Elevatear: a scalable digital therapeuticthat uses augmented reality to enhance access, engagement, and effectiveness of vaping cessationamong the pediatric population

The National Institute on Drug Abuse awarded Ibis LLC $387,369 on September 1, 2026, under the Drug Use and Addiction Research Programs (CFDA 93.279) to develop ELEVATEAR, a scalable digital therapeutic using augmented reality to enhance vaping cessation among adolescents and young adults ages 13–21.

The project addresses the high prevalence of vaping initiation in the pediatric population, particularly ages 13–17, where vaping has increased from 3.8 percent in 2013 to 14.5 percent by 2021. Over half of current vaping occurs among individuals who were never established smokers, making vaping the primary pathway to nicotine use initiation in this age group. Nicotine exposure impacts brain development and can induce epigenetic alterations with longer-term health consequences. Despite the public health significance, limited research and digital therapeutics exist for vaping cessation in young adults, who show low engagement with existing smoking cessation treatments and high relapse rates. ELEVATEAR applies cue-exposure therapy principles to target craving—a key feature of addiction maintenance and relapse—through a novel digital therapeutic platform designed specifically for this population.

Work is performed in San Francisco, California. The award period runs from September 1, 2026, through August 31, 2027.

Abstract

The pediatric population (adolescents and young adults ages 13-21) has demonstrated significant risk of initiating vaping (vaping is also known as e-cigarette use), especially during adolescence (ages 13-17) and vaping has increased four-fold overall (3.8% in 2013 to 14.5% in 2021) in the past decade among young adults (18-21). Although cigarette smoking has decreased during this time, over half (56.2%) of current vaping is done by adolescents and young adults who were never established smokers, indicating that vaping is the primary pathway to nicotine use initiation in this age group. In addition to its impact on overall health, nicotine impacts brain development and induces epigenetic alterations that can lead to longer-term deficits passed on to later generations. Thus, vaping is not only an acute health concern for the pediatric population, but a developmental one at an individual and societal level. Despite this major public health concern, there is limited research and development of digital therapeutics targeting vaping for young adults, who exhibit low utilization of evidence-based strategies designed for smoking cessation. Although over half of young adults report a general desire to quit, lapses and relapses are common. The high rates of use, low engagement in existing treatments, and high rates of relapse among those who initially quit, underscore a need for innovative approaches to target vaping in young adults. Subjective craving, a strong urge to use substances, is a key feature of addiction and plays a significant role in the maintenance of nicotine use and relapse following abstinence. Although CUE-exposure therapy (CET) has been developed to target CUE-induced cravings for a variety of addictive substances, no digital therapeutic exists that specifically targets vaping in young adults. To address this critical need, this phase i sttr application proposes the development and evaluation of a scalable digital therapeutic (DTX) as an adjunctive treatment to care as usual for vaping cessation in the pediatric population. Specifically, we will develop a DTX that delivers augmented reality CUE exposure therapy (AR-CET) for vaping cessation in the pediatric population (aim 1); evaluate engagement, satisfaction, and preliminary effectiveness of elevatear in a single-arm clinical trial (aim 2); and evaluate the commercial feasibility of elevatear by engaging with the FDA and insurance payors throughout the funding period (aim 3).