Background: Most initiation of smoking and vaping occurs in adolescence, making secondary schools a logical setting for prevention. While various school-based programmes targeting nicotine-containing products have been evaluated, no systematic review has examined their effectiveness and user experiences across different nicotine-containing products.

Aim: To describe the effectiveness of and experiences with school-based programmes for both prevention and cessation of nicotine-containing products (i.e., cigarettes, e-cigarettes and other nicotine-containing products) for secondary school students.

Methods: A systematic search was conducted in four databases for school-based prevention programmes implemented after 2004 in Western countries (July 2023 and a search update in October 2024 and January 2026). Reviews and study protocols were excluded. Title and abstract screening were performed using ASReview.

Results: A total of 51 papers were included, evaluating programmes targeting cigarettes (n = 22), e-cigarettes (n = 8), both (n = 9), and broader substance use (n = 12). Programmes specifically targeting cigarettes or e-cigarettes were more effective than those addressing multiple nicotine-containing products or substances. Different intervention components appear to be effective for preventing e-cigarette use compared to cigarette use, highlighting the need to address them separately within programmes. User experiences were not assessed or briefly assessed, limiting insights into which intervention components drive effectiveness.

Discussion: Findings show the need for targeted, student-centred interventions with clearly defined behavioural goals rather than broad multi-substance programmes. The review underscores the importance of involving the target audience in intervention design through co-creation and enhancing the reporting of intervention components to facilitate cross-study comparisons. Future research should prioritize e-cigarette prevention, integrate qualitative methods to gain deeper insights, and account for socio-demographic factors to optimize intervention effectiveness.