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Smoking & Quitting Tobacco and Vaping

Quitting smoking helps at any age, no matter how long or how much you have smoked. Nicotine is addictive, so most people need support and more than one try — that is normal, not a failure. Counseling plus a quit-smoking medicine gives the best chance, and free help is a phone call away at 1-800-QUIT-NOW. Chest pain, trouble breathing, coughing up blood, stroke signs, lung symptoms after vaping and thoughts of self-harm need urgent care.

Get urgent help for these:

  • Chest pain or pressure. NHLBI calls chest pain, heaviness or discomfort the most common heart-attack symptom; others include arm, back, neck or jaw pain, shortness of breath, heavy sweating and nausea. Call 9-1-1 even if you are not sure, and do not drive yourself (NHLBI).
  • Signs of a stroke. Sudden loss of balance, trouble seeing, a drooping face, an arm drifting down, or slurred speech: call 9-1-1 right away, note the time, and do not drive to the hospital (CDC). See our stroke guide.
  • Trouble breathing. Smoking is the most common cause of COPD (MedlinePlus). For people with COPD, NHLBI says to call 9-1-1 for a hard time catching your breath or talking, blue or gray lips or fingernails, not being mentally alert, a very fast heartbeat, or treatment that is not working (NHLBI).
  • Coughing up blood. NHS Wales (UK) says more than a few spots or streaks of blood, or blood with hard breathing, a very fast heartbeat or chest pain, needs an emergency call; a few flecks needs an urgent appointment (NHS Wales). In the U.S., MBHA suggests calling 911 for the first group.
  • Lung symptoms after vaping. CDC lists cough, shortness of breath or chest pain; nausea, vomiting, stomach pain or diarrhea; and fever, chills or weight loss as reported symptoms of vaping-related lung injury (EVALI), which can develop over a few days or several weeks. CDC says to see a health care provider right away (CDC (archived)).
  • Thoughts of suicide or self-harm while quitting. FDA says some people trying to quit, with or without stop-smoking medicines, have had new or worse depression, agitation, panic or thoughts about suicide, and that Chantix or Zyban should be stopped with a call to your provider right away if these appear (FDA). Call or text 988 for free, confidential support, 24 hours a day (988 Lifeline, Smokefree.gov). MBHA suggests calling 911 if someone is in immediate danger.
  • A child or pet swallows nicotine. The NicoDerm CQ label warns that used patches still have enough nicotine to poison children and pets; if swallowed, get medical help or contact a Poison Control Center right away (FDA label, NicoDerm CQ). CDC reports that more than 80% of poison-center calls about e-cigarettes involve children under 5 (CDC).
  • Pregnant and still smoking? Not an emergency — but do not wait. Quitting at any stage of pregnancy is the best thing you can do for you and your baby (Smokefree.gov). Tell your prenatal clinician today.

No shame here

This guide is for anyone who smokes, vapes or uses other tobacco, and the people who love them. Nothing in it is meant to judge. Nicotine is addictive, and CDC reports that in 2022, 67.7% of U.S. adults who smoked said they wanted to quit and 53.3% had tried in the past year, yet only 8.8% managed to quit in that year, and just 38.3% used counseling or medication when they tried (CDC). CDC says quitting often takes multiple tries, and that more than half of U.S. adults who smoked have quit (CDC, CDC).

What smoking does — and what quitting gives back

CDC says cigarette smoking and secondhand smoke cause more than 480,000 U.S. deaths each year, nearly one in five, and that more than 16 million Americans live with a disease caused by smoking (CDC). MedlinePlus says smoking harms nearly every organ; it is the most common cause of lung and oral cancers, and it can also cause cancers of the voice box, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon and rectum, and cervix (MedlinePlus). Cigars and water pipes (hookahs) also contain harmful chemicals and nicotine (MedlinePlus). See our cancer, heart, emphysema and COPD, bronchitis, asthma and pneumonia guides.

The good news is bigger. CDC says quitting has health benefits at any age, no matter how long or how much you have smoked; quitting earlier gives greater benefits, but even people who smoked heavily for many years gain. Quitting can add as much as 10 years to life expectancy and lowers the risk of 12 different cancers (CDC). FDA says the same: no matter how much you smoke or for how long, quitting will benefit you (FDA). CDC’s timeline:

  • Hours to days: blood nicotine drops to zero within 24 hours; carbon monoxide falls to a non-smoker’s level within several days.
  • 1 to 12 months: coughing and shortness of breath decrease.
  • 1 to 2 years: heart-attack risk drops sharply; by 15 years, coronary heart disease risk is close to that of someone who never smoked.
  • 5 to 15 years: stroke risk decreases, and the added risk of mouth, throat and voice-box cancers and of lung cancer falls by half (CDC).

