Anti-smoking pill varenicline may help young people quit vaping, new study suggests

Varenicline — a daily pill already offered through NHS Stop Smoking Services — could also support young people in quitting vaping, new research has suggested.

The medication, proven to be more effective than nicotine replacement gums or patches for smoking cessation, was shown to significantly boost vaping abstinence when combined with behavioural counselling in adolescents and young adults.

The findings were published in JAMA on 23 April 2025.

Researchers noted that electronic cigarettes (vapes) are currently the most commonly used nicotine product among young people, with the highest rates seen in the 18–25 age group.

Alarmingly, the proportion of vapers aged 16 to 25 who have never regularly smoked tobacco is rising.

They warned that e-cigarette use can increase risk for nicotine addiction,uptake of combusted tobacco and other substance use, alongside direct negative health effects of vapour exposure, such as carcinogen and heavy metal exposure and pulmonary inflammation.

The new study found that varenicline, combined with behavioural counselling, was well-tolerated and promoted vaping cessation compared with placebo in youth with moderate to severe addiction to vaped nicotine.

The randomised clinical trial involved young people aged 16 to 25 who vaped nicotine daily or near daily, did not regularly smoke tobacco, and wanted to reduce or quit vaping.

Conducted in a single US state between June 2022 and May 2024, participants were randomly assigned to one of three groups:

• Varenicline titrated to 1 mg twice daily, plus weekly counselling and text message support;
• A placebo alongside weekly counselling and text message support;
• Enhanced usual care, involving only text-based support.

The results demonstrated that continuous abstinence rates during the final month of treatment were 51% in the varenicline group, compared to 14% in the placebo group. At the six-month follow-up, abstinence rates remained higher among those who received varenicline (28%) compared to placebo (7%).

In the enhanced usual care group, abstinence rates were notably lower, at 6% during treatment and 4% at six months.

Importantly, no drug-related serious adverse events were reported.

“Discovering and delivering effective treatments for nicotine addiction, particularly in youth, is important,” the study authors said.

“Most youth who develop addiction to vaped nicotine have never regularly smoked tobacco and wish to quit vaping, highlighting the importance of these findings that an available pharmacotherapy is effective and well tolerated for vaping cessation in this population.”

Darush Attar-Zadeh, a clinical fellow respiratory pharmacist at North West London Integrated Care Board, emphasised that while vapes can aid smoking cessation, they are not risk-free.

“Currently, we only have the Nicorette mouth spray licensed for vaping cessation,” he told The Pharmaceutical Journal. “

“It would be good to see independent research comparing the latest options available in never smokers and ex-smokers who moved onto vapes,” he added.

Varenicline is a generic version of Champix, which Pfizer withdrew from the market in 2021 due to nitrosamine contamination concerns.

It was made available again for NHS patients in November 2024, after being cleared as safe by the Medicines and Healthcare products Regulatory Agency (MHRA).

Research from University College London suggested that varenicline could help over 85,000 people try to quit smoking each year and prevent up to 9,500 smoking-related deaths over the next five years.