Speaker Name: Dr. Eden Evins
Session Description:
Electronic cigarette use (vaping) among adolescents and young adults is common. The high prevalence of e-cigarette use puts youth at risk for nicotine addiction, tobacco smoking, other substance use, carcinogen and heavy metal exposure and pulmonary inflammation. Few treatments have been tested in this population.
To evaluate the efficacy of varenicline for nicotine vaping cessation in youth, 261 youth, aged 16-25 years, who vaped nicotine daily or near daily, did not regularly smoke tobacco, and wanted to reduce or quit vaping, were randomized in a 3-group randomized clinical trial comparing 12 weeks of varenicline titrated to 1mg twice daily over 7 days, weekly counseling, and referral to text messaging vaping cessation support (This is Quitting [TIQ]) (n = 88); identical placebo,weekly counseling, and TIQ referral (n = 87); or enhanced usual care (TIQ referral only)(n = 86), with monthly follow-up to 24 weeks.
Of 261 randomized participants (mean age, 21.4 years; 53% female), 254 completed the trial (97.3%). For varenicline and placebo, continuous abstinence rates were 51% vs 14% during weeks 9-12 (adjusted odds ratio [aOR], 6.5 [95%CI, 3.0-14.1]; P < .001) and 28% vs 7% during weeks 9-24 (aOR, 6.0 [95%CI, 2.1-16.9]; P < .001). Varenicline had higher continuous abstinence rates vs enhanced usual care during weeks 9-12 (51% vs 6%; aOR, 16.9 [95%CI, 6.2-46.3]) and during weeks 9-24 (28% vs 4%; aOR, 11.0 [95%CI, 3.1-38.8]). Continuous abstinence rates were not significantly different between the placebo+behavioral treatment and usual care groups. Two varenicline participants (2%) and 1 placebo participant (1%) discontinued study medications due to adverse events. No drug-related serious adverse events occurred. Baseline cannabis use was reported by 68% of participants.
Varenicline, combined with behavioral counseling, increased nicotine vaping abstinence in youth who do not regularly smoke tobacco, and in those with and without baseline cannabis use.
Learning Objectives:
- Participants will identify harms of nicotine vaping in adolescents and young adults.
- Participants will identify the treatments tested for vaping cessation in teens.
- Participants will identify interventions that have been shown to be effective as well as those that have not shown effectiveness to date in vaping cessation for teens.
References:
Evins AE, Cather C, Reeder HT, Pachas G, Potter K, Evohr B, Gray KM, Levy S, Rigotti NA, Costello MA, Dufour J, Casottana K, Iroegbulem V, Gilman JM, Schuster RM. Varenicline for youth nicotine vaping cessation: A randomized controlled trial. JAMA. 2025. Apr 23:e253810. doi: 10.1001/jama.2025.3810. Online ahead of print. PMID: 40266580
Gilman JM, Cather C, Reeder HT, Evohr B, Pachas GN, Gray KM, McClure EA, Schuster RM, Evins AE. Effect of Cannabis Use on Nicotine Vaping Cessation Outcomes with Varenicline and Behavioral Treatment: Subgroup Analysis of a Randomized Controlled Trial. JAMA Network Open. 2025 Dec 1;8(12):e2547799. doi: 10.1001/jamanetworkopen.2025.47799. PMID: 41385228
Tervo-Clemmens B, Gilman JM, Evins AE, Bentley K, Smoller JW, Nock M, Schuster RM. Substance use is dose dependently associated with suicidal thoughts and psychiatric comorbidities. JAMA Peds. 2024 Jan 29. doi: 10.1001/jamapediatrics.2023.6263. PMID: 38285470
BIO
Dr. Eden Evins is the Cox Family Professor of Psychiatry at Harvard Medical School, founding director of the Center for Addiction Medicine and Center for Comprehensive Healing at Massachusetts General Hospital. She earned her undergraduate degree at the University of Virginia, her MD at the Medical University of South Carolina, and her psychiatry residency at the Harvard-Longwood Program. She conducted fellowships in molecular biology and in clinical and translational research at Harvard hospitals and earned a Master’s in Public Health from the Harvard School of Public Health. She as published over 250 research articles in journals including The Lancet, JAMA, JAMA Psychiatry, Biological Psychiatry, American Journal of Psychiatry, Neuropsychopharmacology. Dr. Evins received three NIH career awards, serves as director of a NIDA funded Addiction Research Fellowship Training Program, has raised over $35 million in extramural funding, and was named one of the Time Top100 in Healthcare in 2026.