Vaping is more popular than ever, especially among young adults, and pharmacy teams are in a prime position to guide patients toward cessation.
In this episode, TRC Healthcare editor, Gina Corley, PharmD, breaks down the health risks of vaping and shares unique barriers to vaping cessation. She also discusses how proven smoking cessation strategies (varenicline, nicotine replacement therapy, and bupropion) may work to help patients quit vaping. Plus, you’ll hear about counseling points and free resources to support patients in their quit journey.
This is an excerpt from our September 2025 Pharmacy Essential Updates continuing education webinar series.
CE Information:
TRC Healthcare offers CE credit for this podcast for pharmacist subscribers at our platinum level or higher and pharmacy technician subscribers. Log in to your Pharmacist’s Letter or Pharmacy Technician’s Letter account and look for the title of this podcast in the list of available CE courses. None of the speakers have anything to disclose.
Clinical Resources from Pharmacist’s Letter, Pharmacy Technician’s Letter, and Prescriber Insights:
- Article: Help Patients Send Their Vaping Habits Up in Smoke
- Chart: Smoking Cessation Drug Therapy
- FAQ: E-Cigarettes and Vaping
- Podcast: Medication Talk – Smoking and Vaping Cessation
Don’t miss out! Subscribe today to stay ahead with trusted insights and tools.
Use code cc1026b at checkout for 10% off a new or upgraded subscription.
🎓 Are you a student? Great news—students can access a free version of Pharmacist’s Letter.
Email us: [email protected].
The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Find the show on YouTube by searching for ‘TRC Healthcare’ or clicking here.
Learn more about our product offerings at trchealthcare.com.
Click here to listen to all podcast episodes.
Listen Now:
Transcript:
This transcript is automatically generated.
00:00:04 Narrator
Welcome to Clinical Capsules from TRC Healthcare, your trusted source for practical, evidence-based updates.
00:00:11 Narrator
On this episode, Assistant Editor and Clinical Pharmacist Gina Corley shares how pharmacy teams can tackle the growing trend of vaping with practical strategies, treatment options, and counseling tips to help patients quit… in an excerpt from our popular Pharmacy Essential Updates webinar series.
00:00:27 Narrator
This podcast offers Continuing Education credit for pharmacists and pharmacy technicians. Please log in to your Pharmacist’s Letter or Pharmacy Technician’s Letter account and look for the title of this podcast in the list of available CE courses.
00:00:38 Narrator
None of the speakers have anything to disclose.
00:00:41 Narrator
Catch new episodes of Clinical Capsules every 2nd and 4th Tuesday—bringing concise, actionable insights from TRC experts straight to your ears.
00:00:50 Narrator
With that, Let’s get started…
00:00:59 Gina Corley
This is an important topic because, as our article states, adult vaping rates are on the rise. In fact, E CIG use in adults has increased by 2% in recent years, with people ages 21 through 24 having the highest usage rates.
00:01:18 Gina Corley
So as pharmacists and techs, we are in a prime position to talk to patients about the risks of vaping and help give them strategies to quit.
00:01:28 Gina Corley
But first, let’s talk about some background info on e-cigs. e-cigs are commonly referred to as vapes or vape pens, so you may hear me use these terms interchangeably.
00:01:40 Gina Corley
Other names include tanks, pod mods, or DAB pens.
00:01:45 Gina Corley
Most e-cigs contain nicotine, but some are nicotine free.
00:01:51 Gina Corley
And others contain cannabis products.
00:01:55 Gina Corley
So when we talk to patients about vaping, it’s important to ask them what they vape. Since there are different options.
00:02:02 Gina Corley
Vape pens work by heating a liquid, commonly referred to as vape juice, to produce an aerosol for the user to inhale.
00:02:10 Gina Corley
A lot of companies make flavored vape juice. Common flavors include mango, menthol, and mint, but there are a ton to choose from, and this can be one of the reasons that many young people find vaping appealing.
00:02:25 Gina Corley
A lot of vape companies market their e-cigs as being safer than smoking.
00:02:30 Gina Corley
While it’s true that e-cigarette aerosol doesn’t contain all of the harmful contaminants of tobacco smoke, e-cigs do contain harmful chemicals such as diacetyl, ethylene glycol and formaldehyde.
00:02:46 Gina Corley
So although these products are arguably safer than smoking cigarettes, we still want to let patients know this does not mean they are safe or healthy to use.
00:02:56 Gina Corley
Some data suggest that e-cigarettes can help patients quit smoking, but other data show that e-cigs often lead to dual use, which is where patients smoke e-cigs and regular cigarettes.
00:03:09 Gina Corley
Plus, FDA recently authorized the marketing of tobacco and menthol flavored JUUL products following an intensive scientific review that showed they may be effective in helping patients quit smoking and this may lead to some patients believing these products are safe.
