Key messages

• Using text message-based interventions may help more young people stop vaping compared to no or minimal support.

• Varenicline may help more people stop vaping compared to placebo (dummy treatment).

• We need more information on whether these and other interventions can help people stop vaping, their potential harms and whether they affect the number of people smoking tobacco.

What are nicotine-containing vapes?

Vapes (also known as electronic cigarettes or e-cigarettes) are handheld devices that heat liquid usually containing nicotine and flavourings. Liquids are stored in a disposable or refillable cartridge, reservoir, or 'pod'. Vapes allow users to inhale nicotine as vapour rather than smoke. Because they do not burn tobacco, vapes expose users to fewer harmful substances than tobacco cigarettes. However, vaping is likely to cause more harm than not vaping. Some people use nicotine vapes to stop smoking; however, some people who vape nicotine have never smoked. People may want to stop using nicotine vapes, but find it difficult due to the addictive properties of nicotine.

What interventions might help people to stop vaping?

Medicines like nicotine replacement therapy (NRT; such as gums, patches), varenicline, bupropion, and cytisine, which help people to stop smoking, could also be used to stop vaping. Behavioural interventions to help people stop vaping could include counselling, text messages, vaping reduction programmes and printed materials.

What did we want to find out?

There is limited guidance on the best ways to stop nicotine vaping. We wanted to know what tools have been tested and whether they can help people stop vaping. We also looked at the potential harms of these interventions, including whether they could cause more people to smoke tobacco.

What did we do?

We searched for studies looking at any intervention designed to support people using nicotine-containing vapes to stop vaping. We compared and summarised our results and rated our confidence in the evidence based on study methods and sizes.

We looked at:

• how many people stopped vaping at least six months after study start;

• changes in tobacco smoking at least six months after study start;

• how many people experienced unwanted effects at least one week after treatment started.

What did we find?

We found 15 studies, including 5800 people who used nicotine vapes. Fourteen studies took place in the USA and one in Italy. Treatments used to help people stop vaping were:

• two types of NRT used together (combination NRT);

• different doses of NRT;

• cytisine (a stop-smoking medicine);

• varenicline (a stop-smoking medicine);

• a plan to help people reduce the nicotine in their vapes and the amount they were vaping;

• text messaging with or without apps;

• media literacy e-learning;

• financial incentives.

Main results

Text message support may help more young people (13 to 24 years of age) stop vaping than no/minimal support. Varenicline may also help people quit vaping. There was not enough information to say whether other interventions could help people stop vaping.

Very few studies reported any serious unwanted effects, but there was not enough information to draw any conclusions about potential harms of the treatments. Two studies looked at whether an intervention (combination NRT; text messaging) affected the number of people smoking tobacco after six months; the evidence suggests these interventions did not affect smoking, but we are very uncertain about the results.

What are the limitations of the evidence?

We found some evidence that young people may be more likely to stop vaping nicotine using a text messaging intervention than using no or minimal support. However, the studies testing this used the same text message intervention, meaning we do not know whether we would find similar results for other texting interventions or in older adults. We also found that varenicline may help more people to stop vaping nicotine than placebo (dummy treatment), but further evidence could change our conclusions.

We were unable to draw any clear conclusions regarding the number of people who quit tobacco smoking at six months or serious unwanted effects of the interventions under study. More studies will help us feel more confident.

Overall, the findings are based on small numbers of studies and participants, and in some cases there were problems with study methods, limiting our confidence in the evidence. More studies are underway, which will improve our confidence in the evidence.

How up-to-date is this evidence?

This review updates our previous review. The evidence is current to 1 July 2025. This is a living systematic review. We search for new evidence every month and update the review when we identify new evidence that strengthens or changes our conclusions.