Varenicline helps young people quit nicotine vaping regardless of cannabis use

Adolescent and young adult nicotine vaping has become an urgent public health concern, as 2024 marked the first year that nicotine vaping was the most initiated drug. Though vaping is the most common way young people use nicotine, few treatments exist to help those trying to quit. What's more, a 2022 Drug Alcohol Dependence study reported around half of young people who vape nicotine also use cannabis, though the impact of this dual substance use on treatment outcomes remains unclear. A new clinical trial by investigators from Mass General Brigham found varenicline-a medication used to help patients quit nicotine-was effective for vaping cessation regardless of cannabis use in a study of 261 participants aged 16 to 25 years. Their results are published in JAMA Network Open.

"We need to increase use of nicotine vaping cessation treatment by young people, and we know that cannabis use is widespread in this population," said first author Jodi Gilman, PhD, Director of Neuroscience for the Center for Addiction Medicine in the Mass General Brigham Department of Psychiatry. "It's fantastic news that cannabis use doesn't appear to be a barrier to successful vaping cessation with varenicline treatment, and we can use our findings to inform screening, treatment, planning, and public health messaging moving forward."

In a previously conducted randomized clinical trial, participants who regularly vaped nicotine received varenicline, placebo, or usual care for the full 12-week trial. All participants also had access to a nicotine cessation support text app.

In the new study, researchers split the participants by cannabis use, with 28% reporting no use in the past month, 38% reporting use one-to-three days per week, and 30% reporting use four-to-seven days per week. Contrary to the authors' hypothesis, cannabis use did not hinder adolescents and young adults from achieving nicotine vaping abstinence. Rather, they found that odds of being able to quit were similar across all levels of cannabis use and that varenicline was associated with higher rates of nicotine vaping abstinence than behavioral support interventions alone. Varenicline did not affect rates of cannabis use.

Future studies could explore the effects of integrated interventions that target cannabis and nicotine co-use may yield additional benefit.