How to quit vaping

A person vaping in New York, July 7, 2024. Millions of Americans use e-cigarettes — there’s little research into how to help them stop. (Justin J Wee/The New York Times)

By Dani Blum

By his junior year of college, Zach Arledge had already tried to quit vaping about half a dozen times. But with each attempt, he found himself reflexively reaching for his Juul within a day.

So when he decided to try again, Arledge wanted to be prepared. He waited until winter break, when he’d have more free time, and took a week off work. He bought sugary cereals to help kick his cravings and melatonin in case he had trouble sleeping.

He drew 72 squares onto paper, each one representing an hour of his first three days without nicotine. He marked them off as the hours ticked by, checking off a chunk when he woke up. Those first days, Arledge felt detached from his body, unable to focus on anything. He chewed on chopsticks and stayed in front of the TV, trying to distract himself.

The nicotine in vapes can be highly addictive, and can raise blood sugar, heart rate and blood pressure, among other health risks. And while some people turn to vaping to stop smoking cigarettes, e-cigarettes can contain substances that also pose health risks.

Despite the popularity of vapes — more than 8 million Americans were current e-cigarette users in 2018, according to federal health data — there is little established guidance to help people like Arledge quit. Many of the recommendations that do exist come from tobacco cessation efforts, not research into vaping specifically.

“The health care system hasn’t caught up completely,” said Suchitra Krishnan-Sarin, a psychiatry professor at the Yale University School of Medicine who studies adolescent tobacco use.

Often, doctors said, patients do not realize they are growing dependent on their vapes and are deeply addicted by the time they even consider quitting.

“You can very easily escalate the amount of nicotine you’re using, almost without thinking about it,” said Dr. Pamela Ling, director of the UCSF Center for Tobacco Control Research and Education.

A single Juul pod can contain about as much nicotine as about a pack of cigarettes. Within a year of taking up vaping, Arledge was going through one a day. He knew, for a while, that it was time to quit. But every time he tried, he just couldn’t push through the withdrawal symptoms.

Doctors said that there are strategies to help people address those symptoms and give up vaping for good.

How to stop vaping

— Make a plan.

Part of planning to quit involves figuring out your triggers: what motivates you to vape, and what people or settings you need to avoid as you wean yourself off the nicotine.

“The more you understand yourself, the more you can prepare,” said Dr. Panagis Galiatsatos, director of the Tobacco Treatment Clinic at Johns Hopkins Medicine.

Some people choose to quit cold turkey, but experts say others might have more success if they gradually reduce how much they vape over several weeks. It can help to set a quit date or a deadline to fully give up vaping.

— Brace for withdrawal symptoms.

Those who are dependent on nicotine may experience withdrawal when they quit. They can feel anxious, nauseated and shaky, Krishnan-Sarin said. “It’s almost like the system is rebalancing itself,” she said.

These symptoms are typically most intense in the first three days and then usually fade over time. People struggling with withdrawal symptoms can manage them in the moment. Keeping water, gum and snacks on hand can help ease the oral fixation people experience when they feel the need to vape.

— Get help.

While there are no medications specifically approved to help people stop vaping, some people may benefit from treatments for quitting smoking, Galiatsatos said. There are anti-smoking drugs without nicotine authorized by the Food and Drug Administration for adults, including bupropion, which blunts cravings, and varenicline, which makes people enjoy nicotine less.

Nicotine replacement therapies like patches, gum and lozenges may also help people give up vaping.

The national quitting help line can provide tips and encouragement, as can texting services like the National Texting Portal, This is Quitting, My Life My Quit and SmokefreeTXT. Quit the Hit, a five-week program that uses group direct messages on Instagram, can also help support people quitting vaping.

Arledge’s last attempt to quit was successful. It took three days for the worst of his cravings to fade away. Now, he often reminds himself of how hard it was to quit vaping when he’s pushing himself to do something difficult, like enrolling in a challenging master’s program or to keep going when he’s lifting weights.

It usually takes several tries for someone to permanently give up e-cigarettes, said Bonnie Halpern-Felsher, a Stanford professor and developmental psychologist who studies teen behavior around tobacco products. It’s important to remember that attempts are part of the process and that if the first try doesn’t stick, she said, “you’re not a failure.”