Years after e-cigarettes were introduced as a potential solution to tobacco addiction, a significant challenge has emerged: helping people quit vaping. Despite the widespread use of e-cigarettes, particularly among young adults, there is a lack of approved therapies and sufficient research on effective cessation methods.
The Vaping Dilemma
E-cigarettes, which aerosolize liquid nicotine, were initially seen as a less harmful alternative to traditional cigarettes. However, many users find themselves more addicted to vaping than they ever were to smoking. Amanda Graham, chief health officer at Truth Initiative, notes that many individuals report using more nicotine with e-cigarettes than they did with traditional cigarettes. This has led to a situation where people are seeking ways to quit vaping, but lack effective tools and support.
Benjamin Toll, a professor at the Medical University of South Carolina, points out that the design of e-cigarettes can make them uniquely addictive. Unlike cigarettes, which have natural cutoff points, vapes with high nicotine levels and large puff counts offer almost no stopping point. The ease of using vapes in various settings further contributes to increased nicotine dependence.
The Need for Dedicated Cessation Aids
Currently, the U.S. Food and Drug Administration (FDA) has not approved e-cigarettes as smoking cessation tools. While some doctors prescribe medications like varenicline (typically used for smoking cessation) off-label for vaping cessation, there is a need for more specific and effective treatments. Richard Stewart, CEO of Achieve Life Sciences, emphasizes that vaping addiction is a "public-health crisis hidden in plain sight."
Achieve Life Sciences is working to address this need with cytisinicline, a medication designed to reduce cravings and diminish the pleasurable effects of nicotine when vaping. In a company-funded study, individuals taking cytisinicline were more than twice as likely to stop vaping compared to those on a placebo. The FDA recently granted cytisinicline Breakthrough Therapy designation to expedite its development and review process. If all goes well, Stewart anticipates that cytisinicline could be the first drug approved for vaping cessation, potentially by 2027. Cytisinicline is already used for smoking cessation in parts of Europe.
Alternative Approaches and Expert Advice
In the absence of approved therapies, some individuals are turning to alternative methods such as nicotine pouches (e.g., Zyn) to wean themselves off vaping. While these pouches may be less dangerous than smoking or vaping due to the lack of inhalation, experts caution against prolonged use, as it can perpetuate nicotine addiction. Amanda Graham advises those using nicotine products to quit vaping to plan for short-term use only, followed by complete cessation of all forms of nicotine.
As the popularity of e-cigarettes continues to outpace research on cessation methods, the development of dedicated vaping-cessation aids and comprehensive support programs remains a critical public health priority.
