'Quit vaping' internet searches increased during EVALI outbreak

E-cigarettes have been sold for more than a decade, seemingly without incident, but in the summer of 2019 serious lung injuries began appearing among some e-cigarette users -- especially adolescents and young adults. By last January of 2020, the Centers for Disease Control and Prevention reported more than 2,700 hospitalizations for EVALI, or e-cigarette or vaping product use-associated lung injury, and confirmed 60 deaths in 27 states with more under investigation. The cases have now been linked primarily vaping of marijuana and additives, but before this was discovered, many people using nicotine-containing e-cigarettes became concerned.

We were curious whether this outbreak led vapers to consider stopping using e-cigarettes or increased people's desire to quit. We thought people might be going to the internet to look into ways to help them quit."

Sara Kalkhoran, MD, MAS, an investigator at MGH's Tobacco Research and Treatment Center, an assistant professor at Harvard Medical School and the lead author of the study

The study has been published in the Journal of General Internal Medicine.

Using Google Trends, Kalkhoran and her colleagues found that searches on such terms as "quit vaping" increased as much as 3.7-fold during the EVALI outbreak. "Then these searches then died down, so the timing of the outbreak was strongly associated with searches on how to get off of these products," Kalkhoran said. She added that this suggests a stronger need for messaging, both from a public health perspective and at a clinical level, "before something like this happens."

It also means that healthcare providers need to be asking patients specifically about vaping, since "people who vape may not think of themselves as smoking. People are looking into quitting these products, so we need to be able to screen in a context where we can actually help them clinically and they don't have to go to the internet for information."