00:03:26 Gina Corley
So if patients ask about trying e-cigs for smoking cessation, we don’t want to encourage their use, but we also don’t want to stand in the way of a quit attempt since e-cigs may be the lesser of two evils.
00:03:42 Gina Corley
But there are a couple unique barriers to vaping cessation to keep in mind.
00:03:48 Gina Corley
For example, most cigarettes come in packs of 20, so patients can easily track how many packs they smoke per day.
00:03:56 Gina Corley
But vapes come in various cartridge sizes with various levels of nicotine and can last anywhere from days to months depending on use.
00:04:05 Gina Corley
So it may be difficult to track consumption. Plus, vape pens are manufactured to look like trendy digital accessories, which may make them more enticing especially to teens or young adults.
00:04:21 Gina Corley
So now let’s jump into treatments. There are currently no FDA approved meds for vaping cessation, so for now, we’ll want to stick to proven smoking cessation strategies.
00:04:34 Gina Corley
Lean towards trying varenicline first. We know this is used to help people quit traditional cigarettes.
00:04:41 Gina Corley
But initial studies show promise for quitting e-cigs in adults and adolescents as well.
00:04:48 Gina Corley
Varenicline works by blocking nicotine, binding to nicotinic receptors, and also partially stimulates nicotinic receptors, which lessens pleasure from nicotine and reduces cravings.
00:05:04 Gina Corley
As far as dosing, varenicline should be titrated over the first week.
00:05:09 Gina Corley
Most patients beginning varenicline for smoking or vaping cessation will get a starter month pack.
00:05:15 Gina Corley
They’ll do 0.5 milligrams once a day on days one through 3, then 0.5 milligrams twice a day on days 4 through 7.
00:05:23 Gina Corley
Then they’ll start on one milligram twice a day from Day 8, and continue.
00:05:28 Gina Corley
Maintenance doses cost about $300 per month for cash paying patients. But varenicline is often covered by insurance.
00:05:38 Gina Corley
We want to make sure patients get counseling about potential side effects of varenicline.
00:05:45 Gina Corley
Including vivid dreams, insomnia or headache, and keep in mind varenicline labeling no longer has a black box warning about psychiatric events based on results of a large trial.
00:05:58 Gina Corley
Next, we’ll talk about nicotine replacement therapy.
00:06:02 Gina Corley
This can be tried second line for vaping cessation, if patients can’t tolerate or are unresponsive to varenicline.
00:06:10 Gina Corley
We want to lean towards using combo nicotine replacement therapy such as a patch plus gum.
00:06:17 Gina Corley
This way the long-acting patch can provide constant nicotine levels, while the short acting gum or lozenge can help reduce breakthrough cravings.
00:06:26 Gina Corley
Costs of these products vary, but keep in mind some insurances will cover nicotine replacement therapy products.
00:06:34 Gina Corley
If patients do not have a prescription, help them find these products on OTC shelves.
00:06:41 Gina Corley
We can help patients figure out which patch dose to start on by figuring out what and how much they vape.
00:06:47 Gina Corley
Once we know this, we’ll first want to check the e-cig’s package or website to estimate nicotine content.
00:06:55 Gina Corley
So for example, JUUL 5% contains about 40 milligrams nicotine per pod, which is similar to smoking a pack of cigarettes for an adult vaping more than half a pod, or 20 milligrams of nicotine per day.
00:07:12 Gina Corley
We can consider a 21 milligram per day patch as a reasonable starting point.
00:07:17 Gina Corley
Or a 14 milligram per day patch if they vape less than this.
00:07:23 Gina Corley
And then bupropion SR can be considered for vaping cessation in patients who also have coexisting depression.
00:07:30 Gina Corley
It works by blocking reuptake of dopamine and or epinephrine, which seems to relieve nicotine withdrawal symptoms and cravings.
00:07:39 Gina Corley
Dosing for bupropion is also titrated up.
00:07:42 Gina Corley
So patients will start with 150 milligrams once per day in the morning for the first three days, then take 150 milligrams twice daily after that.
00:07:54 Gina Corley
Bupropion costs less than $30.00 per month for cash paying patients but is usually covered by insurance.
00:08:03 Gina Corley
A couple of things we want to watch for with bupropion is that it can cause insomnia or agitation.
00:08:10 Gina Corley
If patients complain of insomnia, we can tell them to take their second dose earlier, such as in the afternoon, at least 8 hours after their morning dose.
00:08:20 Gina Corley
We also want to double check patient profiles for any seizure meds.
00:08:26 Gina Corley
Since bupropion is contraindicated in patients with a seizure history.
00:08:32 Gina Corley
Next, I want to briefly mention nicotine pouches, which can be tucked between the gum and lip and contain a powder made of nicotine, flavorings and other ingredients.
