 ACEs; intermediate: 1-3 ACEs; high: ≥4 ACEs), and domains of adversity using inverse probability of retention weighted logistic regression adjusted for baseline confounders.

Most participants (90.1%) reported at least 1 ACE, with 55.8% classified as high risk (≥4 ACEs). High-risk participants showed 20% lower abstinence rates compared to combined low or intermediate-risk groups (risk ratio = 0.79, 95% confidence interval = 0.69-0.91, p < .001). Each additional abuse experience was associated with a 7% decrease in abstinence rates (risk ratio= 0.93, 95% confidence interval = 0.87-0.99, p = .028), while neglect and household dysfunction domains showed no significant associations with cessation outcomes.

This study provides the first evidence of an inverse relationship between ACEs and vaping cessation success among adolescents. The results suggest that trauma-informed approaches may be valuable additions to youth vaping cessation interventions.