BACKGROUND-AIM:
Youth smoking in Taiwan fell from 7.8% (2008) to 2.0% (2023) after the 1997 Tobacco Hazards Prevention Act, but in 2023 e-cigarette usage reached 3.2% in junior high and 6.3% in senior high (~54,000 youths). We analyzed youth quitline usage (May 2021–June 2025) to track quit intention, motivation, and outcomes, and to evaluate policy and youth promotion, focusing on short-video campaigns.

METHODS:
Trend analysis of case-management records were from the Taiwan Health Promotion Administration Quitline (May 2021–June 2025). Policies included expanding pictorial warnings to 50% of packs (2023) and tighter regulation of e-cigarettes and tobacco. Youth-focused promotion focused on the 2023–2024 Student Short Video Competition, which required embedding Quitline and health-education content; 119 entries were collected via Ministry of Education forwarding, with press conferences and award ceremonies to boost visibility. In 2025, outreach expanded to quarterly Instagram events, collaboration with health-promoting schools to upload youth materials, and a “Youth Action Training Camp × AI Creative Video” to train volunteers as campus promoters and peer supporters. Eligible participants were 12–17 years old, self-referred, and consented to case management. Variables: demographics, referral source, quit intention/motivation, daily cigarettes, household smoking, smoke-free home, and 6-month quit success (follow-up to Feb 2025). Cross-year comparisons evaluated effects.

RESULTS:
1409 youths received case management: 241, 155, 323, 376, 314 (2021–2025 H1). Males 85.5%, females 14.5%. Self-referred 78.1%; health bureau 14.3%. Quit intention 74.0%. Motivations shifted from self-determination (29.5–33.5%) and external requests (32.7–50.8%) in 2021–2023 to legal penalties in 2024–2025 (28.4% in 2024; 52.3% in the first half of 2025). Smoking intensity moved toward lighter use: ≤10 cigarettes/day rose from 61.0% (2021) to 87.7% (2025), while 11–20 cigarettes/day declined from 24.7% to 9.0% and ≥21 cigarettes/day from 14.3% to 3.2%. Six-month success improved from 62.5% (2021) to 86.7% (early 2025); overall 67.9%. Short-video and social-media efforts expanded reach (111134 views in 2023–2024). However, 47.7–70.3% lived with smokers and only 25.7–48.3% reported lived at smoke-free homes.

CONCLUSIONS:
Strengthened policies and youth-focused promotion—short-video contests, school collaboration, social media, youth volunteers—were associated with higher uptake and better 6-month quit. Household smoking remain key obstacles, therefore, priorities are smoke-free homes/schools, scalable digital tools and cross-sector collaboration. The limitations of this study: non-random sampling, incomplete responses, six-month outcomes only to Feb 2025. This work was funded by the Health Promotion Administration, Ministry of Health and Welfare. The content of this research may not represent the opinion of the Health Promotion Administration, Ministry of Health and Welfare.