ACT on Vaping: Pilot Randomized Controlled Trial of a Novel Digital Health App With Text Messaging for Young Adult Vaping Cessation

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: 24-hour quit attempts: 87.5% vs 75.9% (11.6% absolute difference); 30-day abstinence: 4.2% vs 0%

• Primary Outcome: Satisfaction with ACT on Vaping averaged 3.8/5.0, exceeding acceptability benchmark of ≥3.5

• Nnt Or Sensitivity: NNT approximately 9 for 24-hour quit attempts (if effect is real)

• Confidence Interval: Not reported

Clinical Application

High feasibility given smartphone ubiquity and low resource requirements for digital interventions Highly relevant to Australian practice given rising vaping rates among young adults; aligns with TGA's recent vaping restrictions and RACGP smoking cessation guidelines emphasizing digital health solutions Young adults aged 18-30 who vape, particularly those with varying levels of quit readiness

Abstract

BACKGROUND: There is no published evidence to support the efficacy of any digital vaping cessation program for young adults (YAs) at differing levels of readiness to quit. In this pilot randomized controlled trial, we evaluated the preliminary acceptability and efficacy of a program for vaping cessation based on acceptance and commitment therapy (ACT on Vaping), delivered via a smartphone app and text messaging. METHODS: YAs aged 18-30 (n = 61) were randomized 1:1 to ACT on Vaping (n = 31) or incentivized text message control (n = 30). Outcome data were collected at 3 months post-randomization. Results were compared against a priori benchmarks for acceptability (satisfaction of ≥3.5 on 5-point scale) and efficacy relative to control (meeting at least one of three): ≥1-point difference in Contemplation Ladder change scores; ≥5 percentage difference in 24-hour quit attempts, ≥5 percentage difference in cotinine-confirmed 30-day point prevalence abstinence (PPA) from all non-therapeutic nicotine/tobacco. RESULTS: Satisfaction with ACT on Vaping averaged 3.8, exceeding the acceptability benchmark. A higher proportion of participants in the ACT on Vaping arm reported a 24-hour quit attempt (87.5% vs. 75.9%), exceeding the efficacy benchmark. Both changes in quit readiness (+0.96 in ACT on Vaping vs. +0.72 in control) and cotinine-confirmed 30-day PPA (4.2% in ACT on Vaping vs. 0% in control) were descriptively higher for ACT on Vaping but did not reach the benchmark level for efficacy. CONCLUSIONS: ACT on Vaping had promising acceptability and preliminary efficacy. A fully powered trial of ACT on Vaping is warranted to evaluate its efficacy. IMPLICATIONS: Digital interventions are a promising yet under-researched approach for reaching and supporting YAs to quit vaping. This proof-of-concept pilot randomized controlled trial evaluated a novel mobile health application and associated text messaging program (ACT on Vaping) for young adult vaping cessation and found preliminary evidence for acceptability and efficacy relative to an incentivized text message control arm, warranting evaluation in a fully powered trial as a next step. TRIAL REGISTRATION: NCT05897242.

References

1. 1.Heffner, J. L., Baker, K., Georgiou, K., Graham, A. L., Kelly, M. M., Konstantinou, P., Lamprou, E., Lele, C., Lok, K. Z., Orzechowski, M., Ruiz, R. A., Serfozo, E., & Karekla, M. (2026). ACT on Vaping: Pilot Randomized Controlled Trial of a Novel Digital Health App With Text Messaging for Young Adult Vaping Cessation. Nicotine & Tobacco Research. https://doi.org/10.1016/j.drugalcdep.2022.109311