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According to the 2025 National Youth Tobacco Survey (NYTS), 1.44 million middle and high school students reported using e-cigarettes

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The authors also noted that "the optimal cessation aid package tested in trials is rarely what is implemented at the population level." Webster defines "bait and switch" as a "ploy of offering a person something desirable to gain favor then thwarting expectations with something less desirable." Clinical trials nearly always wrapped approved products in weeks or months of counseling or support designed to encourage and motivate successful nicotine weaning via NRT, products and counseling worthless to the studys placebo arm