Share on Pinterest New research from RVO Health found that a quitline-based program led to vaping cessation in 45% of young adults. supersizer/Getty ImagesSmoking rates in the U.S. are declining overall, but vaping remains more popular than ever, especially among young people.A new study found nearly half of young adults successfully quit vaping at 3 months with a quitline-based intervention.Overall, quit rates were higher than expected based on previous studies on smoking cessation among young adults, researchers say. The quitline intervention that included nicotine replacement therapy (NRT) seemed most promising for quitting vaping. This is the first randomized trial testing NRT for vaping cessation.Participants also reported satisfaction with coaching calls, which researchers say likely contributed to the higher-than-expected quit rates.
Quitlines are free telephone services for people who smoke and use tobacco that provide support to help them quit.
In the United States, more than 10 million people have reached out to a quitline to help them quit smoking, a promising intervention for successful smoking cessation, according to the Centers for Disease Control and Prevention (CDC).
Research on the effectiveness of quitlines has grown in recent decades.
Now, a new study from the RVO Health Center for Wellbeing Research found that a quitline-based intervention successfully helped young adults quit vaping. E-cigarettes are the most commonly used tobacco product among young people.
The research, funded by the American Heart Association, was published in the American Journal of Preventative Medicine on December 11.
The quitline intervention used in this study provided all participants with some form of treatment. The intervention yielded higher-than-expected quit rates, with nearly half (45%) of participants abstinent after three months. Its the first large randomized trial examining the impact of a quitline-based intervention with nicotine replacement therapy (NRT).
These findings suggest that NRT is a promising intervention and needs further examination in future research trials, said Katrina Vickerman, PhD, director of the Center for Wellbeing Research at RVO Health, a health information and services company that includes platforms like Healthline.
We were excited to see the success of young adults in this study with overcoming their addiction to the high levels of nicotine that many vaping devices can deliver, Vickerman said. Quitline intervention led to successful vaping cessation
While overall smoking rates in the U.S. have declined in recent years, vaping continues to be popular, especially among young people. In 2018, former U.S. Surgeon General Jerome M. Adams, MD, declared a vaping epidemic among youth and young adults.
The long-term effects of vaping are not fully understood, but emerging evidence cites cardiovascular disease and chronic obstructive pulmonary disease (COPD) as possible health risks.
Despite the prevalence of vaping and its possible consequences for human health, only a handful of large studies have tested effective vaping cessation strategies.
When we initiated this study, there were no published vaping cessation trials to base our estimates on, Vickerman told Healthline.
Smoking cessation interventions for youth and young adults have historically achieved lower quit rates in randomized trials, which may reflect challenges engaging these groups in treatment studies. In this study, we provided everyone with treatment, she explained.
At the time we designed this study, there was very little information about dosing NRT for individuals who vape. We wanted everyone to speak to a quitline coach to allow for an assessment of their nicotine addiction, NRT dosing for those randomized to receive NRT through the study, and education on why and how to use NRT, she said.
For the study, Vickerman and co-leader Liz Klein, PhD, MPH of The Ohio State University College of Public Health, examined the effects of a two-call coaching protocol, mailed NRT, and a mobile health mHealth technology program. The mHealth program was delivered via text message and included links to quit resources like videos, podcasts, and online education content. The control group was a two-call coaching program only.
From July 2021 through September 2022, researchers recruited young adults in the U.S. ages 1824 who exclusively used e-cigarettes through ads on Facebook, Instagram, and social websites like Reddit.
A total of 981 participants were eligible and randomized into four groups with a 22 design. After completing the first coaching call, 508 were fully enrolled. Participants who were enrolled vaped regularly, which researchers defined as 20 or more days in the last month.
The four groups were broken down as follows:coaching calls (with no NRT or mHealth)coaching calls with mHealth (no NRT)coaching calls with NRT (no mHealth)coaching calls with mHealth and NRT
The coaching calls were an important part of the study intervention. Vickerman said they follow quitline intervention protocols, which are based on social cognitive theory and current clinical practice guidelines for tobacco cessation.
The calls begin with a series of questions to understand a persons tobacco use history, triggers for use, barriers to quitting, and strengths that can help with quitting. Vickerman noted the impact of these calls exceeded the researchers expectations.
George Chaux, MD, board certified interventional pulmonologist and medical director of Interventional Pulmonary at Providence Saint Johns Health Center in Santa Monica, told Healthline he found the effectiveness of the coaching calls as the control intervention compelling. Chaux wasnt involved in the study.
