The debate over the use of e-cigarettes as a tool to help smokers quit has been fiery – both in Australia and around the world.

Those for their use as a cessation tool argue that e-cigarettes are far less harmful than smoking tobacco and offer the opportunity for users to taper off their nicotine intake gently.

Those against say vaping appeals to non-smoking younger people and creates nicotine addicts who use vaping as a gateway into smoking cigarettes, and thereby disrupt efforts to drive down smoking rates further in Australia.

This suspicion is driven by the fact that cigarette companies are investing in vaping.  Research in this field is still young – because vaping has only been around for a few years so it’s impossible to tell what its long-term effects may be.

So here are two issues:  vaping among non-smoking teenagers and its use as a quit tool and it’s not yet clear whether vaping actually helps to move smokers off cigarettes permanently.

In one of the largest analyses of vaping to date, American researchers mined data that had already been collected about thousands of adults across the United States. In particular, they looked at people who were classed as ‘cigarette smokers’.

They had smoked more than a hundred cigarettes in their lifetime and were using cigarettes on most days at the time they were first surveyed. They also asked whether people were familiar with, or used, e-cigarettes.

Then, they followed up with those same people two years later to see how they’d fared over time. In all, more than 8,000 smokers were surveyed.

In the original survey, less than four per cent of smokers reported using an e-cigarette daily. These e-cigarette users were also typically younger, had higher levels of education and smoked fewer cigarettes than the typical person surveyed. This makes it likely they were a less addicted group in the first place.

So unsurprisingly, when the researchers followed up years later, the daily e-cigarette users were more likely to have stayed away from cigarettes than other smokers.

11 per cent of those who smoked and vaped originally were found to have stopped smoking when they were followed up, compared to 6 per cent of typical smokers. That may not seem like a huge difference, but small margins of reduction in use can be considered important.

Implications

This research doesn’t go to the harm e-cigarettes may pose or the potential ‘gateway effect’ and there is no doubt arguments will continue.

But the study does add to other research which suggests vaping may prove a useful tool in reducing smoking rates in those who are already regularly using cigarettes. What’s needed of course is a randomised trial rather than these surveys.

Last Reviewed: 11/04/2020

© Norman Swan Medical Communications.



References

For reference: Kalkhoran, et al (2019). Electronic Cigarette Use and Cigarette Abstinence Over Two Years among U.S. Smokers in the Population Assessment of Tobacco and Health Study. Nicotine and Tobacco Research doi: 10.1093/ntr/ntz114.

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