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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.

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‘Crushing blow’ for care homes as they face ban on overseas recruitment

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'Crushing blow' for care homes as they face ban on overseas recruitment

Care workers will no longer be recruited from abroad under plans to “significantly” bring down net migration, the home secretary has said.

Yvette Cooper told Sky News’ Sunday Morning with Trevor Phillips programme the government will close the care worker visa route as part of new restrictions which aim to cut the number of low-skilled foreign workers by about 50,000 this year.

Politics live: Govt launches crackdown on migration

She said: “We’re going to introduce new restrictions on lower-skilled workers, so new visa controls, because we think actually what we should be doing is concentrating on the higher-skilled migration and we should be concentrating on training in the UK.

“Also, we will be closing the care worker visa for overseas recruitment”.

The move comes ahead of the Immigration White Paper to be laid out this week, which will give more details on the government’s reforms.

Care England, a charity which represents independent care services, described Ms Cooper’s comments as a “crushing blow to an already fragile sector” and said the government “is kicking us while we’re already down”.

Its chief executive Martin Green said international recruitment is a “lifeline” and there are “mounting vacancies” in the sector.

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Reform: Immigration ‘should be frozen’

Cooper refuses to give immigration target

Ministers have already announced changes to the skilled visa threshold to require a graduate qualification and higher salary.

Ms Cooper told Trevor Phillips that this – along with the care worker restrictions – will result in a reduction “probably in the region of up to 50,000 low-skilled worker visas in the course of this year alone”.

However, she refused to give a wider target on the amount the government wants to see net migration come down by overall, only saying that it needs to come down “substantially”.

Ms Cooper said the Conservatives repeatedly set targets they couldn’t meet and her plan was about “restoring credibility and trust”.

She said: “It’s about preventing this chaotic system where we had overseas recruitment soar while training in the UK was cut and we saw low-skilled migration in particular, hugely go up at the same time as UK residents in work or in training fell. That is a broken system. So that is what we need to change.”

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Care companies say they can’t carry on after NI hike

The government is under pressure after it’s drubbing at the local elections, when Reform UK took control of 10 councils in England.

Richard Tice, Reform’s deputy leader, said the party’s strong performance was because people are angry about both legal and illegal immigration and called for immigration to be “frozen”.

He told Trevor Phillips: “The reality is that we’ve just won by an absolute landslide – the elections Thursday last week – because people are raging, furious, about the levels of both illegal and legal immigration in this country.

“We need to freeze immigration because the way to get our economy going is to freeze immigration, get wages up for British workers, train our own people, get our own people who are economically inactive back into work.”

Net migration – the difference between the number of people immigrating and emigrating to a country – soared when the UK left the EU in January 2020.

It reached 903,000 in the year to June 2023 before falling to 728,000 in mid-2024.

According to the Home Office, the number of ‘Health and Care Worker’ visas increased from 31,800 in 2021 to 145,823 in 2023, with the rise primarily due to an increase in South Asian and Sub-Saharan African nationals coming to work as care workers.

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Sky News investigates UK care homes

The number decreased significantly in 2024 to 27,174 – due to measures introduced by the Tories and greater compliance activity, the government said.

The crackdown is likely to cause concern in the care sector, which has long warned that low wages are driving a recruitment crisis and is now also being hit by the rise in employer National Insurance.

Speaking to the BBC’s Sunday with Laura Kuenssberg, Ms Cooper said there are around 10,000 people in the UK who came on care worker visas for jobs that didn’t exist and “care companies should recruit from that pool”.

“They came in good faith but there were no proper checks, they were badly exploited,” she said.

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Nadra Ahmed, of the National Care Association, told Sky News this was a “scandal of the Home Office’s own making”, with care workers allowed to come to the UK “legitimately but with spurious contracts from profiteers preying on an already fragile sector”.

She added: “Understandably, many of those who are displaced have a preference of which part of the sector they work in or are qualified to do so, based on the promises made to them.

“Our preference would always be to recruit from within our domestic options but sadly we are not able to generate enough interest in social care when the funding remains a barrier to ensure that pay adequately rewards the skills and expertise of our workforce.”

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Labour’s shift on migration may assuage voters’ concerns – but risks harming struggling care sector

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Labour's shift on migration may assuage voters' concerns - but risks harming struggling care sector

Labour and the Conservatives have been left reeling from Reform UK’s rampant success at the local elections.

And it seems both have taken a clear message from the insurgent party’s signature attitude towards migration.

Politics live: Care homes face ban on overseas recruitment

Polls regularly show the issue is a top concern for voters. While stopping the boats driving illegal migration is proving as difficult for Labour as it was for the Tories – the government has the levers to control legal migration much more directly.

This week, Sir Keir Starmer and Yvette Cooper have decided it’s time to pull them, with their long-awaited white paper due to be published on Monday. But the trade offs involved in reforming the system certainly aren’t without controversy.

Speaking to Sky’s Sir Trevor Phillips to sell her plans to reduce visa numbers, the home secretary repeatedly talked about “restoring control”.

It’s no coincidence to hear her invoking the language of Brexit – highlighting the fact it was Boris Johnson who presided over the spiralling increase in migration after the vote to leave the European Union – and attempting to court the voters who believed doing so would close the borders to the influx of overseas workers.

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“It’s about restoring control and order,” she said. “It’s about preventing this chaotic system where we had overseas recruitment soar while training in the UK was cut…

“That is a broken system. So that is what we need to change.”

The home office plan is to link the reduction in overseas workers with government efforts to get the economically inactive back into work. In future, only those with degree-level qualifications will be eligible for skilled worker visas.