This study, although limited, suggests that coaching calls are sufficient alone, Chaux told Healthline, adding that combined forms of NRT may be even more effective for vaping cessation. Why are quitlines so effective?
Quitlines are confidential services that offer guidance, counseling, and self-help resources, with some providing free medications like NRT.
They are available in every state in the U.S. and have the infrastructure to provide large-scale, effective, and cost-effective interventions for smoking cessation.
[Quitlines] are effective in people who are motivated to quit smoking or vaping and simply need support to overcome the cravings of nicotine, Chaux said.
Vickerman noted that young adults in the study seemed more aware of NRT and more open to using it than anticipated.
In fact, 28% reported previous use of NRT before the start of the study, and a quarter of participants who were not provided NRT in the study sought out NRT on their own, she said.
While the 7% improvement in quit rates with mailed NRT was not statistically significant, Vickerman said the findings suggest that NRT is a promising intervention and needs further examination in larger trials.
Our study was underpowered to detect a difference of this size; this would be a clinically important difference if it held up in a future, larger study, she said.
Given that NRT appeared to be safe (with no unusual side effects) and acceptable for young adults in this study, we would feel comfortable dosing and mailing NRT without coach interaction in future studies. The mHealth intervention had a smaller effect but still warrants further investigation in future trials as mHealth interventions are easily scalable and can reach more individuals in need of help at a lower cost, she continued.
Vickerman added they would like to better understand which components of the quitline-based intervention are most effective for helping young adults successfully quit.
It may be that all of the intervention components are not needed, or that one component, like mHealth, is more successful in reaching and engaging participants, but some individuals who vape may need a higher level of support to be successful, like one-on-one coaching, Vickerman said.
Understanding the impact of the individual components can inform how best to use public health resorces and offer vaping cessation interventions through state quitlines. In future trials, we plan to expand who is eligible to individuals who both vape and use other tobacco products, she concluded. Resources to help you quit
Quitlines like 1-800-QUIT-NOW can help you quit smoking and vaping for good. Other quit resources include:Smokefree.govWe Are TruthBecome an ExLive Vape FreeQuit For Life Takeaway
Vaping is widespread among young people despite the possible health risks.
A new randomized trial used a quitline-based intervention to help young adults quit smoking and found nearly half of the participants successfully abstained at 3 months.
Researchers were surprised by higher-than-expected quit rates and how well the coaching calls resonated with the young adult participants who often prefer digital engagement.
The quitline intervention that included nicotine replacement therapy (NRT) seemed most promising for vaping cessation.
Quitlines are free resources available in every state in the U.S., offering support and medications like NRT to help you quit for good. For more information, call 1-800-QUIT-NOW or visit Live Vape Free.
RVO Health provides tobacco cessation services and is a vendor for numerous state quitlines in the U.S.
ESPN baseball reporter. Covered the L.A. Rams for ESPN from 2016 to 2018 and the L.A. Angels for MLB.com from 2012 to 2016.
Less than two years ago, the Texas Rangers rode a potent offense to the first World Series championship in franchise history. Since then — on paper, at least — that group has only improved. Established sluggers were brought in. Young, promising players accrued more seasoning. Core stars remained in their primes. And yet, over the course of 10 baseball months since hoisting the trophy on Nov. 1, 2023, the Rangers have fielded one of the sport’s worst offenses, a sobering reality that continues to vex team officials.
The circumstances of 2025 have only intensified the frustration.
The Rangers have received Cy Young-caliber production from a rejuvenated Jacob deGrom, who had compiled fewer than 200 innings over the last four years. Their rotation went into the All-Star break with the second-lowest ERA in the major leagues. Their bullpen, practically rebuilt over one offseason, ranked third. Their defense (16 outs above average) was elite, as was their baserunning (10.8 runs above average). But the Rangers, despite back-to-back wins over the first-place Detroit Tigers this weekend, find themselves only a game over .500, seven games out of first place and 2 1/2 games out of a playoff spot, because they can’t do the one thing they were expected to do best: hit.
Bret Boone, the former All-Star second baseman who was installed as the team’s hitting coach in early May, has been tasked with fixing that — but he is also realistic.
“I’m not gonna come in here and ‘abracadabra,'” he said, waving his right arm as if wielding a magic wand. “That’s the big misnomer about hitting. Hitting is really hard. The bottom line is — you can prepare as much as you want, but when you get in the box, it’s just you and that pitcher.”