Smokefree.gov adds that scarring of the lungs is not reversible, which is why sooner is better (Smokefree.gov). And The Pricer puts a pack-a-day habit near $3,588 a year (The Pricer).

How the six approaches fit

The best-proven path is counseling plus a quit-smoking medicine; CDC and MedlinePlus both say the combination works best (CDC, MedlinePlus). Chiropractic, acupuncture, herbs and massage lack good evidence as quit methods, as we say below; a coach can support daily habits.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Counseling plus a quit-smoking medicine: nicotine replacement (patch, gum, lozenge, inhaler, nasal spray), varenicline (Chantix), or bupropion, with follow-up and a plan for slips. Medicare Part B pays for up to 8 tobacco counseling sessions a year at no cost if your provider accepts assignment. Quitlines are free. Per The Pricer, a 14-count box of generic patches was $27.72 at one retailer; prescription prices range widely between coupon and retail. Medicines can reduce withdrawal and cravings. Cochrane reviews find nicotine replacement, varenicline and bupropion each beat placebo, with varenicline and combination nicotine replacement among the strongest. Side effects differ by medicine; mood changes need a call.
Chiropractic No established role in treating nicotine dependence. One small feasibility study added spinal manipulation to counseling. About $55 to $100 per follow-up visit paying cash, per The Pricer. Medicare covers only spinal adjustments for a subluxation. Ten people finished that study, so no conclusions can be drawn. A chiropractor can ask about tobacco and refer you to a quitline.
Acupuncture Needles, ear pressure or laser at acupuncture points, tried for cravings. About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture only for chronic low back pain. A Cochrane review found possible short-term effects but no consistent evidence of lasting benefit, and acupuncture was less effective than nicotine replacement. Seek a licensed practitioner who uses sterile needles.
Herbal medicine No herb or supplement has been shown to help people quit. Some are risky with medicines. Cost estimate being researched. NCCIH found no current evidence for SAMe, lobeline or St. John’s wort; St. John’s wort interacts with many medicines. “Natural” does not mean safe.
Massage therapy Relaxation and stress relief during a quit attempt, not a quit method. One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer. We found little research on massage for quitting. It can sit beside proven help as one way to unwind, but it will not stop cravings by itself.
MBHA Wellness Coach A practical partner for your quit plan: triggers, routines, stress, sleep, food and movement, slips, and keeping up with counseling and medicines. Cost estimate being researched. Behavioral support is proven to help, and coaching fits that role, but a coach does not prescribe or replace a quitline, clinician or medicine.

Approach 1 of 6

Conventional medicine (AMA)

The best-supported approach is counseling plus medicine. CDC says to talk to a quit-smoking counselor individually or in a group, use a free quitline, and add medicine (CDC). A Cochrane network analysis of 319 trials found high-certainty evidence that varenicline, nicotine e-cigarettes and cytisine were associated with higher quit rates than control, and that nicotine patch, fast-acting nicotine replacement and bupropion were also better than control (Lindson et al., 2023).

Ask for a plan, not just a prescription. A clinician can screen your health history, choose a medicine, set a quit date, schedule follow-up and plan for slips. Tell them about every other medicine: the Chantix label notes that quitting smoking can change how some drugs, such as theophylline, warfarin and insulin, act in your body, and doses may need adjusting (FDA label, Chantix). The NicoDerm CQ label asks you to check with a doctor or pharmacist if you take prescription medicine for depression or asthma (FDA label, NicoDerm CQ). See our medication safety guide.

What it costs

Medicare Part B covers up to 8 tobacco counseling sessions in 12 months at no cost if your provider accepts assignment (Medicare.gov). The Pricer says a realistic self-pay budget is about $100 to $300 for several weeks of over-the-counter nicotine replacement or a structured counseling program, and that a state quitline can be free (The Pricer).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care is not a treatment for nicotine dependence. We found little research. In a small feasibility study, people were randomly assigned to two months of counseling alone or counseling plus spinal manipulation from chiropractors. Recruitment was hard because people did not want to commit to two months of care, and only ten completed the study. The group with manipulation had greater drops in cigarettes smoked and in urine cotinine, and the three people who reached at least seven days without tobacco were all in that group. The authors called the benefit preliminary and said larger studies are needed (Rose et al., 2017). With ten participants, no one should read this as proof.

