JMIR Publications

ABSTRACT

Background:

Dual use of both e-cigarettes and cigarettes is popular among young adults and may lead to greater nicotine dependence and additive adverse health effects than single-product use. However, existing cessation programs target quitting either e-cigarettes or cigarettes, highlighting a need for interventions to help young adults quit both products (i.e., dual tobacco cessation).

Objective:

This formative study is part of a larger project to develop a smartphone intervention for dual tobacco cessation among young adults. This study aimed to (1) explore desires for and experiences with quitting both e-cigarettes and cigarettes and (2) identify needs and preferences for dual tobacco cessation intervention programming.

Methods:

Semi-structured interviews were conducted to elicit needs for and experience with dual tobacco cessation among 14 young adults (18-29 years old) in 2023. We conducted a thematic analysis to identify common themes related to quitting experiences and cessation needs.

Results:

Participants expressed a strong desire for dual cessation and attempted to quit both tobacco products, mostly “cold turkey.” The priority product for quitting first varied by individual’s perceived harm or level of consumption. Targets for dual tobacco cessation interventions included the following critical content: highlighting the health effects of dual tobacco use compared to single product use; proving cessation support to quit one prioritized product while cutting down the other product with the explicit goal to quit both; emphasizing unique facilitators and barriers to quitting each product (e.g., unpleasant smell of cigarettes facilitating smoking cessation, accessibility and flavors of e-cigarettes hindering vaping cessation); and addressing co-use of tobacco with alcohol/cannabis. Participants wanted personalized interventions via smartphone apps that would tailor support to their tobacco use patterns and unique quitting goals and needs. They also suggested presenting intervention content in multimedia (e.g., videos, graphic pictures, quizzes, and games) to increase intervention engagement.

Conclusions:

This study provides important insights into young adults’ experiences, needs, and preferences for dual tobacco cessation. We highlighted critical targets for future interventions that employ smartphone applications for delivering personalized and tailored support to meet the heterogeneous needs and preferences of young people who want to quit using both e-cigarettes and cigarettes.