Pilot randomised controlled trial of an e-cigarette and tobacco use intervention for hospitalised youth
Abbey R Masonbrink1,2, Shelbie Wooten3, Hung-Wen Yeh3
1Keck School of Medicine, University of Southern California, Los Angeles, California, USA amasonbrink@chla.usc.edu.
Insights
This pilot study evaluated an e-cigarette cessation intervention for hospitalized youth, finding promising implementation but no significant efficacy in abstinence rates. Further research is needed to improve intervention effectiveness.
Area of Science:
- Adolescent health
- Tobacco control
- Digital health interventions
Background:
- E-cigarette use is prevalent among hospitalized youth.
- Effective cessation interventions for this population are limited.
- This study addresses the need for evidence-based cessation support in pediatric healthcare settings.
Purpose of the Study:
- To evaluate the preliminary efficacy and implementation outcomes of an e-cigarette and tobacco cessation intervention for hospitalized youth.
- To assess abstinence rates and intervention acceptability, feasibility, and fidelity.
Main Methods:
- A pilot randomized controlled trial was conducted with hospitalized youth (14-21 years) using e-cigarettes.
- The intervention included health education, motivational interviewing, quit planning, nicotine replacement therapy (NRT), and booster sessions.
- The control group received brief advice and referral; the primary outcome was 3-month e-cigarette abstinence.
Main Results:
- No significant difference in 3-month e-cigarette abstinence was observed between the intervention (43%) and control (42%) groups.
- The intervention demonstrated high acceptability (89% satisfaction) and feasibility, with all participants completing the initial session.
- Fidelity scores were high (mean 43/50), but only 49% made a quit plan and 23% were prescribed NRT.
Conclusions:
- The e-cigarette cessation intervention shows promise in implementation but not efficacy among hospitalized youth.
- Future research should focus on enhancing the intervention's effectiveness to improve cessation rates in this vulnerable population.
Introduction:
We sought to evaluate preliminary efficacy and implementation outcomes of an e-cigarette and tobacco cessation intervention for hospitalised youth in the USA.
Methods:
We conducted a pilot randomised controlled trial at a paediatric hospital with 3-month follow-up from August 2023 to December 2024. Hospitalised youth (14-21 years) with self-reported past 30-day e-cigarette use were eligible. Exclusions included severe medical/psychiatric illness, cognitive impairment and inability to communicate in English. Intervention entailed health education, motivational interviewing counselling, quit planning, nicotine replacement therapy (NRT) and phone booster sessions. Control entailed brief advice and quit programme referral. The primary outcome was self-reported past 30-day e-cigarette abstinence at 3 months with biochemical confirmation with intention-to-treat (ITT) sensitivity analysis. Implementation outcomes included acceptability, feasibility and fidelity.
Results:
In 144 hospitalised youth enrolled, the mean age was 16.2 years (SD: 1.3) and 62% were female. At 3 months there was no difference in past 30-day e-cigarette abstinence between arms (intervention 43% vs control 42%; p=0.91). In ITT analysis we found the OR of abstinence was OR 0.77 (95% CI 0.27 to 2.19, p=0.62) in the intervention versus control. Mean fidelity score was 43 (SD: 3; out of 50). All intervention participants (n=96) completed the initial in-person intervention, 49% made a quit plan, of those 23% were prescribed NRT. Most (89%) were somewhat/very satisfied with the intervention.
Conclusions:
Our study is among the first to demonstrate promising implementation but not efficacy of an e-cigarette cessation intervention in hospitalised youth. Future work is needed to enhance intervention efficacy in this population.
Trial Registration Number:
NCT05936099.
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