Dr. Eden Evins, founding director of the Mass General Hospital Center for Addiction Medicine, and professor of psychiatry at Harvard Medical School, has recently made headlines for leading an effective study. Together, these findings have revealed exciting new areas of intervention for youth nicotine cessation efforts. This new research in The Journal of the American Medical Association gives us a glimpse at that powerful combination. It further explores how combining pharmacotherapy, behavioral therapy, and a digital support tool can improve quit rates for young people.
At the core of the research, the participants were people in the throes of a vaping-addiction battle. Its goal was to determine whether varenicline, a medication generally effective for smoking cessation in adults, would have similar effectiveness in another demographic, the youth population. In our pilot study, 51% of people who enrolled—more than half—successfully quit vaping within 12 weeks. These study participants experienced daily use of varenicline, weekly counseling sessions conducted through Zoom, and a digital support app.
The small original study followed up with the participants six months later. It soon found that 28% of those who first dropped out stayed electric cigarette-free. This high long-term success rate is a testament to the long-term benefits that can be achieved through a multi-pronged approach to addiction treatment.
Over 1.6 million teens in the U.S. say that they vape. Almost 56% of them would like to leave, too, which makes these findings extremely timely and relevant. Using all three support tools—medication, behavioral counseling, and technology—substantially boosts your odds of quitting. In reality, it increases your chances by as much as tenfold compared to only employing one approach.
Varenicline is a type of medication taken in pill form, twice daily for 12 weeks. The first week is a dose ramp up to allow your body to adjust. This is especially important because, as Dr. Evins points out, this medication works to decrease the pleasure people receive from vaping. It’s especially effective at reducing the urge to smoke.
“As a partial agonist that binds tightly to the receptor, varenicline both reduces nicotine withdrawal symptoms and prevents the experience of reward,” – Dr. Eden Evins
In comparison, the third group had no additional supports outside of the app. Their outcomes were no different from those randomized to placebo. Only 14% of people in that cohort dropped out by the 12-week deadline. By the six-month follow-up, that number decreased to only 7%.
Dr. Evins is a passionate proponent of a multifaceted approach to vaping cessation. “I would hope that people feel they deserve three- to 10-fold higher chance for success, so I would strongly recommend they start with varenicline plus behavioral support for vaping cessation,” she stated.
Given the sensitivity of the intervention, the study faced significant challenges with participant enrollment, especially with older teens. As Dr. Evins mentioned, it’s that many 17-year-olds are eager to join in. They would rather wait until their 18th birthday so they do not have to obtain parental consent.
The implications of this study are significant given the rising rates of vaping among adolescents and their desire to quit. With just a 14% cessation success when going cold turkey on a placebo, the need for an effective intervention is clear.
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