The number of adolescents who have attempted to quit e-cigarettes and failed has grown with the rapid increase of teen e-cigarette use in the past five years, according to a study by University of Michigan researchers.

The findings suggest, however, that e-cigarette use has reversed a two decade-long decline among youth who made attempts to quit nicotine and failed.

In 2020, 6% of teens reported a failed quit attempt for either cigarettes or e-cigarettes. This compares with a failed quit attempt level for cigarettes of 4% in 2009, when cigarettes were the primary nicotine product for adolescents and e-cigarette prevalence was still near zero.

The 2020 level of 6% (for both cigarettes and e-cigarettes combined) compares with the percentage of youth with failed attempts to quit regular cigarettes that was at 10% in 1997 and that gradually declined over the next two decades to 2% by 2020.

"These results indicate that failed nicotine quit attempt levels have gone back to where they were about 17 years ago for adolescents," said Richard Miech, research professor at the U-M Institute for Social Research and lead author of the study published in the Journal of the American Medical Association.

The analysis used data from U-M's Monitoring the Future, a project funded by the National Institute on Drug Abuse. The project annually conducts nationally representative surveys of U.S. 8th-, 10th- and 12th-grade students. For this study, the analysis pool was 815,690 students who participated in the project between 1997 and 2020.

The survey asks students about their use of cigarettes and e-cigarettes. The survey asks students who report ever smoking a cigarette, "Have you ever tried to stop smoking cigarettes and found that you could not?" The survey added a new question in 2020 that asks students who report ever vaping nicotine: "Have you ever tried to stop vaping nicotine and found that you could not?" Response categories were "yes" and "no."

"Tobacco control efforts are largely responsible for the two-decade decline in failed nicotine quit attempts, which was brought about by a marked decline in adolescent cigarette use since 2000," Miech said. "Unfortunately, the recent rise in adolescent e-cigarette use, and growing numbers of adolescents who try to quit e-cigarettes and fail, have eroded much of this decline in adolescents who struggle with nicotine."

In addition to Miech, study co-authors include Patrick O'Malley and Lloyd Johnston of U-M and Adam Leventhal and Jessica Barrington-Trimis of the University of Southern California.