Development of an online, theory-based intervention to reduce e-cigarette use and susceptibility to smoking in young adults: A pilot study

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PROJECT SUMMARY/ABSTRACT There has been widespread proliferation of e-cigarette use (i.e., vaping) among young adults (YAs), as well as evidence of strong associations between vaping with cigarette initiation and continued smoking. Despite this, there are no evidence-based vaping interventions with tailored content specifically for YAs that is easily accessible to this age group (i.e., online and viewable on mobile phones) and targets smoking susceptibility. Perceived social norms, such as overestimations of how prevalent and accepted vaping and smoking are, and misperceptions of the harms of vaping and smoking appear to play key roles in YA vaping and smoking behaviors. Indeed, beliefs about social norms, perceptions of harm, and motivations associated with vaping and smoking are linked to vaping frequency and likelihood of smoking onset among YAs; thus, targeting these in a brief intervention can be efficacious. Vaping and smoking prevalence and acceptance will be collected from a longitudinal cohort of YAs ages 18-22 (N~2200; Aim 1). These data from Aim 1 will be used to develop and beta test a brief, online intervention that incorporates personalized normative feedback (PNF), aspects informed by Motivational Interviewing, and education to address misperceptions about vaping and smoking norms and harm. As part of this aim, we will evaluate acceptability and feasibility of intervention content, including believability of the norms presented and interest in the content (Aim 2). The finalized intervention will then be pilot tested among YA current e-cigarette users who have never smoked (N = 50) with an assessment-only control (N = 50; Aim 3) to determine efficacy of the program in reducing vaping frequency and smoking susceptibility. Results from this project will be informative in (1) elucidating social and cognitive factors that contribute to and maintain vaping behaviors in YAs and (2) inform future intervention approaches designed to mitigate the risks of nicotine dependence among the rapidly increasing population of young vapers. Results will be used as framework for an R01 application to conduct a larger randomized controlled trial to test the efficacy of this intervention. I enter this project with strong quantitative skills as a clinical researcher with growing proficiency in tobacco research. This K01 is essential for me to develop additional expertise in areas that will support my objectives of becoming an independent, multidisciplinary investigator of determinants of substance use in YAs. This proposal will afford me with protected research time to develop expertise in a) predictors of addiction and its application to tobacco-product use in youth, b) technology-based substance use intervention development and evaluation, and c) longitudinal study design and advanced analytic methodologies, with mentorship to further refine my skills in the application of my research to inform policy, prevention, and early intervention efforts. I have worked closely with my proposed mentors to develop an ambitious but feasible training curriculum that integrates expert mentoring; coursework, seminars, and readings; scientific meetings; and growth in advanced analyses and manuscript and grant writing skills.