“A few years ago, it would’ve been incredible to me that we would be here today discussing the potential for drug therapy to help addicted young people quit,” FDA commissioner Dr. Scott Gottlieb told CNN after the hearing.
E-cigarettes contain large amounts of nicotine, and it can be hard for kids to keep track of how much they’ve vaped, said Robin Koval, CEO and president of Truth Initiative. There’s concern that kids hooked on vaping will eventually start smoking.
“The evidence shows kids who would otherwise not have smoked who start vaping are four times as likely to go on and use combustible tobacco,” Koval said.
Nicotine replacement therapy is a cornerstone for adults who want to quit smoking, but the gum and patches are not readily available to teenagers, she noted.
“For adults, lozenges and patches are available over the counter, but not for those who are under 18,” Koval said.
Nicotine replacement therapy may not work for young vapers
A doctor can prescribe nicotine replacement therapy off-label for teens hooked on nicotine, Richter said, “but there isn’t strong evidence they’re particularly effective for kids. It’s possible the level of nicotine in the nicotine replacement [products] are not high enough for people who are vaping.”
Some adults also use antidepressants to help them quit smoking, but these medications are worrisome for teenagers, she added.
“There are concerns about giving antidepressants to kids,” Richter said. “Some studies have shown it can increase suicidal thoughts in kids.”
Smoking cessation programs might help, Richter suggested, but these also have not been tested when it comes to quitting vaping.
Koval said, on top of that, it’s not clear whether kids addicted to e-cigarettes would see smoking cessation programs as a legitimate option.
“For young people, quitting vaping is not the same as quitting cigarettes,” Koval said. “A lot of young people will say to us, well, I’m not a smoker. I would never smoke cigarettes. They don’t want to be part of a quit program designed for smokers.”
It’s also easier for kids to maintain an e-cigarette addiction compared to a smoking addiction, Koval said.