Predictors of electronic nicotine product quit attempts and cessation: Analysis of waves 3 and 4 of the PATH study

Introduction: Identifying theory-based predictors of electronic nicotine product (ENP) quit attempts and cessation can guide the development of effective vaping cessation interventions, which are currently limited. This study examined predictors of ENP quit attempts and cessation among adult ENP users. Methods: Using data from wave 3 (W3; 2015–2016) current established ENP users in the Population Assessment of Tobacco and Health study, we used multivariable logistic regression to identify predictors of (i) wave 4 (W4; 2016–2018) quit attempts (unweighted n = 1,135); and (ii) W4 cessation among those who made a quit attempt (unweighted n = 610). Predictors included Social Cognitive Theory (SCT)-based cognitive (interest in quitting, self-efficacy to quit, outcome expectancies, risk perception), behavioral (smoking status, and use of combustibles, non-combustibles, cannabis, and alcohol), and socio-environmental (perceived disapproval, household rules, exposure to advertising) factors. Results: Between W3 and W4, 51.7% of W3 ENP users made a quit attempt. Among those who tried quitting, 68.4% stopped using ENPs. SCT-based predictors of ENP quit attempts included higher interest in quitting ENPs (aOR = 1.18), greater self-efficacy to quit ENPs (aOR = 1.31), and currently using cigarettes (vs non-smoker; aOR = 1.71), non-combustibles (aOR = 2.25), and cannabis (aOR = 1.80). Predictors of ENP cessation included greater self-efficacy to quit ENPs (aOR = 1.33), greater perceived risk of ENPs (aOR = 1.35), and being a current smoker (vs non-smoker; aOR = 3.28). Conclusions: ENP cessation interventions should address cognitive factors, particularly self-efficacy, as it predicted quit attempts and cessation. Cigarette smoking among dual users should be monitored and addressed to ensure that those who quit using ENPs do not maintain cigarette use.