The use of electronic cigarettes, or vaping nicotine, has become increasingly more common over the past decade - particularly among adolescents and young adults. According to a survey from 2022-23, 24.1% of people aged 18-25 report using e-cigarettes in the past month. Even more concerning is that 7.8% of high school students reputed the same in 2024.
Varenicline, also known as Chantix, is a partial agonist at the Nicotinic acetylcholine receptor that blocks the effects of nicotine while providing some partial agonistic effects (similar to buprenorphine on the mu-opioid receptor). Varenicline, along with NRT (nicotine replacement therapy), bupropion and behavioral therapy are the mainstay of treatment for adults with nicotine use disorder.
However, according to an RCT performed at Mass General Brigham and published in JAMA, varenicline + behavioral therapy are effective in increasing abstinence in vaping nicotine in young adults and adolescents who do not smoke tobacco. Varenicline + behavioral therapy had a 51% abstinence rate (compared to 14% in placebo + behavioral therapy) during 9-12 weeks, and a 28% abstinence rate (compared to 7%) up to completion of 24 week study.
Of note: Dosage of varenicline used for the study was the typical dosage of titrating dosage to 1mg at 7 days, then 1mg daily afterwards. Oral titration schedule from UpToDate:
Days 1 to 3: 0.5 mg once daily.
Days 4 to 7: 0.5 mg twice daily.
Day 8+ (up to 12 weeks): 1mg daily.
https://pubmed.ncbi.nlm.nih.gov/40266580/
Evins AE, Cather C, Reeder HT, Evohr B, Potter K, Pachas GN, Gray KM, Levy S, Rigotti NA, Iroegbulem V, Dufour J, Casottana K, Costello MA, Gilman JM, Schuster RM. Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA. 2025 Apr 23:e253810. doi: 10.1001/jama.2025.3810. Epub ahead of print. PMID: 40266580; PMCID: PMC12019676.