E-cigarettes linked to more failed attempts to quit nicotine

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The number of adolescents who have attempted to quit e-cigarettes and failed has grown with the rapid increase of teen e-cigarette use in the past five years, according to a study by University of Michigan researchers. 

The findings suggest, however, that e-cigarette use has reversed a two-decade decline among youth who made attempts to quit nicotine and failed.

In 2020, 6% of teens reported a failed quit attempt for either cigarettes or e-cigarettes. This compares with a failed quit attempt level for cigarettes of 4% in 2009, when cigarettes were the primary nicotine product for adolescents and e-cigarette prevalence was still near zero.

The 2020 level of 6% — for cigarettes and e-cigarettes combined — compares with the percentage of youth with failed attempts to quit regular cigarettes that was at 10% in 1997 and that gradually declined over the next two decades to 2% by 2020.

“These results indicate that failed nicotine quit attempt levels have gone back to where they were about 17 years ago for adolescents,” said Richard Miech, research professor at the Institute for Social Research and lead author of the study published in the Journal of the American Medical Association.

The analysis used data from U-M’s Monitoring the Future study, a project funded by the National Institute on Drug Abuse. The project annually conducts nationally representative surveys of U.S. eighth-, 10th- and 12th-grade students. For this study, the analysis pool was 815,690 students who participated in the project between 1997 and 2020.

The survey asks students about their use of cigarettes and e-cigarettes. Of those who report ever smoking a cigarette, it asked, “Have you ever tried to stop smoking cigarettes and found that you could not?” New in 2020 was a question asking students who reported ever vaping nicotine: “Have you ever tried to stop vaping nicotine and found that you could not?” Response categories were “yes” and “no.”

“Tobacco control efforts are largely responsible for the two-decade decline in failed nicotine quit attempts, which was brought about by a marked decline in adolescent cigarette use since 2000,” Miech said. “Unfortunately, the recent rise in adolescent e-cigarette use, and growing numbers of adolescents who try to quit e-cigarettes and fail, have eroded much of this decline in adolescents who struggle with nicotine.”

In addition to Miech, study co-authors include Patrick M. O’Malley, research professor emeritus, and Lloyd Johnston, Distinguished Research Scientist and research professor, both of ISR; and Adam Leventhal and Jessica Barrington-Trimis of the University of Southern California.

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