MGH Study: Varenicline Boosts Young Adults’ E-Cigarette Quit Rates by 50%

Key Points:

·A study conducted by Massachusetts General Hospital in the United States has shown that varenicline can significantly increase the success rate of e-cigarette cessation among individuals aged 16-25, marking the first randomized controlled trial to validate the effectiveness of this medication for young people. 

·The varenicline group had a quit rate of 50% at the end of the month, significantly higher than the placebo group's 14%; maintenance rates at 6 months were 28% vs 7%, respectively. 

·Researchers are urging doctors to actively inquire about e-cigarette use history and consider medication intervention when there is a need for cessation. 

·The prevalence of e-cigarette use among individuals aged 18-25 is as high as 24%, with illegally flavored products widely available and compliant products scarce. Experts have stated that this study fills a treatment gap and provides a medication pathway for interventions for e-cigarette addiction. 

According to a report by Statnews on April 23, Massachusetts General Hospital's latest research shows that the oral smoking cessation medication varenicline significantly increases the success rate of e-cigarette cessation among individuals aged 16 to 25. The study was published on April 23, 2025, in the Journal of the American Medical Association, marking the first trial of smoking cessation medication for e-cigarettes specifically targeting young people.

In a 12-week randomized controlled trial, a research team tracked 254 participants. The results showed that among those who received varenicline treatment, 50% successfully remained e-cigarette free in the last month, compared to only 14% in the placebo group. Six months later, the percentages of participants still maintaining abstinence were 28% in the varenicline group and 7% in the placebo group.

The research lead, Eden Evins, Director of the Addiction Medicine Center at Massachusetts General Hospital, pointed out that most doctors do not typically consider medication treatment as the first option when treating teenage e-cigarette use issues. Clinicians should proactively ask patients if they use e-cigarettes, if they experience withdrawal symptoms or cravings, and if so, should consider using varenicline for intervention.

Varenicline, marketed under the brand name "Chantix," was first approved by the United States Food and Drug Administration (FDA) in 2006. Its mechanism of action involves blocking nicotine's activation of dopamine in the brain, thereby reducing withdrawal symptoms and cravings. Common side effects include nausea and sleep disturbances.

Despite a decrease in e-cigarette usage among teenagers since the Juul craze, data from 2024 shows that 7.8% of high school students still used e-cigarettes in the past 30 days, with a high of 42% of high school e-cigarette users using them frequently or daily. The usage rate among 18 to 25-year-olds is even higher at 24%. Currently, the FDA has only authorized 34 e-cigarette brands for sale, but a large number of illegal products with fruit and candy flavors are still widely available through channels such as convenience stores and gas stations.

The study also found that simple behavior interventions have limited effectiveness. In the experiment, all participants received weekly behavior counseling for 12 weeks and were recommended to join the text support program "This is Quitting" operated by the non-profit organization Truth Initiative. The results showed that the combined effect of behavioral interventions with medication therapy was significantly better than behavioral interventions alone.

In order to ensure medication adherence, the research team requires participants to upload two medication videos each day and provides a $1 subsidy for each upload. The success of participants in quitting e-cigarettes is verified through the detection of cotinine, a nicotine metabolite, in their saliva. It is important to note that this study did not include individuals who smoke and use e-cigarettes simultaneously, so the results may not be applicable to this group.

Benjamin Toll, a professor at the Medical University of South Carolina and an expert in tobacco control not involved in the study, praised the research for its rigorous design and execution. He stated that "there are currently very few medication intervention options available for treating e-cigarette addiction, and this study provides a breakthrough for the industry.

Stanford University addiction research expert Judith Prochaska added that despite the limited sample size, the research results are of practical significance, and the side effects are manageable, with an overall low quit rate. She emphasized that the youth population lacks effective smoking cessation pathways, with the market flooded with high-nicotine, enticingly flavored products, making them more prone to addiction.

Thor pointed out that there are currently more than 10 generic versions of Venikaran available on the market, with an average monthly cost of around $100 without insurance. However, at his clinic, the cost is reduced to $20 per month due to insurance subsidies.

He added: "As researchers and clinical workers, we urgently need to develop practical and effective new intervention tools to help the public quit various addictive products including e-cigarettes, nicotine pouches, and marijuana.