Abstract
Background: Youth vaping is a major global public health issue with significant physical, psychological and behavioural risks. This systematic review aims to review published studies and guidelines on the effectiveness, safety and acceptability of nicotine replacement therapy (NRT) use to promote vaping cessation in youth aged 17-years or younger.
Methods: We searched MEDLINE, Embase, CINAHL, Scopus, PsychINFO, Cochrane Library, Web of Science, NIH Clinical Trials, EU Clinical Trials, WHO International Clinical Trials Registry Platform, Google Scholar and reference lists of relevant publications for studies on NRT and vaping cessation published in English since 2010. One reviewer screened titles and abstracts, and two reviewers independently performed title-abstract and full text screening according to the pre-determined inclusion criteria. There were no disagreements. Data on study and intervention characteristics, vaping cessation, safety concerns and acceptance of NRT were extracted by one reviewer and checked by another. Risk of bias assessment was performed by one reviewer and verified by another using the "NOS-xs tool" adapted from the Newcastle-Ottawa Scale (NOS) for cross-sectional studies and a novel tool was developed for case series.
Results: Two records and eight guidelines were identified. One case series (n = 6; only one aged ≤ 17) assessed the effectiveness and acceptance of NRT and 4 participants including 1 aged 17 were vape-free at 8-months; all participants 'felt comfortable' using NRT. A cross-sectional study (n = 2229) found 58.9% of participants were interested in using NRT as a vaping cessation aid if it was offered for free. Most of the 8 guidelines supported NRT use in youth aged ≥ 12 years for smoking cessation: none mentioned vaping cessation.
Conclusions: This review underscores the critical gaps in the evidence for NRT use as a vaping cessation tool for youth aged 17 or younger and calls for urgent research to address these gaps. Vaping is a global public health issue and the detrimental effects of nicotine on youth are well established.
Systematic review registration: PROSPERO CRD42024561969.