Boone isn’t here for an overhaul. He’s here to encourage. To simplify. One of his prevailing messages to players, he said, has been to “watch the game” — to put away the tablet, come up to the dugout railing and see how opposing pitchers are attacking other hitters. Boone has emphasized the importance of approaching each game with a plan, whatever that might be. He has occasionally blocked off the indoor batting cage, worried that hitters of this generation swing too often. And he has encouraged conversation.
“That’s what great offenses do,” Boone said. “They’re constantly interacting.”
There might not be a more interesting team to watch ahead of the trade deadline. Rangers president of baseball operations Chris Young is not one to give up on a season, particularly with a team this talented. But one more rough patch might force him to, at least to an extent. Young would prefer to add, but it’s hard to envision a way to improve the lineup from outside.
Any offensive improvement will probably come internally, signs of which emerged recently. The Rangers got Carter back from the bereavement list on July 4 and Langford back from the IL on July 5, making their lineup as close to whole as it has been all year. Over the ensuing week, they scored 53 runs in seven games heading into the All-Star break. Maybe it was a sign of things to come. Or, if recent history is any indication, a short burst of false promise.
Below is a look at five numbers that define the Rangers’ surprising offensive downturn.
1. Semien and Seager’s combined OPS on June 22: .671
The Rangers’ rise began in late November 2021, just before the sport shut down in the leadup to an ugly labor fight, when Semien and Seager secured contracts totaling $500 million. Their deals came within days of each other, ensuring they’d share a middle infield for years to come. And when the Rangers won it all in 2023, it was Semien and Seager hitting back-to-back at the top of the lineup, setting the tone for an offense that overwhelmed teams in October.
Some things haven’t changed: Semien and Seager are still the driving forces of this offense. For most of this year, though, that hasn’t been a positive thing.
As late as June 22, with the Rangers 78 games into their season, Semien and Seager had combined for a .229/.312/.359 slash line. Their combined OPS, .671, sat 44 points below the league average.
Semien, traditionally a slow starter, finished the month of May with the second-lowest slugging percentage among qualified hitters and at times batted ninth. Seager made two separate trips to the IL because of the same right hamstring strain and eventually fell out of whack, batting .188 in June. If the Rangers are looking for good news, though, it’s that Semien and Seager finally got going in the leadup to the All-Star break. From June 23 to July 13 — with Seager and Semien settling into the No. 2 and No. 3 spots, respectively — they slashed .313/.418/.592.
“We all want to be on at the same time,” Semien said. “It’ll never happen like that, but if Corey and I are on, this team goes.”
2. Texas’ slash line against fastballs: .236/.312/.372
One of the Rangers’ coaches recently recalled some of the most iconic homers from the team’s championship run — García’s grand slam in the American League Championship Series, and Seager’s blasts against Houston’s Cristian Javier and Arizona’s Paul Sewald.
They all had one thing in common: turning on high fastballs and pulverizing them.
The Rangers were one of the best fastball-hitting teams in 2023. That has been far from the case since. The Rangers slashed just .233/.315/.379 against four-seam fastballs in 2024, worse than every team except the Chicago White Sox, who lost a record 121 games. This year, it isn’t much better.
The Rangers’ slash line against four-seamers was only .236/.312/.372 heading into the All-Star break, good for a .684 OPS that ranked 27th in the majors. Burger (.473 OPS), Heim (.500), Pederson (.620) and García (.660) were especially vulnerable. Against four-seamers that were elevated, no team had a higher swing-and-miss percentage than Texas (55.5%).
Being in position to hit the fastball has been one of the points of emphasis from the hitting coaches in recent weeks. It doesn’t mean every hitter will look fastball first — approaches are individualistic and often alter based on matchups — but it does underscore the importance of narrowing the focus. Opposing pitchers are too good these days. Hitters can’t account for everything. And the best offenses are able to take something away from an opposing pitching staff. The 2023 team took away the fastball as an attack weapon. But the Rangers, in the words of one staffer, have been “stuck in between” ever since — late on velocity and off balance against spin.
It’s a tough way to live.
3. Rangers’ chase rate with RISP: 32.2%
When asked about the biggest difference between the 2023 offense and the 2025 version, Rangers manager Bruce Bochy mentioned the approach in run-scoring opportunities. The team from two years ago, he said, was much better at situational hitting with runners in scoring position. This team seems to chase too much in those situations.
