Helping young adults quit vaping

Vaping is hard to quit. For most young adults it starts as a social habit and becomes something harder to name — a reflex, a response to stress, something that happens before they’ve decided to do it.

ACT on Vaping is a mobile app built to help. Six days, avatar-led, based on Acceptance and Commitment Therapy — a clinical framework about changing your relationship with difficult urges rather than fighting them. A clinical trial had already run. Fred Hutch needed someone to go deeper — into the daily experience, the moments of friction, the things that made people stay or disengage.

I was brought in as the sole researcher. What I was handed was a research brief. What I walked into was more complicated: a study about addiction, identity, and a very personal decision to change — with people who had volunteered to try.

The app had been adapted from a version built for a different audience. Before a single diary entry came in, I thought the translation might be incomplete — not wrong, but not rebuilt from scratch for who it was now serving.

And “young adults aged 18–30” is a wide range. A 19-year-old in their first year of college and a 28-year-old managing a full-time job are in different places — in their relationship with vaping, what support looks like to them, how much they’ll share with a stranger.

Nine days felt too short to change anything real. Both assumptions were wrong.

The study ran over 9 days: one onboarding session, six days of diary prompts, a mid-point check-in call, and a 30–60 minute exit interview. 9 of 11 participants completed everything.

The onboarding session was the most important thing I designed. I made it more informative than inquisitive — I wasn’t going to ask people about their vaping habits in the first 30 minutes. I gave context, made clear I was coming from support not judgment, and asked about motivations rather than habits. Understanding why someone wanted to quit helped me understand who I was talking to.

I told everyone upfront: you don’t have to share anything you’re not comfortable sharing. That wasn’t just courtesy — it was research design. People are more honest when they don’t feel pressured to perform.

The diary prompts were a tradeoff. I could have repeated the same questions daily for cleaner longitudinal data. Instead, each day tracked what the app covered that day. The risk was less consistency. The benefit: people actually showed up every day. I kept a few questions consistent for the data that mattered, and gave optional photo, voice, and open-text options for people who had more to say.

The mid-point check-in wasn’t a welfare call — it was a research tool. Diary entries can tell you what someone did. They can’t tell you why a response was short, or what someone meant by “it was fine.”

Two moments stand out: one participant said sessions were too short; another said they were too long. In the check-ins I pushed both on what specifically felt missing or unnecessary. The real issue wasn’t duration — it was content depth and pacing. Two different problems that looked identical on the surface.

Every participant said they’d recommend the app to someone trying to quit. The range of techniques — trigger mapping, urge surfing, leaves on a stream — was consistently appreciated. One participant said it was better than therapy because they didn’t have to talk.

The avatar was the most polarising finding. Some genuinely connected — “I felt like I was talking to a mentor.” Others found it uncanny, robotic, hard to engage with. Voice didn’t sync with visuals. Several turned off the video and just read captions. The feedback wasn’t “remove it” — it was more specific: people wanted either highly realistic or clearly cartoonish. The middle ground, aiming for realistic without getting there, was where the discomfort lived.

Text messages were useful in theory, inconsistent in practice. People paid attention when messages felt personal. They ignored what felt automated.

And the number I hadn’t expected:

Exit interviews explained why. For most participants, vaping had been unconscious — something that happened before they’d decided to. The app made them aware. Of their triggers, what they were actually doing in those moments, and what quitting would realistically take. That awareness — not quitting, not behaviour change — was what moved the number.

One participant, in the exit interview, said: “I know that this journey is mine.”

It stopped me. Not because it was surprising — but because it named something I’d been noticing across all nine participants without being able to say it. Everyone’s relationship with vaping was different. Their reasons for wanting to quit were different. What support looked like to them was different.

As a researcher you’re always looking for patterns — things true enough across enough people to act on. But that quote is a reminder that pattern-finding has limits. The most you can do is understand a wide enough range of experiences to go in well-informed, knowing no single design works for everyone, and that sitting with that honestly is part of the work.

I’ve carried that one with me.

My audience wasn’t designers or PMs — it was clinical researchers and medical stakeholders. People who think in efficacy, trial design, and evidence.

I dropped UX language entirely. Instead of “usability” or “friction,” I talked about what participants struggled with, what helped, and what got in the way of the app doing its job. I framed findings in terms of the goals they’d started with: motivation, confidence, engagement, and whether specific intervention components were working.

For the avatar findings, I was careful not to editorialize. I presented what participants liked and didn’t as separate, non-competing findings. That made the harder feedback easier to hear.

The thing I most wish I’d done: a follow-up study, 4–6 weeks out. The confidence metric was real — but I don’t know what happened to it after the programme ended. Did it hold? Did behaviour change? Did the techniques stick?

A week is enough to generate awareness. Whether awareness becomes anything more — that needed more time than the study had.

Study conducted in collaboration with Daniella Kim · Fred Hutch Cancer Center · July 2024