Vaping cessation interventions: A narrative review of randomized controlled trials

The increasing prevalence of electronic cigarette (e-cigarette) use, particularly among young individuals, has led to a pressing need for effective vaping cessation interventions. We conducted a narrative review of published and ongoing randomized controlled trials (RCTs) evaluating behavioral, pharmacological, and combination interventions aimed at vaping cessation among adolescents and adults using e-cigarettes. PubMed, Google Scholar, and ClinicalTrials.gov were searched from 2004 (year of first e-cigarette patent) to 27 April 2025. The outcome of interest was abstinence from vaping at the maximum follow-up and results were synthesized narratively. A total of 11 RCTs, involving 8182 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 ranging from 1 to 24 months, and most focused on adults or young adults. Behavioral interventions, particularly text messaging programs, showed potential to support vaping cessation beyond 6 months, although findings were inconsistent across trials. Varenicline demonstrated promise as a pharmacological aid; however, 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) demonstrated superiority over control following treatment discontinuation. Fourteen ongoing RCTs were also identified, most of which are evaluating behavioral approaches in younger populations. Overall, the current evidence base for vaping cessation remains limited, highlighting the need for larger, high-quality trials with longer follow-up to establish effective interventions across diverse populations.