The numbers bear that out.
The Rangers’ chase percentage with runners in scoring position was 32.2% coming out of the All-Star break, fourth worst in the major leagues. Their strikeout percentage, 23.7%, was fifth worst. Their slash line, .230/.304/.357, was down there with some of the worst teams in the sport. The Rangers’ lineup has some strikeout in it — with Burger, Jung and García at the top of that list — but team officials believe it should be much better adept at driving in runs.
Not being able to has led to some dramatic highs and lows. The Rangers have scored eight or more runs 13 times, including two instances over a 72-hour stretch in which they hung 16 runs on the Minnesota Twins. But there have also been 25 games in which they have been held to one or zero runs, third most in the major leagues.
4. Carter’s and Jung’s wOBA ranks since 2023: 205th and 264th
Entering the second half, 380 players had accumulated at least 300 plate appearances since the start of the 2024 season. Among them, Carter ranked 205th with a .308 weighted on-base average. Jung, with a .295 wOBA, ranked 264th.
Jung looked like a budding star at third base in 2023, making the All-Star team and finishing fourth in AL Rookie of the Year voting. Carter came up in September and surged throughout October. With those two and Langford, Texas’ draft pick at No. 4 earlier that summer, the Rangers had three young, controllable players they could surround with their long list of established stars. It seemed unfair, yet it hasn’t come close to panning out.
Carter struggled through the first two months of 2024, was diagnosed with a stress reaction in his back, couldn’t fully ramp back up, got shut down for good in August, didn’t look right the following spring training and started the 2025 season in Triple-A. Carter appeared in just 45 games in 2024. Jung played in only one more, after a wrist fracture held him out for most of the first four months.
Then came a stretch of 101 plate appearances this June during which Jung notched just 15 hits, 5 walks and 27 strikeouts. Eight of those strikeouts came over his last four games, when his chase rate jumped to 45.9% — 12 percentage points above his career average. A Rangers source described him as “defeated” and “lost.”
On the second day of July, Jung was optioned to Triple-A Round Rock.
5. Rangers’ wRC+ since 2023: 94
There might not be a better representation of the Rangers’ drop-off than weighted runs created plus, which attempts to quantify total offensive value by gathering every relevant statistic, assigning each its proper weight and synthesizing it all into one convenient, park- and league-adjusted metric. The league average is 100, with every tick above or below representing a percentage point better or worse than the rest of the sport at that time.
During the 2023 regular season, the Rangers put together 117 wRC+. In other words, their offense was 17% above league average. Only one team — the Atlanta Braves, another currently underperforming club — was better. From the start of the 2024 season to the start of the 2025 All-Star break, the Rangers compiled a 94 wRC+, putting them 6% below the league average. Only eight teams were worse.
Five every-day players from that 2023 team are still on the Rangers — not counting Carter, who didn’t come up until September — and all of them have seen their OPS drop by more than 100 points. Seager? 1.013 OPS in 2023, .856 OPS since. García? .836 in 2023, .681 since. Heim? .755 in 2023, .605 since. Semien? .826 in 2023, .693 since. Jung? .781 in 2023, .676 since.
For Young, it’s not just the individual performances but how they coalesce.
“What we had was just a really balanced approach and a collective mindset in terms of the way we were attacking the opposing pitcher,” Young, in his fifth season as the head of baseball operations, said of the 2023 offense. “We had other guys who could grind out at-bats. We had guys who could hit for average. We had guys who slugged. And I still think we have that in our lineup. It’s just, for whatever reason, a number of them have had bad years to start the season. When you have a couple guys having down years, you can survive. When you have a majority of them having down years, it’s magnified. And then guys start pressing and putting pressure on themselves, and it makes it even harder.”
Electric bikes are a menace. They go almost as fast as a car (if the car is parking), they’re whisper quiet (which makes them impossible to hear over the podcast playing in your headphones), and worst of all, they’re increasingly ridden by teenagers.
By now, we’ve all seen the headlines. Cities are cracking down. Lawmakers are holding emergency hearings. Parents are demanding bans. “Something must be done,” they cry at local city council meetings before driving back home in 5,000 lb SUVs.
And it’s true – some e-bike riders don’t follow the rules. Some ride too fast. Some are inexperienced. These are real problems that deserve real solutions. But if you think electric bikes are the biggest threat on our roads, just wait until you hear about the slightly more common, slightly more deadly vehicle we’ve been quietly tolerating for the last hundred years.