A more practical role: a chiropractic clinic can ask about tobacco, advise quitting and refer. A pilot in six clinics trained chiropractors in “Ask, Advise, Refer”; clinics made progress, though none sustained the referral step (Buettner-Schmidt et al., 2018). If your chiropractor offers a quitline number, take it.

What it costs

The Pricer puts a self-pay chiropractic follow-up visit at about $55 to $100 (The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

A Cochrane review of 38 studies of acupuncture and related methods found that compared with sham acupuncture, the short-term effect was small but present (risk ratio 1.22), while the long-term effect was not clear (1.10, with a range that included no effect). Acupuncture was less effective than nicotine replacement, and there was no evidence it beat psychological help. Continuous ear (auricular) acupressure beat sham in the short term, but indwelling needles did not clearly do so, and electrostimulation was not effective. The authors concluded there is no consistent, bias-free evidence of benefit lasting six months or longer, that no firm conclusions can be drawn, and that these methods alone are likely less effective than evidence-based ones (White et al., 2014). NCCIH reaches the same conclusion (NCCIH).

Safety. NCCIH says few complications are reported relative to the millions of people treated, but poorly sterilized needles or improper treatment can cause infections and punctured organs (NCCIH). Choose a licensed practitioner, and tell them about blood thinners.

Bottom line: if acupuncture helps you relax, it can be one tool beside counseling and medicine. It is not a substitute for them.

What it costs

About $90 to $185 per follow-up visit paying cash, per The Pricer (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement has been shown to help people quit. NCCIH says there is no current evidence that SAMe, lobeline (from Lobelia inflata) or St. John’s wort help, that a few studies of them found nothing effective, and that St. John’s wort interacts with many medicines, with potentially serious consequences (NCCIH, NCCIH). A Cochrane review of lobeline found no long-term trials and short-term evidence suggesting no benefit (Stead and Hughes, 2012). NCCIH reminds readers that “natural” does not necessarily mean safe, and some supplements have side effects or interact with drugs (NCCIH).

Cytisine is a plant-derived compound used as a quit aid in some countries. A Cochrane review found moderate-certainty evidence that it helps more people quit than placebo (Livingstone-Banks et al., 2023). NCCIH described it as not yet FDA-approved (NCCIH); we could not confirm its current U.S. status, so ask your pharmacist.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

We found little research on massage as a way to quit. Massage is not a quit method, and no source we opened says it helps people stop smoking. NCCIH reports that relaxation techniques such as guided imagery and progressive muscle relaxation may help people quit or cut cravings (NCCIH), which is different from massage.

What massage can offer is time to unwind; Smokefree.gov has tips for coping with stress without cigarettes (Smokefree.gov). If you enjoy it, book it as part of a broader plan. See our circulation guide.

What it costs

One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer (The Pricer).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Behavioral support helps. A Cochrane overview of 33 reviews concluded that behavioral support raises quit rates at six months or longer, with no evidence it increases harm, whether or not medicine is also used; the evidence is strongest for any form of counseling and for guaranteed financial incentives (Hartmann-Boyce et al., 2021). An MBHA Wellness Coach is not a tobacco counselor, but the daily work of quitting is where a coach fits:

Coaching does not diagnose, prescribe, or replace a quitline, clinician or medicine; mood changes and medicine questions go back to your clinician.

What it costs

Cost estimate being researched.

Another approach

Quit-smoking medicines, by class

FDA lists seven approved products: five forms of nicotine replacement and two non-nicotine tablets. Talk to your clinician, nurse or pharmacist about which fits your age, pregnancy status and medical history (FDA). We do not give doses.

Nicotine replacement (NRT)

  • Over the counter (age 18 and older): skin patch, chewing gum and lozenge (FDA). Brand names on FDA’s list include Habitrol and NicoDerm (patch), Nicorette (gum and lozenge) and Commit (lozenge) (FDA).
  • By prescription: nicotine inhaler and nasal spray, sold as Nicotrol (FDA, FDA). The Nicotrol NS label says it should be used as part of a comprehensive behavioral program and that use beyond six months is not recommended (FDA label, Nicotrol NS).
  • Evidence: NRT gives your body nicotine without the other chemicals in smoke (Smokefree.gov). In Cochrane reviews, combining a patch with a fast-acting form gave higher long-term quit rates than one form (risk ratio 1.27, high certainty); gum or lozenge worked about as well as the patch; and using NRT before the quit day may help, with moderate certainty (Theodoulou et al., 2023). CDC also suggests pairing a patch with gum or lozenge (CDC).
  • Label cautions: ask a doctor first if you have heart disease, a recent heart attack or irregular heartbeat, uncontrolled high blood pressure, stomach ulcers, diabetes or a history of seizures; ask a doctor or pharmacist if you take medicine for depression or asthma. Under 18, ask a doctor. Stop and ask a doctor for palpitations or nicotine-overdose signs such as nausea, vomiting, dizziness and a rapid heartbeat. With the patch, vivid dreams or sleep trouble are a reason to remove it at bedtime (FDA label, NicoDerm CQ, FDA label, Nicorette).

