The U.S. Surgeon General has identified the use of e-cigarettes, known as vaping, as an epidemic among our youth, addicting a new generation to nicotine. In addition, the growing number of cases of lung injury and deaths associated with e-cigarette use reported to CDC adds to the urgency in addressing this epidemic. The Massachusetts Youth Health Survey (MYHS, 2017) reports 20.1% of high schoolers currently use e-cigarettes while 10% of middle schoolers have tried e-cigarettes. Since the MYHS report, the vaping epidemic has risen nationally at an alarming rate with an additional 1.5 million more youth using e-cigarettes from 2017 – 2018 (National Youth Tobacco Survey, 2018). Given the vaping epidemic among youth in Massachusetts, the Center for Tobacco Treatment Research and Training at the University of Massachusetts Medical School responded to school nurses’ requests for assistance in helping students quit by collaborating with the Massachusetts Department of Public Health and interested schools in the development of a customized vaping cessation initiative. A school nurse working group from across Massachusetts was convened to (1) gather information about relevant issues in their schools and resources needed, and (2) guide the development of practical resources for students and school personnel. Working group members provided input on: (1) the vaping environment in their schools, (2) cessation needs, and (3) barriers to assisting students who vape to quit, including lack of quitting resources and knowledge about vaping. Information gained from the working group and a continuous refinement process was used to develop and finalize vaping cessation resources for schools, school nurses and youth including: (1) brief student materials on vaping addiction and available resources, and (2) brief provider’s guide and a more comprehensive clinical protocol with booklet for school nurses and other providers to assist youth dependent on nicotine through the process of quitting vaping.

Background: E-cigarette use, more commonly known as vaping to our youth, has been a growing epidemic with adolescents in the United States. The recent advisory from the U.S. Surgeon General emphasizes that we must act now to protect the health of our nation’s youth from a lifetime of nicotine addiction. According to a recent 2018 Center for Disease Control MMWR article , more than 3 million high school students (grades 9 – 12) and 570,000 middle school students (grades 6 – 8) in the United States are currently vaping; defined as ≥ 1 e-cigarette in the past 30 days. Researchers from the Monitoring the Future Survey (MTS) report current e-cigarette use of a nicotine substance among middle school and high school students increased nationally by 78% from the year 2017 to 2018. This is the largest increase ever recorded for any substance in the 44 years the MTF has tracked adolescent drug use. Data from the 2017 Massachusetts Youth Risk Behavior Survey (MYRBS) reports a prevalence rate for high schoolers who ever used an e-cigarette is 41.1% and 20.1% for high schoolers who have used an e-cigarette in the past 30 days. Additional data from the MYRBS reports the prevalence rate for middle schoolers ever using an e-cigarette at 9.9%. Given this epidemic, we conducted a literature search to identify potential interventions to assist adolescents who vape to quit. Methods: A review of literature dated 2018 from the PubMed database and materials retrieved in 2018 from professional tobacco cessation organization websites were reviewed. The search included “E-cigarette Cessation” and “Vaping Cessation” as Medical Subject Headings (MeSH) for the PubMed literature review. The following search terms were used to search for professional organization websites: 2018 + vaping cessation + adolescents, vaping cessation, vaping + teens, youth vaping cessation and adolescent vaping cessation. The research questions for this literature and website review were: 1. Does this article or website provide any vaping/e-cigarette cessation tools? 2. Do the authors recommend future research for vaping/e-cigarette cessation? and 3. Do the authors recommend using current tobacco cessation programs to help adolescents quit vaping? Results: The review identified 14 published articles and 13 websites. Among the articles and websites reviewed, only one website was identified as providing a vaping/e-cigarette cessation tool. Future research to provide evidence-based vaping cessation was recommended by 35.7% of the published article authors and 7.7% of the professional website organizations. 23.1% of the websites reviewed recommend using current tobacco cessation programs to quit vaping, while in comparison, only 7.7% of the authors of the published articles made a recommendation to use current cessation tools to help adolescents quit vaping. Conclusion: Based on the literature and website reviews, only one cessation tool was found that specifically targets vaping among adolescents. No other websites and no peer-reviewed published literature presented cessation tools to support teens in their efforts to quit vaping. This presents a significant gap in resources to assist adolescents who are already dependent on nicotine through vaping. Funding Source: Massachusetts Department of Public Health Tobacco Cessation and Prevention Program