Efficacy of a group-based brief tobacco intervention among young adults aged 18-20 years in the US Air Force.

Melissa A Little,Robert C Klesges,Kara P Wiseman,Gerald W Talcott,Xin-Qun Wang,Kinsey Pebley,Margaret C Fahey

doi:10.18332/tid/143282

Abstract

INTRODUCTIONMost smokers begin using tobacco before the age of 25 years, making it important to reduce tobacco use during adolescence and early adulthood. Rates of use are historically higher among military personnel. While ‘Tobacco 21’ made it illegal for US retailers to sell tobacco to those aged <21 years, the policy did not address cessation for current youth and young adult tobacco users. Additionally, there is limited research on cessation interventions among young adults under 21 years. The current study evaluated the efficacy of a group-based Brief Tobacco Intervention (BTI) among US Air Force trainees, who are predominantly aged 18–20 years and directly impacted by Tobacco 21 legislation.METHODSParticipants were 2969 US Air Force Trainees from April 2017 through January 2018 cluster randomized to three conditions: 1) BTI + Airman’s Guide to Remaining Tobacco Free (AG), 2) AG alone, and 3) the National Cancer Institute’s Clearing the Air (CTA) pamphlet. To assess the efficacy of the interventions among people aged 18–20 years, a domain analysis (<21 years, n=2117; and ≥21 years, n=852) of a multinomial logistic regression model was run.RESULTSMono tobacco users aged <21 years at baseline who received the BTI+AG had higher odds of quitting tobacco at 3 months (OR=2.13; 95% CI: 1.02–4.46). Dual and poly users aged <21 years at baseline who received the BTI+AG intervention had higher odds of reducing the number of tobacco products used at 3 months (OR=2.94; 95% CI: 1.03–8.37).CONCLUSIONSThe BTI was effective for people aged 18–20 years. The current study offers insight into components of interventions that might be successful in helping this age group decrease tobacco use.

Highlights

Most smokers begin using tobacco before the age of 25 years, making it important to reduce tobacco use during adolescence and early adulthood
We examined whether the Brief Tobacco Intervention (BTI), which previously produced null results when tested with a sample of young adults[29], was effective for people aged 18–20 years who we know from the literature are less likely to quit[8], and, importantly, are legally unable to purchase tobacco[10] making the need to quit even more salient in this population
Regular mono electronic nicotine delivery systems (ENDS) use at baseline and regular mono tobacco and ENDS use at follow-up were higher among participants aged 21 years

Summary

Introduction

Most smokers begin using tobacco before the age of 25 years, making it important to reduce tobacco use during adolescence and early adulthood. Tobacco use is increasing among young people in the US, with 12.5% of middle school and 27.5% of high school students reporting past 30-day use of a tobacco product in 20191. This is an increase of approximately 1.32 million youth from the previous year, largely driven by the rise in electronic nicotine delivery systems (ENDS)[2]. Young people who use multiple products report higher nicotine dependence, greater difficulty quitting, and a greater likelihood of transitioning to other tobacco products[5,6,7]

Methods

Results

Discussion

Conclusion