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

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Discussion: 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.