Indicators of dependence and efforts to quit vaping and smoking among youth in Canada, England and the USa.

Introduction:
This text provides an analysis of a study examining indicators of dependence and cessation behaviors among youth e-cigarette users in Canada, England, and the USa. The study compares changes between 2017 and 2019, focusing on the role of dependence as a barrier to stopping e-cigarette use.

Key Points:

* The study used repeated cross-sectional online surveys conducted in 2017, 2018, and 2019 with national samples of youth aged 16-19 years in Canada, England, and the USa.
* Measures included perceived addiction, frequency of experiencing strong urges, plans to quit smoking/using e-cigarettes, and past attempts to quit.
* The proportion of past 30-day vapers reporting strong urges to vape on most days or more often increased in each country between 2017 and 2019.
* Indicators of dependence among smokers were consistently greater than e-cigarette users; however, differences had narrowed by 2019, particularly in Canada and the USa.
* Few studies have assessed intentions or attempts to stop vaping, and none have examined vaping cessation behaviors among youth or non-users of tobacco.
* The study found that the use of high nicotine concentration salt-based products, such as JUUL, is more prevalent among youth vapers in Canada and the USa than in England.
* The market-wide shift towards nicotine salt products in North america occurred between 2017 and 2019, the period during which the study observed increases in the frequency of youth vaping and dependence.

Main Message:
The study highlights the importance of understanding the role of dependence as a barrier to stopping e-cigarette use among youth. The findings suggest that the use of high nicotine concentration salt-based products, such as JUUL, may contribute to the increasing prevalence of dependence symptoms among young e-cigarette users. The study emphasizes the need for further research on vaping cessation behaviors among youth and the impact of product standards and marketing regulations on country-level differences in e-cigarette dependence.

hammond D, Reid JL, Rynard VL, et al. Indicators of dependence and efforts to quit vaping and smoking among youth in Canada, England and the USa. Tobacco control. Published online February 1, 2021. doi:10.1136/tobaccocontrol-2020-056269