A vaping cessation text message program for adolescent e-cigarette users

JAMA Network

About The Study: A tailored, interactive text message intervention increased self-reported vaping cessation rates among adolescents recruited via social media channels.

Quote from corresponding author Amanda L. Graham, PhD:

“Health care providers, teachers, and parents have been asking how to help teens quit vaping. This study is a critical breakthrough that demonstrates the power of a behavioral intervention for vaping cessation. Text messages serve as powerful reminders of an initial commitment to quit and can deliver proven behavior change support right to a young person’s phone.

“We also did not see evidence that teens who quit vaping transitioned to smoking. The intervention was effective in reducing dual use (smoking and vaping) and keeping teens in this study from starting to smoke.”

Contact information for Amanda L. Graham, PhD: email Megan Kelley (mkelley@truthinitiative.org).

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jama.2024.11057)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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Journal

JAMA

Some e-cigarette chemicals mimic nicotine, possibly bypassing regulation

Products also use flavors and sweeteners like those preferred by people who are younger or using e-cigarettes for the first time, raising concerns about unknown health risks

Duke University Medical Center

DURHAM, N.C. – In what appears to be an effort to bypass public health regulations covering vaping products, some tobacco companies have begun replacing nicotine in e-cigarettes with related chemicals that have similar properties but unknown health effects, Duke Health researchers report.

In a research letter appearing Aug. 7 in JAMA, study authors at Duke and Yale University also found that the quantity of these chemicals, known as nicotine analogs, are not accurately disclosed on the packaging.

“Vaping products containing nicotine are subject to federal laws that prohibit sales to people  under the age of 21,” said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine.

“Nicotine analogs are currently not subject to the FDA process and have not been studied for their health effects,” Jabba said. "Our analysis of some of these analog-containing vaping products sold in the U.S. found significant and concerning inaccuracies in the ingredients these products claim to contain and what they actually contain. Further, it’s possible manufacturers are attempting to avoid FDA tobacco regulation.”

One chemical, known as 6-methyl nicotine, has been shown in rodent experiments to be far more potent than nicotine in targeting the brain’s nicotine receptors and more toxic than nicotine. Another, called nicotinamide, is marketed as targeting the same brain receptors as nicotine, despite evidence it does not bind to these receptors.

The nicotine analogs were included in flavored e-cigarettes, which prior research has indicated are preferred by youths and those who vape for the first time.

Jabba and colleagues, including co-senior author Sven Eric Jordt, Ph.D., analyzed an e-cigarette product sold under the brand name Spree Bar, which comes in at least nine flavors and is listed as containing 5 percent 6-methyl nicotine. Study results showed the actual amount of the chemical was about 88% less than labeled. The e-cigarettes also included an artificial sweetener that is up to 13,000 times sweeter than table sugar, and an artificial coolant that mimics menthol’s effects.

A second brand of e-cigarettes -- marketed as Nixotine, Nixodine, Nixamide and Nic-Safe – contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine. This brand did not include sweeteners or coolants.

“These products appear to be designed to circumvent the laws and regulations in place to protect people -- especially children -- from the harmful effects of smoking and tobacco use,” Jordt said. “We do not know what these chemicals do when they are heated and inhaled. These are questions that should be answered before we allow products on the market.”

In addition to Jordt and Jabba, study authors include Hanno C. Erythropel, Peter Silinski, Paul T. Anastas, Suchitra Krishnan-Sarin and Julie B. Zimmerman.

Yale’s Tobacco Center of Regulatory Science received funding support for the study from the National Institute on Drug Abuse, which is part of the National Institutes of Health (U54DA036151), and the Center for Tobacco Products of the FDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA.

 

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JAMA