Many teens who vape want to quit. A recent clinical trial suggests that a drug used to stop smoking can help.
In the last four weeks of a 12-week trial, 51 percent of the 88 teens and young adults taking the drug varenicline, which was paired with counseling and text messaging support, abstained from vaping completely, researchers report April 23 in the Journal of the American Medical Association. That’s compared with only 14 percent of the 87 receiving the same support but taking a placebo drug.
Once the 12-week intervention ended, researchers checked in with participants monthly for three more months. The continuous abstinence rate for weeks 9 to 24 for those who had taken varenicline was 28 percent compared with 7 percent on the placebo.
“For one of the most addictive substances we have, the 28 percent quit rate is pretty good at 24 weeks,” says Lindy McGee, a pediatrician at Baylor College of Medicine in Houston and Texas Children’s Hospital who was not involved in the trial.
Adolescence is a crucial period of brain development. Neural connections related to thinking, reasoning, memory and emotional regulation are strengthened or pruned. The adolescent brain is more susceptible to addiction, and consistent nicotine exposure disrupts this process of reorganization.
The 2024 National Youth Tobacco Survey found that close to 8 percent — about 1.2 million — of high school students reported using e-cigarettes in the past 30 days. Around 30 percent of those reported vaping daily, suggesting an addiction to nicotine. A 2020 survey found that 64 percent of high school students intended to quit vaping and 67 percent had tried to quit in the past year, researchers reported in 2021 in the Journal of Adolescent Health.
A challenge when helping patients under 18 quit, McGee says, is that state laws differ on whether drugs can be prescribed without parental consent. McGee encourages her patients to talk to their parents about quitting, unless the teen feels it’s unsafe to involve their parents. The school day can also pose logistical issues for the main medication option for teens, nicotine replacement therapy, which includes lozenges or gum to manage nicotine cravings. Their daytime use may require the school nurse to be involved, she says.
Varenicline, a prescription medication sold under the brand name Chantix, has been shown to help adults stop smoking. And a small clinical trial in adults found it may be effective for quitting vaping, researchers reported in 2024 in the American Journal of Preventive Medicine. Varenicline binds to nicotine receptors in the brain, which can help lessen the rewarding feeling that nicotine induces and reduce withdrawal symptoms.
In the new clinical trial, the 16-to-25-year-old participants, who were not regular smokers, had vaped five or more days each week for the past three months. Along with higher rates of abstinence from vaping, which researchers verified with a biochemical test, the varenicline group experienced reductions in nicotine cravings and withdrawal symptoms.
When making a quit plan with her patients, which can include counseling, text support and medication, McGee asks teens about what’s motivating them to help them set goals. She also screens for anxiety and depression to address those conditions as needed.
Varenicline is now another medication option she would raise with her 16- and 17-year-old patients and their parents, McGee says. And as a twice-a-day pill, it can be taken outside of school hours. “I’m glad to know that there is something else potentially in my toolbox.”