Varenicline (Chantix and generics)

  • A nicotine receptor partial agonist, by prescription. A Cochrane review found high-certainty evidence that it helps more people quit than placebo (risk ratio 2.32), than bupropion, and than a single form of NRT, and it may be as effective as dual-form NRT (Livingstone-Banks et al., 2023).
  • The label lists nausea (the most common problem), vivid or strange dreams, constipation, gas and vomiting; warns of reported seizures, alcohol effects and accidental injuries; and says it is not recommended for ages 16 and under (FDA label, Chantix).
  • Mood. The label reports serious mood and behavior events, including agitation, depressed mood and suicidal thoughts, and says to stop it and contact a provider if these appear. It notes depression also occurs in people quitting without medicine, and that in a large trial of people without a psychiatric history it was not linked to more significant neuropsychiatric events (FDA label, Chantix). Cochrane found people on varenicline probably report more serious adverse events overall, while heart and mental-health data fit both benefit and harm (Livingstone-Banks et al., 2023).
  • The label says safety with other quit-smoking therapies is not established, and combining it with a nicotine patch led to many stopping because of side effects (FDA label, Chantix). Do not combine on your own.

Bupropion SR (Zyban on FDA’s list)

  • A non-nicotine tablet by prescription. A Cochrane review found high-certainty evidence that bupropion raises quit rates versus placebo (risk ratio 1.60); it may be as successful as a single form of NRT but less effective than combination NRT or varenicline, and may slightly raise serious adverse events (Hajizadeh et al., 2023).
  • FDA lists dry mouth and insomnia as the most common side effects; because it contains the same ingredient as an antidepressant, FDA urges talking to your provider about antidepressant risks. It is not approved for children or teens (FDA).

Mental-health warning, all prescription quit medicines: new or worse depression, anxiety, panic, agitation, aggression, mania or suicidal thoughts are reasons to stop and call your provider; these happen more often in people with a mental-health history (FDA). Call or text 988 in a crisis (988 Lifeline).

What it costs

The Pricer found prescription prices for generic bupropion SR and varenicline can differ enormously between coupon and retail prices; check your insurance and a discount program before paying full price (The Pricer).

Another approach

Counseling, quitlines and text support

Counseling can be one-on-one, in a group, by phone, or by text. CDC points to free, confidential coaching through a quitline at 1-800-QUIT-NOW (CDC). Smokefree.gov lists 1-800-QUIT-NOW and 1-877-44U-QUIT, plus LiveHelp online chat, and a free text program: text QUIT to 47848 for a 6 to 8 week program, or CRAVE to 47848 for craving support (Smokefree.gov, Smokefree.gov). The free quitSTART app tracks cravings (Smokefree.gov).

  • Phone counseling works. A Cochrane review of 104 trials found moderate-certainty evidence that multiple proactive counseling sessions raised quit rates among helpline callers (risk ratio 1.38) compared with self-help materials or a single brief call (Matkin et al., 2019).
  • Text messages help. Automated text programs beat minimal support (risk ratio 1.54, moderate certainty); the evidence for smartphone apps was of very low certainty (Whittaker et al., 2019).
  • Incentives help. High-certainty evidence shows financial incentives improve long-term quit rates (risk ratio 1.52) (Notley et al., 2025). Ask your employer or health plan.
  • Exercise. Cochrane found no evidence that adding exercise improves quitting, though the evidence was too weak to rule out a modest benefit (Ussher et al., 2019).

Hypnosis, mindfulness and yoga

A Cochrane review of 14 hypnotherapy studies (1,926 people) found insufficient evidence that it beats other support or quitting unaided; any benefit is small at most, and no evidence of harm was found (Barnes et al., 2019). For mindfulness, a 21-study Cochrane review did not detect a clear benefit or harm for quit rates, though the evidence was low or very low certainty (Jackson et al., 2022); A 2018 yoga trial found more people had stopped at the end of treatment, but no difference at 3 and 6 months (NCCIH). In short, these are reasonable extras for stress, not replacements for counseling and medicine.

