E-cigarettes are the most frequently used tobacco product among adolescents and young adults. Over 40% of adolescents who used e-cigarettes tried quitting in 2023, but few programs support them, particularly on social media. Test the efficacy of e-cigarette cessation support groups on Instagram in a randomized controlled trial. 500 participants were randomized to intervention or active control with baseline, 5 week (end of program), 3 and 6 month follow up surveys in 2022-2024. Healthy volunteers in California were recruited via social media advertisements. Participants reported age 13-21 years, English literacy, using social media at least 4 days per week, using e-cigarettes at least weekly, access to device with photo capability, considering quitting within 6 months. Instagram direct message support groups for 5 weeks provided motivational interviewing, social support, skill building, and group quit attempts. Controls were referred to state quitline resources including telephone, online, texting or mobile app. 7-day point prevalence abstinence from e-cigarette use. Data was analyzed in 2024-2025. Mean age was 18.9 years, 39.8% female, 51.2% male; 41.1% non-Hispanic white, 17.2% Hispanic, and 27.4% multiracial; 35.1% sexual minority. 70.4% used e-cigarettes daily, and 78.2% within 30 minutes of waking. Retention rates were 43.6% at 5 weeks, 23.0% at 3 months and 28.0% at 6 months. Generalized linear mixed models (GLMM) in a time-averaged difference examined 7-day point prevalence abstinence accounting for repeated measures and clustering effects. Intention to treat analysis counting missing as vaping found greater abstinence in the intervention group (18.2% vs 11.8%) (OR = 2.15, 95% CI = 1.1, 4.2, p=0.025). Complete case analysis also found greater abstinence over 6 months for intervention (53.9%) compared to control (40.4%) (OR = 2.07, 95%CI = 1.21, 3.52, p=0.008). There were no differences in vaping reduction, attitudes, or use of evidence-based methods. Intervention participants reported higher social support with no difference in overall program evaluation. Social media support groups were acceptable to diverse young people and improved abstinence rates on average over 6 months compared to quitline referral. Clinicaltrials.gov (protocol # NCT04707911).
Ling et al. (Sun,) studied this question.