Non-nicotinic cytisinicline helps abstinence from vaping

Use of non-nicotinic cytisinicline appears to help adults abstain from vaping nicotine. Researchers reported their findings on May 6, 2024 in JAMA Internal Medicine.

“No medication has been approved by the FDA for vaping cessation in the United States,” said lead author Nancy A. Rigotti, MD, director of Massachusetts General Hospital’s Tobacco Research and Treatment Center and a professor of medicine at Harvard Medical School in Boston. “Our study indicates that cytisinicline might be an option to fill this gap and help adult vapers to stop using e-cigarettes.”

As background, the authors noted that many persons who vape nicotine would like to quit but are unable to do so. Cytisinicline, a plant-based alkaloid that targets nicotinic acetylcholine receptors, cuts nicotine dependence and helps adults to stop smoking cigarettes.

The purpose of the study was to determine the efficacy and safety of cytisinicline vs placebo in producing abstinence from vaping in adults seeking to quit vaping.

In this randomized and placebo-controled trial the investigators compared 12 weeks of treatment with cytisinicline vs placebo, with follow-up to 16 weeks.

They enrolled 160 adults who vaped nicotine daily, wanted to quit, and did not currently smoke cigarettes. And 131 (81.9%) completed the trial.

The subjects were randomized (2:1) to cytisinicline, 3 mg taken 3 times daily (n = 107) or placebo (n = 53) for 12 weeks.

All subjects received behavioral support on a weekly basis.

The primary endpoint was biochemically verified continuous e-cigarette abstinence during the last 4 weeks of treatment (weeks 9-12) .  Missing individual outcomes were deemed to be non-abstinence.

Of the160 randomized subjects (mean 33.6 years; 83 female), 115 (71.9%) had formerly smoked.

At the end of 12 weeks, subjects treated with cytisinicline were more than twice as likely as those receiving placebo to have successfully abstained from vaping for weeks 9 to 12 (31.8% vs 15.1%.)

Cytisinicline was well tolerated. Four subjects (3.8%) stopped using cytisinicline due to an adverse event.

The authors concluded, “In this randomized clinical trial, cytisinicline for 12 weeks, with behavioral support, demonstrated efficacy for cessation of e-cigarette use at end of treatment and was well tolerated by adults, offering a potential pharmacotherapy option for treating nicotine e-cigarette use in adults who seek to quit vaping. These results need confirmation in a larger trial with longer follow-up.”