Another approach

E-cigarettes and vaping: what the evidence shows

This is the topic where sources differ most, partly because they were written at different times, so here is each piece plainly.

What vapes are and the risks

  • CDC says e-cigarettes heat a liquid into an aerosol that typically contains nicotine; the aerosol is not harmless “water vapor,” and can contain cancer-causing chemicals, heavy metals such as nickel, tin and lead, and flavorings such as diacetyl, which is linked to a serious lung disease; some products marketed as zero nicotine were found to contain it (CDC).
  • CDC also reports seizures, battery fires and explosions (most while charging), and nicotine poisoning, and says using both cigarettes and e-cigarettes may mean greater toxin exposure and worse respiratory health than either alone (CDC).
  • Vaping-related lung injury (EVALI) is covered in the urgent box above; CDC and NIDA advise against THC vaping products, especially from informal sources (CDC (archived), NIDA).

Can vaping help you quit smoking?

  • Not an FDA-approved quit aid. FDA says no e-cigarette has been approved as a method to help quit smoking, though some may help adults move away from cigarettes (FDA). A marketing authorization means a product can be sold, not that it is safe or “FDA approved” (FDA).
  • The newest evidence is more favorable than older pages. The Cochrane living review (80 trials, 29,861 people) found high-certainty evidence that nicotine e-cigarettes raise quit rates compared with nicotine replacement (risk ratio 1.61, about four more quitters per 100) and moderate-certainty evidence of a gain over non-nicotine e-cigarettes. Serious adverse events were low and probably similar to NRT, with no serious short-term harm detected. The authors say longer trials are needed, and that products tested were regulated nicotine devices; illicit or THC products may differ (Lindson et al., 2026). NIDA’s older fact sheet says vaping might be less harmful than cigarettes for people who switch completely, but nicotine in any form is highly addictive (NIDA); MedlinePlus says using vapes to quit has not been proven (MedlinePlus).
  • MBHA’s take: proven medicines and counseling come first. If you are using a regulated nicotine vape to stay off cigarettes, talk with a clinician about a plan to eventually stop all nicotine, and avoid doing both. See Smokefree.gov’s note that there is no safe level of tobacco use (Smokefree.gov).

Quitting vaping

Smokefree.gov has a quit-vaping plan, and lists withdrawal such as irritability, headaches, sadness, trouble concentrating, sleep trouble and hunger (Smokefree.gov, Smokefree.gov). Cochrane found low-certainty evidence that text-message programs may help 13- to 24-year-olds stop vaping (risk ratio 1.32) and that varenicline may help; evidence for combination NRT was inconclusive (Butler et al., 2025).

Other nicotine products

Oral nicotine pouches have limited evidence as a way to quit smoking (Hartmann-Boyce et al., 2025). For smokeless tobacco, counseling, brief advice and varenicline probably help people quit, NRT may help, and bupropion is not supported (Livingstone-Banks et al., 2025).

Another approach

Withdrawal, weight worry, mood and slips

Withdrawal

Smokefree.gov says withdrawal is uncomfortable but not harmful. Common signs are cravings, irritability, trouble sleeping, trouble concentrating, restlessness, feeling sad, anxious or down, and hunger. Symptoms are strongest in the first days or weeks and the worst usually pass in under two weeks; the first week is when you are most at risk of slipping. Its tips: distract yourself; avoid triggers for a while; keep a regular sleep schedule and limit caffeine, alcohol and big late meals; walk when restless; keep healthy snacks; and consider a quit medicine (Smokefree.gov). A cough that gets worse at first can be the cilia in your lungs coming back to life (Smokefree.gov).

Mood

People who smoke are more likely to have anxiety or depression, and some feel more of it after quitting; watch for this, especially with a past history (Smokefree.gov). The reassuring news: a Cochrane review of 102 studies found mental health does not worsen on average after quitting, with small to moderate improvements in anxiety, depression and stress, including among people with mental-health conditions; certainty ranged from very low to moderate (Taylor et al., 2021). If feelings worsen, call 1-800-QUIT-NOW or 988 (Smokefree.gov). See our depression and anxiety guides, and the sleep problems guide.

