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Background:  Given increasing use of e-cigarettes among adolescents in the United States and its potential for nicotine addiction, encouraging adolescents to quit using these products has become a public health priority. This study examined factors at various socio-ecological levels associated with e-cigarette quit intention (pre-contemplation, contemplation, or preparation) using the Stages of Change of the Trans-theoretical Model among the U.S. adolescents.  Methods:  We used cross-sectional data from the past 30-day adolescent exclusive e-cigarette users participating in Wave 4 of the Population Assessment of Tobacco and Health study ( n  = 349). Weighted adjusted multinomial logistic regression models were used to analyze the data.  Results:  Compared to pre-contemplators and contemplators, preparators were more likely to believe that nicotine in e-cigarettes was “very/extremely harmful” (vs. “not at all harmful”) to health ( p  &lt; 0.001) and people cause a “lot of harm” (vs. “no harm”) to themselves when they use e-cigarettes ( p  &lt; 0.001). In comparison to pre-contemplators, contemplators and preparators were more likely to report that their parents/guardians talked with them about not using e-cigarettes than those whose parents/guardians did not talk with them ( p  &lt; 0.001). Additionally, contemplators and preparators were also more likely to report that they “often/very often” (vs. never) noticed health warnings on e-cigarette packages ( p  &lt; 0.001).  Conclusion:  Our findings suggest that harm perception, influence of family, and e-cigarette health warnings are some of the important factors associated with the stages of change for intention to quit among adolescent e-cigarette users. This study will help public health practitioners and researchers design multi-level e-cigarette cessation interventions for adolescents.

Factors Associated with E-Cigarette Quit Intention Among Adolescents in the United States