The experiences of young adults attempting to quit e-cigarettes: A mixed-methods analysis.

Introduction: Young adult users of e-cigarettes have expressed intention to quit using these products. The purpose of this study was to explore the experiences of young adult e-cigarette users with trying to quit e-cigarettes.

Methods: Using an explanatory sequential mixed-methods design, a convenience sample of young adults living in the US in 2021 who had used e-cigarettes in the past 30 days completed a cross-sectional survey (n=592), and then a subsample of participants (n=25) completed a follow-up Zoom interview. Relationships between e-cigarette dependence and quitting were examined along with differences between motives for use, abstinence experiences, and stress intolerance of those who had and had not tried to quit e-cigarettes, and associations between quitting e-cigarettes and covariates. Interviewees discussed quit attempts and reasons to quit e-cigarettes. All interviews were transcribed verbatim, data were coded, and emergent themes were compared to quantitative results.

Results: Most participants (73.5%) had attempted to quit using e-cigarettes. Variables associated with quit attempts included past cigarette smoking (AOR=1.72; 95% CI: 1.06-2.81), cognitive coping (AOR=0.056; 95% CI: 0.42-0.75), loss of control (AOR=1.45; 95% CI: 1.08-1.94), and cue exposure (AOR=1.40; 95% CI: 1.12-1.76). Increased e-cigarette dependence was associated with more e-cigarette quit attempts (p<0.001) and shorter periods of abstinence from using e-cigarettes (p<0.001). Emergent interview themes described social (e.g. environments), emotional (e.g. using when distressed), and physical (e.g. withdrawal symptoms, including headaches and shaking) barriers to quitting e-cigarettes.

Conclusions: Tobacco prevention messages, research, and cessation services should consider that young adults may experience co-occurring distress during e-cigarette quit attempts.