Effective Vaping Cessation: Study Shows Champix as a Solution

2023-07-06 06:38:00

A recent study tried to find out if the famous drug to help people quit smoking is effective in quitting electronic cigarettes.

The study in brief

The analysis was conducted for 24 weeks. 140 participants were divided into two groups. One was treated with varenicline (Champix), a smoking cessation aid, the other received only one tablet without effect. During all the stages of the study, Champix would have proved to be more effective for vapological withdrawal. Its effectiveness was even more than twice as high.

See research findings

Smoking cessation and vaping cessation

Quitting e-cigarettes can sometimes be a challenge.

Over the past six years, the number of vapers has drastically increased around the world. In France, the market began to grow considerably from 2017, with an increase in sales of vaping products of around 15%, then 21% the following year, without almost never slow down since. The latest data available, collected by the Xerfi research institute in 2022, indicate that France would now have more than three million vapers.

If the number of smokers in France has decreased at the same time, for some users of electronic cigarettes who have managed to get away from smoking, it is now time to do the same with vaping. But how to do it ? While smoking cessation aid is now well documented, vaping cessation aid is much less so due to the relative novelty of the product. Are quit smoking medications as effective for quitting vaping? This is the question that researchers from the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) have tried to answer, in part.

Champix, a drug widely used around the world

Among the drugs used worldwide to help people quit smoking, there is one that is often seen as a last resort. Her name, Champix and Europeand Chantix in the United States.

Only available with a doctor’s prescription, it is usually prescribed when other treatments have been tried in the past and have not produced satisfactory results. The active molecule in Champix is varenicline. It is a partial agonist of the cerebral nicotinic receptors whose mode of action is twofold: to stimulate the nicotinic receptors, and therefore reduce the desire to smoke, but also to block it so as to prevent the fixation of nicotine on it. . In France, only Champix 0.5 mg is reimbursable, up to 65%. Its selling price is set at €54.98.

In 2019, the French Observatory of Drugs and Addictive Tendencies (OFDT) stated in his report (in PDF format) that Champix’s market share represented 3.5%, down from the previous year (4.7%).

Does varenicline help quit smoking?

In their study1, the CoEHAR researchers wanted to assess “the efficacy and safety of varenicline” (1 mg twice daily, given for 12 weeks and followed through week 24) combined with vaping advice (to download, in docx format) among exclusive vapers intending to stop vaping.

To do this, 371 e-cigarette users were recruited. To be eligible, all had to vape daily for at least one year, have already made a quit attempt in the past, materialized by stopping vaping for at least 24 hours, have the will to stop vaping, and reduce their vaping by at least 50% before committing to the target quit date. In total, 140 people out of the 371 were able to participate in the study, the others not respecting all the above criteria.

Table of participants.

Methodology

The study was conducted as a double-blind, randomized, parallel-group, placebo-controlled trial. In other words, the participants were separated into two groups each comprising 70 people. The first group received a classic dose of Champix, the second, a simple tablet without any effect. Both groups received the same weaning advice.

Following an initial medical check-up, participants were invited to return to the clinic regularly for follow-up, on the basis of once a week, for 12 weeks. Weeks 4, 6 and 8 were the subject of telephone contact rather than face-to-face. At each of the physical visits, various tests were carried out in order to monitor changes in the IUN (nicotine consumption), eCO (exhaled carbon monoxide) levels, blood pressure, heart rate, weight/ BMI [seulement à la visite de la semaine 12]MNWS (Minnesota Nicotine Withdrawal Scale, questionnaire to assess the effect of smoking cessation) [seulement aux semaines 1, 2, 4, 6, 8, 12] and adverse events.

The study then continued from week 12 to week 24, with neither group receiving treatment.

Study results

Control of vapological withdrawal was carried out by means of saliva samples from participants in order to measure the level of cotinine, the breakdown product of nicotine.

A total of 113 of the 140 participants completed the study and attended all medical visits. 57 were in the group that received varenicline and 56 the placebo.

In blue, the participants who received Champix, in red, those who received the placebo.

As shown in the table above, varenicline has been shown to be more effective in quitting vaping than placebo.

The difference between the two groups was particularly marked during week 4 since 41.4% of subjects in the group who received Champix had temporarily stopped vaping at this time, compared to 22.9% in the placebo group. .

In contrast, relapse rates (i.e., resumption of vaping) increased over time in the varenicline-treated group. By week 12, across all groups, 29.2% of participants had started vaping again. At week 24, they were 35.8%. From week 12 (which is the week of cessation of treatment) to week 24, the increase in the relapse rate was more marked in the group that received Champix (+ 17.2% against + 9.9% for the placebo group).

However, as the researchers point out in their findings, “varenicline was consistently superior to placebo”. In fact, the drug has “more than doubled the odds of quitting vaping compared to placebo”.

Champix could therefore well represent an interesting solution for vapers wishing to stop using an electronic cigarette.

Although it is stated that “the funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of data; preparing, reviewing or approving the manuscript; and the decision to submit the manuscript for publication”, it should be noted that this research was funded by Pfizer, the laboratory that markets Champix. One of the researchers who participated in this study, Riccardo Polosa, also received funding from Pfizer, at a time which is not indicated.

1Caponnetto, P., Campagna, D., Ahluwalia, J.S. et al. Varenicline and counseling for vaping cessation: a double-blind, randomized, parallel-group, placebo-controlled trial. BMC Med 21, 220 (2023). https://doi.org/10.1186/s12916-023-02919-2