00:08:44 Gina Corley
Common brands include Rogue, Velo and ZYN.
00:08:48 Gina Corley
Patients may ask about these due to FDA’s recent authorization of ZYN pouches.
00:08:54 Gina Corley
But we want to reinforce that although this may be the case none of these pouches are approved as safe and they should not be used as nicotine replacement therapy products.
00:09:06 Gina Corley
Lastly, let’s go over a few practical common tips you can use in the pharmacy.
00:09:13 Gina Corley
Much like quitting smoking, helping patients quit vaping starts with a conversation.
00:09:19 Gina Corley
So consider the Ask, Advise, Refer model as an easy and efficient way to identify patients who vape.
00:09:29 Gina Corley
This can help you provide counseling and refer patients to additional resources if necessary.
00:09:37 Gina Corley
We want to ask our patients if they vape, advise them to stop and refer them to services or other tools that can help.
00:09:46 Gina Corley
And we can develop a simple script to help guide these conversations.
00:09:51 Gina Corley
For example, if patients report vaping, follow up with strong clear advice to quit, such as saying…
00:09:59 Gina Corley
“As your pharmacist, I want you to know that quitting vaping or other tobacco products now is the best way to improve your health.”
00:10:06 Gina Corley
And then connect the dots to next steps. You might say…
00:10:11 Gina Corley
“There are many effective treatments to help you quit, and I can help you identify the best one for you today.”
00:10:18 Gina Corley
You can also suggest free services such as calling 1-800-QUIT-NOW.
00:10:23 Gina Corley
This connects patients with a trained quit coach who can develop a personalized plan for them.
00:10:30 Gina Corley
And give practical tips such as how to deal with cravings and withdrawal.
00:10:35 Gina Corley
Or patients can text quit to 47848 to use smoke free text.
00:10:41 Gina Corley
Patients who do this will get daily text messages to support them in their quit attempt.
00:10:48 Gina Corley
It also provides 24/7 access to advice, encouragement, and tips to becoming smoke or vape free.
00:10:57 Gina Corley
Some of these resources can even be specifically tailored towards teens who vape.
00:11:04 Gina Corley
And then the most effective option is in person behavioral support and counseling with specialists.
00:11:10 Gina Corley
But we know this may not always be practical.
00:11:14 Gina Corley
To help, many pharmacies now also have smoking cessation programs that people who vape can also participate in.
00:11:23 Gina Corley
For more resources, check out our e-cigarettes and vaping chart, which gives more info about the uses and risks of e-cigs along with our smoking cessation drug therapy chart that has dosing information, pros and cons, and patient counseling points.
00:11:41 Gina Corley
And… if you want to go even deeper into this topic, check out the latest January episode of our other podcast, Medication Talk… “Smoking and Vaping Cessation.”
00:11:53 Gina Corley
In that discussion, a panel of experts explores advanced strategies, combination therapies, and real-world challenges in helping patients quit nicotine products.
00:12:06 Gina Corley
It’s a longer, in-depth conversation packed with clinical pearls and nuanced insights that build on what we covered here…
00:12:15 Gina Corley
Perfect for anyone looking to expand their knowledge beyond the quick overview we talked about in this Clinical Capsules episode.
00:12:25 Narrator
Thanks for listening—we hope today’s episode gave you practical insights you can use right away.
00:12:30 Narrator
Now that you’ve listened, pharmacists and pharmacy technicians can receive CE credit. Just log into your Pharmacist’s Letter or Pharmacy Technician’s Letter account and look for the title of this podcast in the list of available CE courses.
00:12:42 Narrator
We’ve linked the resources we mentioned—and more on today’s topic—right in the show notes. Those links will take you straight to our websites, where you’ll find even more concise, evidence-based charts, articles, and tools.
00:12:54 Narrator
If you’re not yet a subscriber, now’s the time—sign up today to stay ahead with trusted, unbiased insights, and continuing education. Listeners save 10% on a new or upgraded subscription just use code cc1026 at checkout.
00:13:11 Narrator
Looking for more? Check out our other TRC podcasts like Medication Talk and Rumor vs Truth, or dive deeper with our full Pharmacy Essential Updates webinar series.
00:13:22 Narrator
If you found this episode helpful, follow Clinical Capsules and leave a quick rating or review—it helps others discover the show. Better yet, share what you learned with a friend or colleague and let them know they can find the show on any podcast app.
00:13:35 Narrator
Have a question or a topic suggestion? Reach out using the ‘send us a text’ link in the show notes or email [email protected]. Your perspective matters—share your thoughts anytime to help shape future episodes.
00:13:49 Narrator
Thanks for listening… stay sharp, stay current—and join us next time on Clinical Capsules!
Clinical Capsules