Employers who want to employ lower-skilled workers, on a temporary basis, will have to demonstrate they are training and recruiting UK workers as well.

The home secretary says 180 occupations will be removed from the shortage list, with the shortfall filled by training schemes to fill the gaps with home-grown workers. Questions abound about how training schemes will marry up with immediate business needs now.

But it’s the closure of the specific care worker visa which is leading to the loudest alarm bells thus far.

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Reform: Immigration ‘should be frozen’

Many in the sector are desperately worried about pre-existing staffing shortfalls, unconvinced by government advice to recruit from a pool of 10,000 workers already in the UK on care visas.

Professor Martin Green, of Care England, said: “This is a crushing blow to an already fragile sector. The government is kicking us while we’re already down.”

But the government is determined to try and wean the economy off its dependence on overseas labour.

The increase in net migration is staggering. Before Brexit, the highest figure was 329,000, in the year up to June 2015.

But by June 2023, the annual number had soared to 906,000. While last year that figure fell to 728,000, following restrictions on dependents on care and student visas – the number is still strikingly high.

Kemi Badenoch’s Tories have decided there’s no room for evasion and have regularly issued dramatic apologies for the decisions of the past.

“The last government,” said Shadow Home Secretary Chris Philp on Sunday, as if he had no part of it, “made some very serious mistakes with immigration. They allowed it to be far, far too high…that was a huge mistake.”

But Mr Philp is characteristically full of criticism of Labour’s “failure” on the “radical reforms” needed.

He wants to see parliament voting for an annual cap on numbers, although hasn’t specified what that would be.

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Ms Cooper says migration targets have no credibility after years of Tory failures – but also acknowledged that she wants the numbers to fall “substantially” and “significantly” below 500,000.

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She claims the skilled worker visa changes will lead to 50,000 fewer visas being issued this year alone – a small proportion of that overall too, but a quick result all the same.

Will it be enough?

Reform UK are clearly delighted to be directing the government’s policy agenda.

Deputy leader Richard Tice told Sir Trevor “the Labour Party is talking the talk. Will they actually walk the walk? I actually think the people are voting for us because they know that we mean it.”

But the policy is a risk.

Assuaging voters’ concerns on migration could mean taking a serious hit to an already anaemic economy and struggling care sector. Not to mention the longer-term political decision to move the party firmly to the right.

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World

‘Have the meeting now!’: Trump says Ukraine should ‘immediately’ agree to direct talks with Russia

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'Have the meeting now!': Trump says Ukraine should 'immediately' agree to direct talks with Russia

US President Donald Trump has demanded that Ukraine should “immediately” agree to direct talks with Russia in a bid to end the war.

It comes after Ukraine’s President Volodymyr Zelenskyy said his team were “ready to meet” Russian representatives following Vladimir Putin suggestion of peace talks, subject to an unconditional ceasefire starting on Monday.

Russia‘s president put forward the proposal for talks in Istanbul on Thursday after European leaders including Sir Keir Starmer threatened him with fresh sanctions if Russia failed to comply with an unconditional 30-day ceasefire starting on Monday.

Analysis:
Why calls for Ukraine talks are likely a delaying tactic from Putin

However, in a post on his Truth Social platform on Sunday, Mr Trump said he was “starting to doubt that Ukraine will make a deal with Putin”.

He urged them to accept the meeting invitation “immediately”, adding “have the meeting now”.

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Putin’s call for peace talks genuine?

Mr Trump wrote: “President Putin of Russia doesn’t want to have a ceasefire agreement with Ukraine, but rather wants to meet on Thursday, in Turkey, to negotiate a possible end to the bloodbath.

“Ukraine should agree to this, immediately. At least they will be able to determine whether or not a deal is possible, and if it is not, European leaders, and the US will know where everything stands, and can proceed accordingly.

“I’m starting to doubt that Ukraine will make a deal with Putin, who’s too busy celebrating the Victory of World War ll, which could not have been won (not even close!) without the United States of America.

“Have the meeting now!”

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Kremlin: ‘We don’t share Starmer’s view’

Shortly after Mr Trump’s post, Mr Zelenskyy posted on X saying: “We await a full and lasting ceasefire, starting from tomorrow, to provide the necessary basis for diplomacy.

“There is no point in prolonging the killings. And I will be waiting for Putin in Türkiye on Thursday. Personally. I hope that this time the Russians will not look for excuses.”

When Mr Putin first suggested the talks, Mr Trump hailed it “a potentially great day for Russia and Ukraine” and said he would “work with both sides to make sure it happens”.

Read more from Sky News:
Pope Leo calls for Ukraine peace
Michael Clarke Q&A on Ukraine war

Turkish president Recep Tayyip Erdogan also said he “fully supported” Mr Putin’s proposal and was ready to host the talks, after the two leaders spoke over the phone on Sunday.

But security and defence analyst Michael Clarke told Sky News presenter Matt Barbet there is a “long way between now and Thursday” and a “fair bit of brinkmanship” going on.

He said even if the talks do go ahead, “the chances are they’ll extend over a long period and there won’t be a ceasefire as a result of them, and the Russians will keep playing this out”.

European leaders hold call with Ukraine. Pic: Number 10
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European leaders hold call with Mr Trump. Pic: Number 10

Mr Putin’s counteroffer of talks came after Sir Keir, Mr Zelenskyy, French President Emmanuel Macron, recently elected German Chancellor Friedrich Merz and Polish Prime Minister Donald Tusk met in Kyiv.

The leaders said they had secured Mr Trump’s backing after briefing him on the progress made on the so-called “coalition of the willing” plans in a 20-minute phone call.

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