The popularity of electronic nicotine-releasing devices, such as e-cigarettes, is steadily increasing. Among cigarette smokers, those who choose e-cigarettes report buying them primarily to abstain from smoking and relieve withdrawal symptoms from traditional cigarettes, save money, and have a “smoking” experience with reduced health risks. However, the perception that e-cigarettes are equally or even more harmful than combustible cigarettes has increased among many users, and there has been a growing interest in quitting electronic devices as well.
It is unclear whether existing smoking cessation guidelines can be applied to vaping products, and no studies are available on the efficacy of approved drugs in smoking cessation pathways to also aid e-cigarette cessation.
Varenicline, a drug that relieves nicotine withdrawal symptoms and reduces cravings for smoking, is the most effective drug for quitting. However, the efficacy and safety of varenicline within vaping cessation pathways has never been studied. To evaluate these lines of intervention, CoEHAR researchers conducted the first randomized controlled trial of varenicline in 140 exclusive vapers, examining abstinence rates from e-cigarettes.
I study “ Varenicline and counseling for vaping cessation: A double-blind, randomized, parallel-group, placebo-controlled trial“, demonstrates for the first time that the use of varenicline in a cessation program among e-cigarette users who intend to quit can be effective in total abstinence. The e-cigarette abstinence rate in the varenicline group was 34.3%, significantly higher than the 17.2% in the placebo group. Furthermore, varenicline has been shown to have an acceptable safety profile.
“Considering the sample of vapers we included in the study, varenicline doubles the chances of quitting vaping” explains Pasquale Caponetto, professor of clinical psychology at the University of Catania and first author of the study “a very important fact, considering that varenicline only serves to relieve withdrawal symptoms and does not in any way replace all those rituals connected to vaping”.
“Vaping is a harm reduction approach and can lead to smoking cessation. Here we establish the principle that for those seeking complete nicotine cessation, varenicline combined with professional support can help them do so.” comments Prof. Riccardo Polosafounder of CoEHAR.
I study
Particular attention was paid to the research and selection of participants: only adult vapers who used e-cigarettes daily and with at least one failed quit attempt were included. Divided into two groups, randomly administered varenicline or a placebo, psychological assistance was provided by cessation professionals, experts in nicotine and e-cigarette addiction, to maximize the effectiveness of drug treatment. Prolonged abstinence was verified by measuring the levels of cotinine present in the participants’ saliva. Considering the whole sample, the reduction in e-cigarette consumption was observed by 33.6% and 26.3% at weeks 12 and 24, respectively. None of the study participants relapsed into cigarette smoking.
“I believe the success of our strategy has been to provide highly motivated participants with a combined approach to vaping cessation: a structured plan of vaping reduction combined with the use of a drug that controls nicotine addiction”explains Prof. Polosa.
The presence of vaping cohabitants and high levels of anxiety have been found to significantly reduce the chances of successfully abstaining from e-cigarette use. This study suggests that the use of varenicline as part of a vaping cessation program for adult e-cigarette users can lead to prolonged abstinence without serious adverse effects. These findings could assist the efforts of health authorities in assisting users who wish to achieve complete nicotine cessation.
However, it is essential to conduct longer follow-up studies to verify long-term efficacy.
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