Weight worry

Smokefree.gov says many people gain some weight after quitting because smoking dulls appetite and speeds metabolism, but it is better for your health to quit as soon as possible. Tips: control portions, stay hydrated, exercise (even 10 minutes a day), eat mindfully, and find ways to cope with stress other than food (Smokefree.gov). Cochrane found no intervention with moderate-certainty evidence of a clinically useful effect on long-term weight gain, and no moderate- or high-certainty evidence that weight-limiting programs reduce the chance of quitting (Hartmann-Boyce et al., 2021). So do not wait to quit because of weight. See our weight control guide.

Slips and relapse

Smokefree.gov: a slip is not failure; think about what triggered it, restart quitting today or tomorrow, and try something new, like a medicine or text program (Smokefree.gov). Cochrane found skills training alone gave no worthwhile benefit in preventing relapse, while extending varenicline helped (moderate certainty) (Livingstone-Banks et al., 2019).

Another approach

Pregnancy, secondhand smoke and young people

Pregnancy

Smokefree.gov lists smoking-related pregnancy complications including miscarriage, ectopic pregnancy, placental abruption, placenta previa, preeclampsia and preterm birth; quitting before birth makes a baby less likely to be born too early or with a birth defect such as cleft lip, and more likely to have a healthy weight (Smokefree.gov). CDC says no tobacco product, including e-cigarettes, is safe in pregnancy (CDC).

  • It is never too late. Smokefree.gov encourages pregnant women to try quitting without medicine first, because more research is needed on medicine safety; if that has not worked, ask your doctor if medicine is right. The free SmokefreeMOM text program starts with the text MOM to 47848 (Smokefree.gov).
  • Cochrane found moderate-certainty evidence that counseling and incentives help women stop smoking in pregnancy (Freijah et al., 2026); incentive schemes in pregnancy have high-certainty evidence (Notley et al., 2025). For medicine, NRT may increase quitting in late pregnancy, but certainty is low; no evidence supports bupropion, and no trials tested varenicline or e-cigarettes (Claire et al., 2020).

See our pregnancy guide.

Secondhand smoke

CDC says there is no safe level of secondhand smoke, and even brief exposure can cause harm. In adults who do not smoke it raises the risk of coronary heart disease by 25 to 30%, stroke by 20 to 30% and lung cancer by 20 to 30%. In children it raises the risk of respiratory infections and can trigger asthma attacks; infants are more likely to die of SIDS (CDC). Smokefree.gov says separate rooms, air cleaning and airing out do not remove secondhand smoke, and that a smokefree home and car are the best protection (Smokefree.gov).

Teens and young adults

CDC’s 2024 data: 1.63 million (5.9%) middle and high school students currently used e-cigarettes; 87.6% of them used flavored products and 26.3% vaped daily (CDC). CDC says nicotine can harm brain development, which continues until about age 25, and that addiction signs can appear quickly (CDC). On quitting, Cochrane found limited evidence for youth programs, with one cessation-focused study likely lowering current vaping (risk ratio 0.73, moderate certainty) (Barnes et al., 2026). FDA says anyone under 18 should speak with a doctor before using a quit product (FDA).

Another approach

Paying for help: Medicare, Medicaid and lung screening

  • Medicare Part B covers up to 8 counseling sessions in 12 months to stop smoking or using tobacco; you pay nothing if your provider accepts assignment (Medicare.gov). That page does not mention medicines, so ask your plan about prescription quit medicines. We did not confirm drug coverage.
  • Lung cancer screening. Medicare Part B covers a yearly low-dose CT scan if you are 50 to 77, have no symptoms, currently smoke or quit within 15 years, have at least a 20 pack-year history, and get an order after a visit to discuss benefits and risks; you pay nothing if the provider accepts assignment (Medicare.gov). See our cancer guide.
  • Medicaid. Coverage varies by state. CDC reports that between 2018 and 2022 the number of states with comprehensive Medicaid coverage rose from 15 to 20, with gaps and barriers remaining in many states, and that expansion enrollees must have coverage for all treatments (CDC MMWR, 2024). Call your plan or your state quitline.
  • Free: quitlines and SmokefreeTXT can cost nothing, per The Pricer, and some state quitlines also offer free or discounted nicotine replacement (The Pricer).

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)(3) organization and does not endorse any particular products or practices. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. We strongly recommend that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition. MBHA provides administrative support, education and navigation — not medical, legal or tax advice — and cannot guarantee claim, billing or fundraising outcomes. MBHA is not an emergency service: in an emergency, call 911 or go to the nearest emergency room.