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Varenicline effective for improving vaping cessation rate in adults
Clinical Question
Is varenicline effective for increasing the vaping cessation rate in adults who use electronic cigarettes?
Bottom line
Adults who want to quit using electronic cigarettes are more likely to achieve prolonged abstinence with the combination of varenicline and counseling than with counseling alone. This study evaluated the standard dosing titration schedule of varenicline. 1b
Reference
Study design: Randomized controlled trial (double-blinded)
Funding: Industry
Setting: Outpatient (any)
Synopsis
Evidence is currently lacking regarding the value of varenicline for achieving successful abstinence in adults who use electronic cigarettes (also known as vaping). These investigators identified adults, 18 years or older, with exclusive daily vaping for 12 months or more and a stated willingness to quit vaping as shown by successfully reducing their average daily vape use by at least 50% before a baseline visit. Eligible patients (N = 140) randomly received (concealed allocation assignment) the standard dosing titration schedule of varenicline or matched placebo for 12 weeks. All participants also received the same vaping cessation counseling consisting of one-on-one counseling at each clinic visit for a total of 10 minutes by clinical psychologists experienced in nicotine dependence and vaping behaviors. The primary endpoint consisted of the proportion of patients with continuous abstinence from vaping as demonstrated by saliva cotinine measurements. Complete follow-up occurred for 65.5% of patients at 24 weeks. Participants lost to follow-up were considered treatment failures. Using intention-to-treat analyses, verified continuous abstinence occurred significantly more often at both 12 and 24 weeks in the varenicline group than in the placebo group (40.0% vs 20.0% and 34.3% vs 17.2%, respectively; number needed to treat = 6).
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
POSSIBLE benefit
The "clinic effect" could easily explain these results. Seeing patients repeatedly in clinic strengthens the resolve to quit.
VARENCLINEINE TREATMENT FOR VAPING
GOOD TO KNOW
Impact assessment
Excellent