Studies have consistently found that vaping products and varenicline are the most effective smoking cessation tools to date, and this is believed to be due to the fact that these aids address both the physiological and psychological aspects of the addiction to smoking.
A study published in JAMA Internal Medicine on June 17th reiterated that nicotine-containing electronic cigarettes (ECs) and the prescription drug varenicline are the most effective aids for quitting smoking. Led by Anna Tuisku, Ph.D., the research from Lapland Central Hospital in Finland, involved 458 participants aged 25 to 75 who smoked daily and volunteered to quit. They were randomly assigned to one of three groups: 18 mg/mL nicotine-containing ECs with placebo tablets, varenicline with nicotine-free ECs, or placebo tablets with nicotine-free ECs.
The study’s findings indicated that after 26 weeks, 40.4% of the participants using nicotine-containing ECs achieved seven-day smoking abstinence, confirmed by exhaled carbon monoxide levels. In comparison, 43.8% of the varenicline group and 19.7% of the placebo group achieved abstinence. The differences in abstinence rates were significant between the placebo and the EC group (risk difference [RD], 20.7%) and between the placebo and the varenicline group (RD, 24.1%). However, in this particular study no significant difference between the EC and varenicline groups was reported (RD, 3.4%).
Vapes are Also The Most Effective Aids Among Disadvantaged Groups
A 2021 trial looking into the feasibility of distributing vapes to homeless smokers, found that the trial participants who received vape starter kits were more successful at quitting smoking, than their peers who just received smoking cessation advice and support by a local Stop Smoking Service.
While, a recent study published in PLOS Mental Health examining the effectiveness of smoking cessation aids among individuals with and without mental health conditions, revealed that vapes were the most preferred and effective smoking cessation tools. These were followed by Varenicline and heated tobacco products.
The survey included over 5,000 regular smokers who had attempted to quit within the past year. Approximately 45% of the participants had a diagnosed mental health condition, reflecting previous research indicating higher smoking and addiction rates among this group, compared to those without mental health issues.
Participants reported using a variety of cessation aids, with non-combustible nicotine products like vapes being the most common. These were used by 39% of individuals with mental health conditions and 31% of those without. Other frequently used aids included over-the-counter nicotine replacements such as lozenges and patches, while less than 5% of participants used prescription medications or behavioral interventions.
The study concluded that the same smoking cessation aids were equally effective for individuals with and without mental health conditions, with the most effective being vapes, followed by varenicline and heated tobacco products.
Similarly, the 2023 study “Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses” concluded that the most effective smoking cessation tools were nicotine vapes, varenicline, and cytisine, in that order.
The next most effective was combining nicotine replacement therapies (NRTs)—such as nicotine patches and fast-acting NRTs—with bupropion. While the least effective methods identified included nortriptyline, non-nicotine vapes, and the strategy of gradually reducing the nicotine dosage in NRT.
Why and how do they work?
Experts have explained that the reason why nicotine vapes are highly effective, is the fact that they provide a similar hand-to-mouth experience and rapid nicotine delivery that mimics smoking, helping to satisfy both physical and behavioral aspects of nicotine addiction.
Varenicline, on the other hand, works by targeting nicotine receptors in the brain, reducing withdrawal symptoms and nicotine cravings. It partially stimulates these receptors, providing some nicotine-like effects while also blocking the pleasurable effects of nicotine from cigarettes.
Both methods address the physiological and psychological dependencies associated with smoking. Vapes offer a replacement that closely mimics the act of smoking, while varenicline directly mitigates cravings and withdrawal, together providing robust options for smokers aiming to quit.
However, while the long-term effects of vaping are still being studied, and despite fears of damage to respiratory and oral health, including coughing, throat irritation, dry mouth, and potential lung damage, to date there is no concrete evidence linking vaping to any of these health issues. In contrast, Varenicline, is known to cause side effects such as nausea, insomnia, vivid dreams, and headaches. Some users experience mood changes, depression, or suicidal thoughts, although these are less common.