Vaping Cessation Interventions: A Review of Randomized Controlled Trials (Preprint)

BACKGROUND The increasing prevalence of electronic cigarette (e-cigarette) use, particularly among young individuals, has led to a pressing need for effective vaping cessation interventions. OBJECTIVE To summarize the available evidence on vaping cessation interventions, identify key challenges, and highlight future research directions METHODS We searched PubMed, Google Scholar, and clinicaltrials.gov. for randomized controlled trials (RCTs) evaluating behavioral, pharmacological, and combination interventions aimed at vaping cessation. The search period spanned from 2004 (year of first e-cigarette patent) to April 27, 2025. The outcome of interest was abstinence from vaping at a maximum follow-up. RESULTS A total of 11 RCTs, involving 8,182 participants, were identified. These trials investigated behavioral therapy, including tailored text messaging support (n=4), nicotine replacement therapy (NRT; n=3), varenicline (n=3), and cytisine (n=1). Studies were published between 2021 and 2025, with follow-up periods ranging from 1 to 24 months. Most RCTs focused on adults or young adults. Behavioral interventions showed potential to support quitting at follow-up beyond 6 months; however, results were not consistent across trials. While varenicline demonstrated promise as a pharmacological aid for vaping cessation, available RCTs had small sample sizes and short follow-up periods, limiting the strength of the evidence. None of the RCTs investigating the efficacy of NRT (567 participants) or cytisine (160 participants) for vaping cessation showed superiority over the control after treatment discontinuation CONCLUSIONS With millions of people using e-cigarettes daily and limited data on their long-term safety, stronger evidence is needed to guide vaping cessation strategies.