FDA-sanctioned smoking cessation medication aids in breaking vaping dependency

Adolescents and young adults who consumed varenicline — a twice-daily, FDA-sanctioned smoking cessation medication for adults — are over three times more probable to effectively quit vaping in contrast to those who were given merely behavioral counseling, as per recent findings from Harvard-affiliated Mass General Brigham. Results have been published in JAMA.

“Vaping is immensely popular among youngsters, and we understand that early exposure to nicotine can make substances like cocaine increasingly addictive later on, yet this is the first treatment study to examine this susceptible demographic,” remarked lead author A. Eden Evins, director of the Center for Addiction Medicine at Massachusetts General Hospital and the William Cox Family Professor of Psychiatry in the Field of Addiction Medicine at Harvard Medical School. “Our goal was to assist teens and young adults in quitting, and we discovered that prescribing varenicline is the optimal approach to achieve that.”

As per the researchers, around 25% of individuals aged 18-25 engaged in vaping in 2023, with approximately 8% of high school students vaping in 2024. Vaping has emerged as a trendy alternative to traditional cigarettes, presenting the additional complications of being easily concealable and usable in public settings. Nonetheless, these devices comprise many of the same known health risks, such as nicotine addiction, carcinogenic and heavy metal exposure, along with pulmonary inflammation. Developing treatment strategies is essential to offer safe, effective options for adolescents and young adults looking to quit. 

Since varenicline is already authorized for smoking cessation in adults, it can be prescribed to anyone between the ages of 16 and 25 wishing to eliminate nicotine vaping.

To explore such a treatment method, the Mass General Brigham team engaged 261 participants aged 16 to 25 in a randomized clinical trial. The participants were divided into three treatment categories. The first involved varenicline, weekly behavioral counseling, and access to a complimentary text support service called “This is Quitting.” The second group received placebo pills, weekly behavioral counseling, and the text service. The third consisted solely of the text service. Each group underwent treatment for 12 weeks, followed by monthly check-ins for an additional 12 weeks after treatment.

Weekly, participants reported their success in quitting vaping, which was confirmed through cotinine saliva tests. At the conclusion of the 12-week treatment and during the three-month follow-up, the varenicline group achieved the highest abstinence rate. After 12 weeks, 51% of varenicline users had ceased vaping, compared to 14% in the placebo group and 6% in the text-only group. By 24 weeks, 28% of varenicline users had quit vaping, contrasted with 7% of placebo users and 4% in the text-only group.

These results highlight the significance of medication in assisting young individuals struggling with nicotine addiction to quit vaping, given that the varenicline group demonstrated three times greater success in quitting compared to their placebo counterparts — even while both engaged in behavioral therapy. Additional studies are necessary to investigate the possible effects of alternative therapeutic methods, as well as to examine younger individuals who use nicotine vapes.

Since varenicline is already authorized for smoking cessation in adults, it can be prescribed to anyone between the ages of 16 and 25 wishing to eliminate nicotine vaping.

“Not only was varenicline effective for this age group — it was also safe. Importantly, we did not observe any participants who ceased vaping transitioning to cigarette use,” stated Randi Schuster, founding director of the Center for School Behavioral Health at MGH and an associate professor of psychology in the Department of Psychiatry, HMS. “Our findings demonstrate the efficacy and safety of this treatment in addressing the pressing public health issue of adolescents addicted to nicotine due to vaping.”

This research was supported by the National Institutes of Health.