Dr. Mark Eisenberg, a cardiologist at McGill University in Canada, initially recommended vaping to a patient struggling to quit smoking. It proved successful, but the patient later returned to Eisenberg’s office with a new dependence.
“Now he’s addicted to e-cigarettes,” Eisenberg says. “He said, ‘I want to get off e-cigarettes. What do I do?’”
Finding a clear answer to that question remains a challenge. Nearly two decades after e-cigarettes entered the U.S. market and gained millions of users, effective strategies for quitting vaping remain scarce—despite the fact that roughly 60% of vapers express a desire to stop.
E-cigarettes are often touted as a solution to the widespread problem of tobacco use, which claims millions of lives globally each year, according to Amanda Graham, chief health officer at Truth Initiative. “So far, that has not come to fruition,” Graham says. “What we see is a lot of people saying, ‘I’m using way more nicotine now than I ever did with a cigarette.’”
The U.S. Food and Drug Administration (FDA) does not currently approve e-cigarettes for smoking cessation, but many individuals utilize them for this purpose. E-cigarettes, which heat and aerosolize liquid nicotine, provide smokers with a substitute for nicotine in traditional cigarettes and a familiar action: holding something to the lips and inhaling. This aspect can render vapes an effective—and seemingly less dangerous, although not totally safe—alternative to cigarettes, according to some experts. (, however, finds that many smokers use both e-cigarettes and cigarettes rather than quitting smoking outright, which may compound their health risks.)
However, not all vapers are former smokers. In fact, data indicates that among U.S. adults, individuals aged 18 to 24 exhibit the highest vaping rates. Considering the surge in vaping among teenagers and young adults, it’s likely that many of these individuals began vaping without ever being regular smokers—hence the widespread concern that .
E-cigarettes’ design can make them uniquely addictive, says Benjamin Toll, a professor at the Medical University of South Carolina who researches tobacco cessation.
Cigarettes are undeniably highly addictive as well. But the limited number of cigarettes in a pack and the relatively quick burn time of each cigarette provide natural stopping points. However, “if you have a 2,000-puff vape” filled with high levels of nicotine, Toll says, “there’s [almost] no stopping point.” And because vapes don’t involve fire, they are easier to use in places where many individuals wouldn’t consider smoking. Some individuals “hit their vape and put it under their pillow” so they can use it first thing in the morning, Toll says. This constant use and exposure to nicotine can lead to even higher levels of dependence than smokers experience, he says.
“Many people go to vaping as a way to quit smoking, and then they can’t quit vaping,” Toll says. “That breaks my heart.”
Overcoming this addiction isn’t simple, but many individuals are eager to try. Currently, around 60% of people who enroll in one of Truth Initiative’s indicate that their primary goal is to quit e-cigarettes, according to Graham.
Unfortunately, there aren’t many tools available to assist with this endeavor. Truth Initiative offers digital resources, including a for adolescents and young adults, which the suggests is significantly more effective than attempting to stop without support. Limited research, as Eisenberg outlined in a , suggests that certain medications used by cigarette smokers to quit—including varenicline, which helps reduce nicotine cravings and withdrawal symptoms—might also be beneficial for vapers. Doctors occasionally prescribe such medications, as well as products like nicotine patches and gums, off-label for adults seeking assistance with vaping cessation.
However, a need for more tools specifically designed for vaping addiction persists, as it represents “a public-health crisis hidden in plain sight,” says Richard Stewart, CEO of Achieve Life Sciences, a pharmaceutical company working to secure FDA approval for the U.S.’ first dedicated vaping-cessation aid. The company’s medication, cytisinicline, is intended to not only reduce cravings but also make using nicotine less pleasurable when an individual vapes while on the drug. In published in May, people who took cytisinicline were more than twice as likely to stop vaping as people who took a placebo.
The FDA recently , which is designed to expedite the development and regulatory review process for novel and promising drug candidates. (Cytisinicline is already used for smoking cessation in parts of Europe, but not the U.S.) “We think we’ll be the first drug approved for vaping cessation,” possibly as soon as 2027 if all goes well, Stewart says.
Meanwhile, some individuals attempting to quit vaping are employing their own methods. Anecdotal evidence suggests that some individuals are using —which users place in their mouths for a slow release of nicotine—to gradually wean themselves off vaping, mirroring the use of e-cigarettes for transitioning away from cigarettes. Pouches appear to be less hazardous than both cigarettes and e-cigarettes, as they don’t involve inhaling anything into the lungs. However, switching to another new product could prolong an individual’s dependence on addictive nicotine, Graham says.
For individuals turning to Zyn and other nicotine products for help quitting vaping, Graham offers this advice: “plan to use it short-term, and then to quit using all forms of nicotine.”
But in a world where the popularity of e-cigarettes has far surpassed research on quitting them, that can be easier said than done.