Shannon Lea Watkins1, Johannes Thrul2, Wendy Max3, Pamela M Ling4. 1. Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA. 2. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 3. Institute for Health & Aging, School of Nursing, University of California San Francisco, San Francisco, CA. 4. Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA.
Abstract
INTRODUCTION: Young adults have high combustible cigarette and e-cigarette use rates, and low utilization of evidence-based smoking cessation strategies compared to older adults. It is unknown whether young adults who try to quit smoking without assistance, with evidence-based strategies, or with e-cigarettes, are equally successful compared to older adults. AIMS AND METHODS: This analysis used a population-based sample from the Population Assessment of Tobacco and Health study of young adult (aged 18-24, n = 745) and older adult (aged 25-64, n = 2057) established cigarette smokers at Wave 1 (2013-2014) who reported having made a quit attempt at Wave 2 (2014-2015). Cessation strategies were: behavioral therapy, pharmacotherapy, product substitution, 2+ strategies, and unassisted. Logistic regression estimated associations between cessation strategy and short-term cessation status at Wave 2 (quit, no quit); multinomial logistic regression predicted long-term cessation patterns at Waves 2 and 3 (sustained quit, temporary quit, delayed quit, no quit). RESULTS: No cessation strategy (ref: unassisted) significantly predicted short-term cessation. No cessation strategy (ref: unassisted) significantly predicted long-term cessation patterns for young adults. Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day (adjusted odds ratio [AOR]: 1.70; 95% confidence interval: 1.08, 2.67) but did not predict long-term cessation patterns. CONCLUSIONS: Despite differences in cessation strategy use between young and older adult smokers, strategy effectiveness largely did not differ by age group. No strategy examined, including e-cigarettes, was significantly associated with successful cessation for young adults. More work is needed to identify effective interventions that help young adult smokers quit. IMPLICATIONS: (1) Neither behavioral support, pharmacotherapy, nor product substitution was associated with short-term cessation for young or older adults compared to quitting unassisted. (2) Neither behavioral support, pharmacotherapy, nor product substitution was associated with longer-term cessation for young or older adults compared to quitting unassisted. (3) Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day but was not associated with longer-term cessation.
INTRODUCTION: Young adults have high combustible cigarette and e-cigarette use rates, and low utilization of evidence-based smoking cessation strategies compared to older adults. It is unknown whether young adults who try to quit smoking without assistance, with evidence-based strategies, or with e-cigarettes, are equally successful compared to older adults. AIMS AND METHODS: This analysis used a population-based sample from the Population Assessment of Tobacco and Health study of young adult (aged 18-24, n = 745) and older adult (aged 25-64, n = 2057) established cigarette smokers at Wave 1 (2013-2014) who reported having made a quit attempt at Wave 2 (2014-2015). Cessation strategies were: behavioral therapy, pharmacotherapy, product substitution, 2+ strategies, and unassisted. Logistic regression estimated associations between cessation strategy and short-term cessation status at Wave 2 (quit, no quit); multinomial logistic regression predicted long-term cessation patterns at Waves 2 and 3 (sustained quit, temporary quit, delayed quit, no quit). RESULTS: No cessation strategy (ref: unassisted) significantly predicted short-term cessation. No cessation strategy (ref: unassisted) significantly predicted long-term cessation patterns for young adults. Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day (adjusted odds ratio [AOR]: 1.70; 95% confidence interval: 1.08, 2.67) but did not predict long-term cessation patterns. CONCLUSIONS: Despite differences in cessation strategy use between young and older adult smokers, strategy effectiveness largely did not differ by age group. No strategy examined, including e-cigarettes, was significantly associated with successful cessation for young adults. More work is needed to identify effective interventions that help young adult smokers quit. IMPLICATIONS: (1) Neither behavioral support, pharmacotherapy, nor product substitution was associated with short-term cessation for young or older adults compared to quitting unassisted. (2) Neither behavioral support, pharmacotherapy, nor product substitution was associated with longer-term cessation for young or older adults compared to quitting unassisted. (3) Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day but was not associated with longer-term cessation.
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