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Evins AE, et al. Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA. Published online April 23, 2025. doi:10.1001/jama.2025.3810

https://jamanetwork.com/journals/jama/fullarticle/2833137

“ In this 12-week randomized clinical trial in 261 treatment-seeking youth, aged 16 to 25 years, continuous abstinence rates in the last month of treatment (51% vs 14%) and at 6-month follow-up (28% vs 7%) were higher in the varenicline group than in the placebo group. Treatment-emergent adverse events did not differ significantly between groups.

Varenicline, when added to brief cessation counseling, is well tolerated and promotes nicotine vaping cessation compared with placebo in youth with addiction to vaped nicotine.”

TRC Research Commentary

Kaplan, Bekir et al. Beneficial and Harmful Tobacco-Use Transitions Associated With ENDS in the U.S. American Journal of Preventive Medicine, Volume 68, Issue 5, 896 – 904

https://www.ajpmonline.org/article/S0749-3797(25)00025-X/abstract

“ENDS-related tobacco-use transitions were assessed among U.S. youth and adults using weighted Population Assessment of Tobacco and Health Study Waves 4 (2016–2017) and 5 (2018–2019) adult and youth data.

The total sample size (N=31,733) represented ∼256 million people. For those using a combustible tobacco product in Wave 4, 2.1 million (∼4.6%) transitioned to exclusive ENDS use or ENDS-assisted cessation of a combustible tobacco product (benefit). In addition, 4.6 million (∼%2.2) transitioned from nonuse to ENDS or, among people who use ENDS exclusively in Wave 4, added combustible or transitioned to combustible tobacco use in Wave 5 (harm).

For every one beneficial transition, ENDS use was associated with 2.15 harmful transitions; this ratio ranged from 0.75 to 2.77 in sensitivity analyses. With effective restrictions on ENDS access and marketing for tobacco-naïve people, the population benefits of ENDS could outweigh population harms.”
Comment: The harm-to-benefit ratio is over two to one in this study. Authors indicate there could be benefits ‘with effective restrictions on ENDS access and marketing. Presently, no country has been able to provide such effective restrictions, and e-cigarette and heated tobacco product use has only increased, especially in ‘tobacco-naive people’ like youth. Stephen Hamann