Her practice admits up to 10 new patients weekly. “I’d say 75 percent have vapes as part of their story,” she said.

The other day she was assessing a middle-schooler whose dependence was so severe that he had been skipping classes to vape in the bathroom.

“He’s going to class now but sees himself as vulnerable, because he’s worried he won’t be able to resist the cravings,” Dr. Levy said. “It’s all he thinks about. It’s like treating a patient who has stopped heroin but wants to inject himself with an empty needle.”

She occasionally combines talk therapy with nicotine patches. Some doctors prescribe antidepressants to ease withdrawal. Dr. Levy also recommends deep breathing, yoga and exercise.

Typically, that initial intervention doesn’t occur with a doctor. “Schools are usually the first to catch young people vaping and then try to figure out what to do,” said Dr. Halpern-Felsher. She and her team developed a free online guide called the Tobacco Prevention Toolkit, which includes a major unit on vaping and Juuls. The program has reached 200,000 students.

One school told her that the kit’s message about how manufacturers are manipulating teens inspired some indignant students to cut back.

Without a holy grail for vaping cessation, the toll on families is searing.

“I believe the companies who created these things should pay for treatment,” Vicki, the suburban Boston mother, said through angry tears. “They targeted children. They said it was just about trying different flavors and having fun. Well, they’re the devil to me.”