Behavioral Intervention for Youth to Promote Vaping Cessation

Up to 400 adolescents, ages 14-19, who report weekly nicotine vaping (or use of other non combusted nicotine products, "vaping") and are willing to try to quit or reduce vaping will be enrolled; eligible participants will be randomly assigned in a 1:1 ratio to a double-blind intervention consisting of (1) QuitVaping intervention plus texting support or (2) EUC only.

Participants assigned to the QuitVaping intervention will receive referral to TIQ texting app and 12 brief, weekly, study intervention visits with monthly follow up visits until week 36. Those who are assigned to EUC will be offered TIQ texting app referral to support vaping cessation. All participants will receive education about nicotine, vaping and addiction, advice to quit vaping, TIQ referral, and weekly blinded assessments with biochemical verification of abstinence. The person conducting the assessment will be blind to study condition such that the intervention will be double blind. Following completion of the 12-week intervention period, participants will have follow-up visits at weeks 16, 20, 24, 28, 32, and 36. Visits will be conducted remotely on a secure video conferencing platform or in-person.

The enrollment visit will include a detailed description of the study, informed consent/assent, assessments to confirm eligibility, assessments of vaping and other drug use behavior, and medical and psychiatric diagnostic and symptom assessments. Written informed consent will be obtained from participants age 18 years. Written informed assent will be obtained from participants ages 16-17, no parental consent required. An opt-out consent form will be sent to a parent or legal guardian of participants ages 14-15. If a parent or legal guardian does not opt their child out within two weeks of verified review of the opt out consent form, the participant is considered consented and written informed assent will be obtained.

Eligible, consented participants will then be scheduled for weekly visits which will include assessments for all participants, and behavioral vaping cessation sessions for those assigned to QuitVaping. Saliva will be collected at assessment visits for cotinine measurement in participants who report nicotine abstinence. Urine NNAL will be collected at week 12 in participants who report continuous 4-week abstinence (weeks 9-12). Instructions for how to perform the tests will be sent to participants, and during virtual assessment visits, participants will hold the assays up to their device's camera so study staff can record the test results.

Inclusion criteria

• Age 14-19 inclusive
• Self-report of at least weekly nicotine vaping (or use of other non combusted nicotine products, "vaping") for the prior ≥3 months
• Self-report of no regular combusted tobacco use (i.e., 5 or more days of smoke smoked tobacco use per week) prior to enrollment and exhaled CO <10 ppm for those with an in person baseline visit
• Report willingness to try to quit or reduce vaping in the next 30 days
• Able to understand study procedures and read and write in English or Spanish
• Have a parent or legal guardian who is able to participate in the opt out process
• Competent and willing to provide written informed consent (if age 18) or assent (if under 18)

Exclusion criteria

• Use of a smoking cessation medication in the prior month (nicotine patch, gum, nasal spray, or inhaler, varenicline, bupropion)
• Unwilling to abstain during the study from using smoking cessation aids other than those provided by the study
• Unwilling to provide saliva or urine samples
• Any condition or situation that would, in the investigator's opinion, make it unlikely that the participant could adhere safely to the study protocol