Text message program from Truth Initiative helps teens quit e-cigarettes

Teens enrolled in Truth Initiative’s text message-based quit-vaping program were 35% more likely to quit vaping nicotine within seven months compared to those not enrolled in the program, according to research published in the Journal of the American Medical Association. The study, which surveyed 1,503 e-cigarette users ages 13-17, also found the program is effective for teens with high levels of nicotine dependence and mental health concerns.

The research represents the first randomized clinical trial to evaluate a quit-vaping program in this age group. It found that 37.8% of teens enrolled in the interactive program reported abstaining from vaping nicotine at the seven-month mark compared to 28% in the control group, a statistically significant difference. Quit rates among teens exceeded those of a similar clinical trial conducted among users ages 18-24 enrolled in the program and were significantly higher than abstinence rates in most teen quit smoking trials.

The text message intervention tested in this study is now part of EX Program, a free cessation resource tailored to meet the unique challenges faced by young people. EX Program offers proven, evidence-based tools designed to support quitting through personalized quit plans, 24/7 access to the nation’s most established online quit community, and messages from other teens who have attempted to or successfully quit e-cigarettes. These tools have helped millions quit nicotine over nearly two decades, solidifying EX Program as one of the most effective cessation resources available.

Young people can take the first step toward quitting by texting EXPROGRAM to 88709.

By texting EXPROGRAM to 88709, you consent to recurring messages from EX Program to help you quit vaping, and agree to the Terms & Conditions and Privacy Policy. Text STOP to opt-out. Text HELP for info. Msg & Data Rates May Apply. 

Effectiveness among highly addicted e-cigarette users

All participants of the clinical trial, which took place between October 2021 and October 2023, received incentivized monthly text messages about e-cigarette use to encourage them to complete the study. The intervention group was also enrolled in the program, while control participants did not receive additional support. As a double-blind study, researchers randomly assigned participants to groups and participants did not know which intervention they were receiving.

The study found that the text message intervention now part of EX Program was effective among teens with high levels of nicotine dependence and mental health issues. Most teens in the study were highly addicted to nicotine. More than three-quarters (76.2%) used e-cigarettes within 30 minutes of waking – a common way to measure addiction – and 93.6% reported feeling somewhat or very addicted to vaping nicotine. Most (87.3%) had tried to quit in the past year, and more than half (53.4%) had previously made three or more quit attempts. Teens also shared problems with depression, sleep, anxiety, trauma, and substance use, as well as high rates of using multiple substances.

“The significant treatment effect observed in this study against this backdrop of risk factors underscores the power of a digital behavior change intervention to drive clinically meaningful outcomes,” the researchers write.

Young people want to quit in 2025

Youth nicotine addiction remains a serious public health concern. Among middle and high school students who currently vape, nearly 40% — over 620,000 teens — report using e-cigarettes frequently (38.4%), according to the 2024 National Youth Tobacco Survey, signaling signs of persistent nicotine addiction. Interest in quitting also remains high: Almost half (48%) of young people aged 18-24 are making quitting nicotine a priority for their 2025 New Year’s resolutions, according to new survey data from Truth Initiative.

Studies show that mental health symptoms improve after quitting nicotine. Quitting smoking is linked with lower levels of anxiety, depression, and stress, according to a 2014 meta-analysis of 26 studies published in the British Medical Journal. And while evidence of a link between quitting vaping and improvements in mental health symptoms is emerging, Truth Initiative survey data show support for this connection: 90% of e-cigarette users who quit said they felt less stressed, anxious, or depressed.

Mounting evidence to support tailored, interactive text message interventions for quitting vaping

This study builds on previous research demonstrating the effectiveness of the text message intervention in young people. A previous randomized clinical trial found that young adults ages 18-24 who used the text message intervention had nearly 40% higher odds of quitting compared to a control group. A second clinical trial proved the program was not only successful in helping young people quit vaping, but also in ensuring they don’t later use combustible tobacco products in place of e-cigarettes.

Combined with the results of the most recent study, this research indicates that a tailored, interactive text message intervention, such as the one now part of EX Program, can effectively deliver vaping cessation treatment and encourage youth and young adults to quit vaping.

“Text messaging is a scalable and cost-efficient approach to delivering vaping cessation treatment on a population basis,” researchers write. “These results begin to fill an important gap in understanding how to help adolescent e-cigarette users quit vaping nicotine.”