Development of a Self-Help Smoking Cessation Intervention for Dual Users of Tobacco Cigarettes and E-Cigarettes

• Main Authors: Lauren R. Meltzer, Vani N. Simmons, Bárbara Piñeiro, David J. Drobes, Gwendolyn P. Quinn, Cathy D. Meade, Karen O. Brandon, Amanda Palmer, Marina Unrod, Paul T. Harrell, Christopher R. Bullen, Thomas Eissenberg, Thomas H. Brandon
• Format: Article
• Language: English
• Published: MDPI AG 2021-02-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: dual use; e-cigarette; self-help; smoking cessation; qualitative; focus groups
• Online Access: https://www.mdpi.com/1660-4601/18/5/2328
• ISSN: 1661-7827; 1660-4601

Most users of electronic cigarettes (e-cigarettes) report initiating use to quit combustible cigarettes. Nevertheless, high levels of dual use (i.e., using both combustible cigarettes and e-cigarettes) occur among adults. Using formative data from in-depth interviews and employing learner verification, we adapted an existing, validated self-help smoking-cessation intervention (Stop Smoking for Good; SSFG) to create a targeted intervention for dual users, If You Vape: A Guide to Quitting Smoking (IYV). In Phase I, in-depth interviews (<i>n</i> = 28) were conducted to assess relevance of the existing <i>SSFG</i> materials (10 booklets, nine pamphlets) and identify new content for the booklets. Next, for Phase II, learner verification interviews (<i>n</i> = 20 dual users) were conducted to assess their appeal and acceptability. Several key themes emerged from the Phase I in-depth interviews. Findings led to the inclusion of e-cigarette-specific strategies used by successful quitters such as gradually reducing nicotine levels, switching from tobacco flavor to alternative flavors, and limiting e-cigarette use to places one would normally smoke (i.e., not expanding use). Suggestions from Phase II learner verification included broadening the visual appeal for a younger, more diverse demographic, expanding tips for quitting smoking via e-cigarettes, and expanding terminology for e-cigarette devices. Beginning with an efficacious self-help intervention, we used a systematic process to develop a version specifically for dual users.