E-Cigarette Quit Intention, Quit Attempt and Abstinence Among U.S. Adults

Background E-cigarette use remains prevalent in the United States, yet limited research has explored e-cigarette cessation behaviors, primarily focusing on only the proportion of individuals interested in e-cigarette cessation. Understanding the sequential pathway from e-cigarette quit intention to quit attempt and abstinence may inform the development of targeted e-cigarette cessation interventions.Methods This study used Waves 4–6 (2016–2021) restricted data from the adult questionnaire of the Population Assessment of Tobacco and Health Study (unweighted N = 1,884; weighted N = 13,406,444). We included participants who were current e-cigarette users at Wave 4. Weighted generalized structural equation modeling was employed to investigate the sequential associations between quit intention (Wave 4), any quit attempt (Wave 5), and abstinence (Wave 6), controlling for sociodemographic, psychological, and behavioral factors.Results Participants who with greater quit intention at Wave 4 were more likely to report any quit attempt at Wave 5 (OR = 1.23, p < 0.001). Participants who made any quit attempt at Wave 5 were more likely to achieve abstinence at Wave 6 (OR = 1.69, p < 0.05). However, the direct association between Wave 4 quit intention and successful abstinence at Wave 6 was not significant.Conclusions This study is among the first to use nationally representative data to examine the sequential pathway of e-cigarette cessation behaviors among U.S. adults. Our results support the importance of designing and implementing tailored efforts that target different stages of e-cigarette cessation, including initiating and enhancing quit intention, promoting and supporting quit attempt, and facilitating the maintenance of abstinence.