Does varenicline promote abstinence in youths who vape?

INTRODUCTION: Vapes are the most used tobacco product by school children in the U.S.A. Vaping commonly leads to combustible cigarette smoking, marijuana use, and initiation of other drugs of abuse. Consequently, ways to help youths stop vaping are required.

AREA COVERED: The varenicline for nicotine vaping cessation in adolescents (ViVA) clinical trial was of varenicline in youths using vapes but not smoking cigarettes. Adding varenicline to behavioral counseling significantly increased the abstinence rate from 14% to 51% at 12 weeks. The efficacy of varenicline reduced through weeks 9-24 to 28%.

EXPERT OPINION: More youths in the varenicline group than placebo group adhered to their medication and undertook counseling, and this may have biased the data toward higher abstinence in the varenicline group. The results of ViVA do not apply to adults, and those youths who are not actively seeking to stop vaping, and youths who smoke and are, probably, addicted to smoking/nicotine. Longer-term clinical trials in both youths and adults will be necessary to determine whether varenicline causes meaningful abstinence and is safe in long-term vaping.