They’re called cars. And unlike e-bikes, they actually kill people. A lot of people. Over 40,000 people die in car crashes in the US every year. Thousands more are permanently injured. Entire neighborhoods are carved up by high-speed traffic. Kids can’t walk to school safely. But don’t worry – someone saw a teenager run a stop sign on an e-bike, so the real crisis must be those darn batteries on two wheels.
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It’s amazing how worked up people get over a few dozen e-bike crashes when many of us step over a sidewalk memorial for a car crash victim on the way to the grocery store. We’ve been so thoroughly conditioned to accept car violence as part of modern life that the idea of regulating them sounds unthinkable. But regulating e-bikes? Now that’s urgent.
To be clear, this isn’t about ignoring the risks that come with new technology. E-bikes are faster than regular bikes. They’re heavier, too. And they require education and enforcement like any other mode of transport capable of injuring someone, be it the rider or a pedestrian bystander. But the scale of the problem is what matters – and the scale here is completely lopsided. Let’s take New York City, for example. It’s got more e-bike usage than anywhere else in the US, and there are still only an average of two pedestrians per year killed by an e-bike accident. That number for cars? Around 100 per year in NYC. It’s not complicated math – cars are 50x more lethal in the city.
And yet, the person on the e-bike is the one getting the stink eye.
We’ve become so numb to the everyday destruction caused by automobiles that it barely registers anymore. Drunk driving? Distracted driving? Speeding through neighborhoods? It’s just background noise. But the moment someone on an e-bike blows through a stop sign at 16 mph, it’s front-page news and a city council emergency.
Here’s an idea: If we want safer streets, how about we start by addressing the machines that weigh two and a half tons and can hit 100 mph, not the ones that top out at 20 or 28 and are powered by a one-horsepower motor the size of an orange.
But we don’t. Because cars are familiar. Cars are “normal.” Cars are how we built our entire country. And so we turn our attention to the easy target – the new kid on the block. The same old playbook: panic, overreact, and legislate the hell out of it.
Sure, an e-bike might startle you on a sidewalk. But a car can climb that sidewalk and end your life. Which one do we really need to be afraid of?
This isn’t a strawman argument, either. Cars are literally used as mass casualty weapons. It happens all the time. It happened last night in Los Angeles when a disgruntled car driver deliberately plowed into a crowd outside a nightclub, injuring over 30 people. And that wasn’t the only car attack yesterday. Another car rammed into pedestrians on a sidewalk in NYC yesterday morning, leaving multiple pedestrians dead. These aren’t exceptions. This is the normal daily news in the US. It’s depressing, but it bears repeating. This is normal. These are everyday occurrences. Twice a day, yesterday.
While we’re busy debating throttle limits and helmet rules for e-bikes, maybe we should also talk about how tens of millions of drivers still routinely speed, blow stop signs, or scroll Instagram at 45 mph in a school zone. Or how car crashes are the number one killer of teenagers in America. Or we can continue to focus on the kid who forgot to put his foot down at a red light while riding an e-bike to school.
This isn’t satire anymore – it’s just sad. It’s a collective willingness to avoid a real, genuine threat to Americans while simultaneously scapegoating what is, by comparison, a non-threat.
The truth is, electric bikes aren’t the menace. They’re a solution. They’re one of the few glimmers of hope in a transportation system drowning in pollution, congestion, and daily tragedy. They make mobility cheaper, cleaner, and more accessible. And yet we treat them like an invasive species because they disrupt the dominance of the automobile.
It’s time to stop pretending we’re protecting the public from some great e-bike emergency. The real emergency is that we’ve accepted cars killing people as a fair trade for getting to Target five minutes faster.
So yes, let’s make e-biking safer. Let’s educate riders, build better bike infrastructure, and enforce traffic rules fairly. Those are all important things. We absolutely SHOULD invest in training programs to educate teens on safe riding. We absolutely SHOULD cite and fine dangerous riders who could threaten the lives of pedestrians. But let’s stop pretending that e-bikes are the problem when they’re clearly a symptom of a much bigger one.
If you’re really worried about the dangers on our streets, don’t look for the kid on the e-bike. Look for the driver behind them, sipping a latte and going 20 over the speed limit.
Now that’s the menace.
Image note: The first and last images in this article were both AI-generated, and represent everyday car/bike interactions
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