JMIR Publications

ABSTRACT

Background:

In the United States, e-cigarettes, or vapes, are the second most-commonly used tobacco product. Despite abundant smartphone app-based cigarette cessation programs, there are few such programs for vaping and even less supporting data.

Objective:

This initial evaluation of the Pivot vaping cessation program aimed to assess participant engagement and retention, changes in attitudes toward quitting vaping, changes in vaping behavior, and participant feedback.

Methods:

U.S. adults aged ≥ 21 years who vape daily, report ≥ 5 vape sessions per day, and plan to quit vaping in the next 6 months were recruited online. Participants completed an online screening form, screening call, electronic informed consent, registration, and onboarding before beginning Pivot. Data were self-reported via app and web-based questionnaires. Outcomes focused on engagement and retention (i.e., weeks in the program, number of Pivot app openings, number of messages sent to coach); vaping attitudes (i.e., success to quit [STQ], difficulty to stay quit [DTQ]); vaping behavior (i.e., quit attempts, Penn State Electronic Cigarette Dependence Index [PSECDI], 7- and 30-day point prevalence abstinence [PPA], continuous abstinence [defined as ≥ 7-day PPA at 12 weeks + 30-day PPA at 26 weeks + 0 vaping sessions since 12 weeks]); and participant feedback.

Results:

Seventy-three participants completed onboarding (intention-to-treat [ITT] sample); 68/73 (93%) completed the 12- and 26-week questionnaires (completer samples). On average, participants were active in Pivot for 13.8 (SD 7.3) weeks, had 71.3 (SD 79.7) app sessions, and sent 37.6 (SD 42.3) messages to their coach over 26 weeks. STQ and DTQ (scale 1-10) improved from baseline to 12 weeks: STQ 4.9 (SD 2.9) to 7.0 (SD 3.0); DTQ 4.0 (SD 2.8) to 6.2 (SD 3.1); both P < .001). Most participants (64/73, 88%) made ≥ 1 quit attempt. At 26 weeks, ITT 7-day PPA, 30-day PPA and continuous abstinence rates were: 35/73 (48%), 33/73 (45%), and 22/73 (30%), respectively. Thirty-three participants did not achieve 7-day PPA at 26 weeks; their mean PSECDI score decreased from baseline (13.9, SD 3.1) to 26 weeks (10.8, SD 4.5) (mean change -3.2, SD 3.9, P < .001); almost half (16/33, 48%) had improvement in e-cigarette dependence category. At 2 weeks, 51/71 (72%) reported using Pivot increased their motivation to quit vaping; at 4 weeks, 55/70 (79%) reported using Pivot decreased the amount they vape per day.

Conclusions:

This study evaluated Pivot’s initial performance in adult daily vapers. At 6 months, almost half of participants achieved abstinence. With the rise in vaping popularity and attendant need for evidence-based cessation programs, this study supports Pivot as a viable solution. Clinical Trial: ClinicalTrials.gov NCT05642598; https://clinicaltrials.gov/study/NCT05642598.