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Background The pediatric hospital represents a valuable opportunity to identify and treat e-cigarette use among adolescents and young adults (AYAs). However knowledge on how best to provide this care is lacking. We aim to fill this gap by developing and preliminary testing an intervention to treat e-cigarette use among hospitalized AYAs.

Methods We enrolled AYAs (14-21 years) admitted to a pediatric hospital who reported past 30 day e-cigarette use. We offered an evidence-based intervention including education, motivational interviewing, and quit plan development by a health educator and pharmacotherapy prescription by a physician. We used previously developed survey items (multiple choice, Likert scale items) to assess demographics, e-cigarette use behaviors, nicotine dependence, motivation and confidence to quit at baseline and post-intervention. We also assessed intervention acceptability and feasibility using 5-point Likert scale items. Descriptive statistics were used to calculate proportions, means and standard deviations (SD).

Results Of 334 AYAs approached, 68 (20%) were eligible and enrolled (i.e., reported past 30 day e-cigarette use). The mean age was 16.3 years (SD:1.3), forty-six (68%) were female, and thirty-six (53%) had government insurance. Forty (59%) reported occasional use (<9 e-cigarette use days), six (9%) were more frequent users (10-19 e-cigarette use days) and twenty-two (32%) were regular users (20-30 e-cigarette use days). The mean nicotine dependence score was 7.9 (SD:5.3; low dependence). Compared to baseline the sufficient knowledge to quit increased (22% to 52% [p=0.004]) and confidence to quit increased post-intervention (39% to 70% [p=0.004]). Twenty-five (46%) committed to a quit plan, thirty-two were eligible for pharmacotherapy (47%) and seven were prescribed pharmacotherapy (13%). Forty-eight AYAs were somewhat to very satisfied with the intervention (89%) and fifty-three rated the information as mostly to very helpful (98%). Thirty-six (67%) somewhat to strongly agreed that being in the program was minimally disruptive to their clinical care.

Conclusions Preliminary testing indicates our intervention is feasible and acceptable and may have positive effects on motivation, confidence and quit plan initiation. AYAs agreed the intervention was acceptable and not disruptive to clinical care. We will continue enrolling until our pilot study n=144 is reached, findings may change with the larger sample size. Future work is still needed to further develop evidence-based treatment of e-cigarette use, including nicotine dependence and marijuana co-use, in this population.

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Development of an E-cigarette & Tobacco Use Intervention for Adolescents and Young Adults in the Pediatric Hospital