Peer Vaped Nicotine Use in Adolescents and Young Adults: Associations With Abstinence and Intervention Adherence During a Quit Attempt.

BACKGROUND

Vaped nicotine use is associated with nicotine dependence, mental health symptoms, and physical health problems in adolescents, and peer nicotine use is a robust predictor of nicotine vaping in adolescents and young adults.

OBJECTIVE

Examine associations between peer nicotine vaping and participant nicotine vaping cessation outcomes or nicotine dependence treatment adherence among adolescents and young adults enrolled in a vaping cessation trial.

DESIGN

Exploratory secondary analysis of a 12-week randomized controlled trial with 3-month follow-up.

METHODS

Participants completed a three arm, 12-week trial of varenicline and counseling, placebo and counseling, or enhanced treatment-as-usual. Participants (N=280; ages 16-25) indicated number of close friends in their broad peer network who use nicotine vapes, and a subset reported on frequency of nicotine vaping among their 10 closest friends as well as frequency of vaping by their best friend. Analyses evaluated the effect of peer vaping on biochemically-verified 7-day nicotine abstinence (end-of-treatment and follow-up) and treatment adherence. Multilevel mixed-effects models accounted for treatment condition.

RESULTS

Participants reported a mean of 6.9 (SD=6.8) close peers in their broad peer network used vaped nicotine at baseline; more peers using nicotine vapes was inversely associated with end-of-treatment abstinence (β=-.11, p=.03), and more frequent vaping among participants' top 10 closest peers and best friend vaping frequency were inversely associated with abstinence at end-of-treatment and follow-up (βs=-.25 to -.32, ps≤.05). For every 1 SD increase in participants' best friend's vape frequency, participants were 76% less likely to maintain a vape quit at 3-month follow-up (β=-1.26, p=.044; OR=0.24). Measures of peer vaping were also inversely associated with study medication adherence (βs>=-.52, ps≤.007) and fewer counseling sessions attended (βs=-.49 to -.60, ps≤.008).

CONCLUSION

Peer vaping behavior may be associated with adolescents' capacity to quit vaped nicotine. Interventions that directly address peer network influences may enhance vaping cessation outcomes.