Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 28, 2025
Date Accepted: Dec 29, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Feasibility and Engagement of a Peer-Driven Mobile Intervention for Adolescent E-Cigarette Cessation: A Cluster-Randomized Pilot Study
ABSTRACT
Background:
E-cigarette use remains prevalent among U.S. adolescents, with many reporting daily use and high nicotine dependence. Although mobile interventions offer potential support for e-cigarette cessation, there is a lack of evidence-based interventions focused on adolescents.
Objective:
To evaluate the feasibility, engagement, and preliminary efficacy of Vaper-to-Vaper (V2V)—a multi-component, mobile, peer-driven texting intervention designed to support adolescent e-cigarette cessation
Methods:
The V2V texting intervention included four components: peer-written messages, peer videos, asynchronous peer coaching, and a gamified fictional story. A cluster-randomized pilot study was conducted in five Massachusetts high schools with schools randomized to either the V2V intervention (n=3) or a control group (n=2) that received a link to the NCI Smokefree.gov Quit Vaping website. Eligible participants (grades 9–12, current e-cigarette users) were followed for three months. Engagement and satisfaction were assessed among intervention participants. Secondary outcomes included comparing changes in self-efficacy, smoking Urges, and number of Days Vaped. E-cigarette cessation was biochemically verified using the Abbott iScreen Cotinine Test.
Results:
Seventy-one adolescents enrolled (39 intervention, 32 control), with a 96% follow-up rate at three months. Among intervention participants, engagement was highest with peer messaging (80%), followed by gamification (50%) and peer coaching (49%); peer video engagement was lowest (37%). Satisfaction scores were high (mean = 25.3, SD = 4.7). The intervention group showed greater improvements in confidence to quit (44% vs. 28%) and reductions in smoking urges (−3.8 vs. +0.9) and days vaped (−3.6 vs. −2.9) compared to controls, though differences were not statistically significant. Cotinine-validated 7-day point prevalence abstinence was similar between groups (21.6% intervention vs. 22.6% control).
Conclusions:
The V2V intervention demonstrated feasibility and acceptability among adolescents, with strong engagement and satisfaction Clinical Trial: ClinicalTrials.gov https://clinicaltrials.gov/study/NCT05140915 NCT05140915
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