O2118: E-Programs to Stop E-Cigarette Use Among Adolescents: A Systematic Review and Meta-Analysis of Digital Prevention Tools

Background: E-cigarette use has risen dramatically among adolescents, necessitating preventive strategies that can effectively reach and engage this population. Digital interventions (e.g., web-based modules, mobile applications, and social media campaigns) may overcome traditional barriers by offering accessible, scalable solutions. This systematic review and meta-analysis aimed to evaluate the efficacy of digital preventive interventions in reducing e-cigarette use and related risk factors among adolescents.

Methods: A systematic search of Medline, Embase, PsycINFO, Scopus, CINAHL, Cochrane Library, and clinical trial registries was conducted for studies published between January 2000 and June 2023. Eligible studies were randomized controlled trials (RCTs), cluster RCTs, or quasi-experimental designs that (1) targeted adolescents aged 11–19, (2) focused on preventing e-cigarette use, and (3) delivered the intervention primarily via digital platforms. Two reviewers independently screened and selected articles, extracted data, and assessed risk of bias. A random-effects model was used to compute pooled effect sizes (odds ratios or standardized mean differences) with 95% confidence intervals.

Results: Fourteen studies (N = 5,492 adolescents) met inclusion criteria. Overall effect sizes for sustained reductions in e-cigarette use at 6–24 months post-intervention were not statistically significant (OR = 0.71, 95% CI = 0.44–1.13, p = 0.15). However, subgroup analyses indicated short-term reductions in e-cigarette experimentation immediately following the intervention (OR = 0.62, 95% CI = 0.39–0.98, p = 0.04). Digital interventions also showed modest improvements in knowledge (SMD = 0.24, 95% CI = 0.10–0.38, p < 0.01) and prevention intentions (SMD = 0.19, 95% CI = 0.06–0.33, p = 0.01). Attitude measures favored the intervention groups in several studies, although effect sizes were generally small. The risk of bias was rated low-to-moderate across included studies, and publication bias assessments were inconclusive.

Conclusion: Digital preventive interventions targeting adolescent e-cigarette use hold promise for short-term improvements in knowledge, intentions, and experimentation rates. However, the observed lack of sustained effects highlights the need for ongoing engagement strategies, culturally tailored content, and further research into intervention designs that produce longer-term behavior change. Policymakers and educators should consider the potential of digital formats while continuing to refine these programs for greater efficacy and broader public health impact.