JMIR Publications

ABSTRACT

Background:

Using social media to deliver e-cigarette cessation interventions to young people is promising, but low participant engagement and retention may undermine intervention efficacy. Peer mentoring holds great potential to address these issues.

Objective:

This study aimed to understand the feasibility and acceptability of integrating peer mentoring into a social media-based intervention to help adolescents and young adults quit e-cigarette use.

Methods:

We conducted a one-arm pilot trial with 24 adolescent and young adult e-cigarette users (ages 16-21). Participants were assigned to one of two Instagram groups, where they received an existing vaping cessation intervention, Quit the Hit (QTH), in which a trained counselor posted 1-3 evidence-based vaping cessation messages to the group for 25 weekdays (5 weeks). As an adjunct to QTH, each group included two peer mentors of similar age to participants who had successfully quit vaping. The mentors provided social support and shared their quitting experiences. Participants completed a baseline survey and a follow-up survey at the end of the intervention (week 5) and were invited to participate in post-intervention focus groups.

Results:

Participants’ mean age was 18.6 years (SD 1.2), and 58.3% were male. A majority (83.3%) identified as straight/heterosexual, 29.1% identified as non-Hispanic White, and 45.8% were high school students. On average, participants vaped e-cigarettes 5.1 days per week (SD 1.7), and 33.3% reported daily vaping. All participants had made at least one quit attempt in the past year. Nearly all (95.8%) engaged in the group by either posting or liking others’ comments at least once. Mean program engagement was 29.4 posts or likes (SD 25.5) over the 5 weeks. The study retention rate was 91.7% at week 5. Using an intent-to-treat approach, 66.7% (16/24) of participants were abstinent (7-day point-prevalence abstinence) at week 5. On a 5-point Likert scale, participants rated peer mentoring as highly useful (mean 4.6, SD 0.3) and reported high levels of satisfaction (mean 4.7, SD 0.3). All participants who completed the follow-up survey said they would recommend the program to others. Focus group findings supported these results, highlighting positive feedback on both the quality and usefulness of peer mentoring and the peer mentored version of the QTH program. Suggestions for future improvements were also discussed.

Conclusions:

Integrating peer mentoring into social media–based e-cigarette cessation interventions for adolescents and young adults is feasible and acceptable. Participants engaged in the intervention and demonstrated strong retention. They rated both the peer mentoring and the overall program highly. Self-reported abstinence at 5 weeks was high. Larger trials are warranted to evaluate the efficacy of the peer mentored intervention. Clinical Trial: Registration: Clinicaltrials.gov (NCT07437196)