Vaping has value as an aid for smokers who want to give up, a large US study has shown. The researchers wrote about their study and findings in eClinical Medicine, a peer-reviewed Lancet journal (citation below).
E-cigs, Electronic Cigarettes, Smoking, & Vaping
The term e-cigarettes refers to electronic cigarettes, battery-powered devices that vaporize a liquid for inhalation; many contain nicotine.
In this article, the terms ‘smoking’ and ‘vaping’ refer to tobacco cigarettes and e-cigarettes, respectively. Somebody who smokes tobacco cigarettes is a (regular) ‘smoker’ while a person who is vaping is a ‘vaper’.
E-cigs & Smoking Cessation
The debate about the role of e-cigarettes in aiding smoking cessation is a contentious one, with nations diverging in their responses. E-cigarettes, while containing substances that are bad for human health, are still perceived as less harmful than regular tobacco cigarettes.
Regular tobacco smokers have a higher risk of developing several cancers, cardiovascular diseases, strokes, diabetes, and chronic respiratory diseases. Given this, some people believe that e-cigarettes could serve as an intermediary solution for adults struggling to quit smoking, especially when conventional FDA-endorsed methods, such as nicotine gums or patches, have failed.
Vaping can help regular smokers quit
In this latest study, the largest vaping trial in the US to date, the researchers found that e-cigarette usage nudged regular smokers toward quitting. This was even the case with volunteers who had entered the trial saying that they were not planning to give up smoking.
“This is not a panacea for smoking cessation.”
The researchers were surprised to find that all the hypotheses that they tested in the study were confirmed.
Prof. Carpenter explained:
“It’s rarely the case that you’re proven correct for almost everything that you predicted. Here, it was one effect after another: No matter how we looked at it, those who got the e-cigarette product demonstrated greater abstinence and reduced harm as compared to those who didn’t get it.”
The researchers structured the study to mirror real-world scenarios closely, marking a pioneering approach in e-cigarette research.
Previous studies had only recruited motivated volunteers, i.e., people who wanted to quit smoking. They also gave the volunteers very detailed instructions on e-cig usage. In other words, prior research had been very structured.
Prof. Carpenter said:
“Some people have said, ‘That’s fine, but the results of those studies don’t apply to the real world because the real world isn’t as structured.’ So what we did was take a hands-off approach – we called it a naturalistic approach.”
“First off, we took smokers who did and did not want to quit. So right off the bat, not everybody wanted to quit. Secondly, we gave them very little instruction on how to use it.”
In this latest study, the researchers gave the volunteers e-cigs and told them that they could do what they liked – they could use them a lot, a little, or not at all – it was up to them. The people in the control group were not given anything.
Vapers more likely to give up smoking
Those in the vaping group were more likely to give up smoking compared to their counterparts who did not receive e-cigarettes.
Additionally, more of the vaping group members reported a decrease in daily cigarette consumption and ‘quit attempts.’ Notably, quit attempts are a critical metric since regular smokers usually require several attempts before successfully giving up smoking.
The study, which lasted four years, included volunteers from eleven cities across the United States. The researchers had planned to gather biochemical samples from participants who lived in the Charleston area to conform their self-reports regarding smoking behavior. Unfortunately, due to the coronavirus pandemic (COVID), in-person sample collection was not possible. However, relying on the volunteers’ self-reports is still ‘highly reliable’, Prof. Carpenter explained.
Something for policymakers to think about
This latest study, the researchers explained, will be another data point for policymakers and those involved in public health when considering what to do about e-cigarettes.
Dr. Carpenter added:
“No one wants e-cigarettes in the hands of kids, and we should do all we can to stop that. But we shouldn’t do so by denying this option for adult smokers who can’t otherwise quit.”
Other countries, such as the United Kingdom, have taken a much more liberal approach to vaping than the United States. In April 2023, the UK announced that its Swap to Stop program would hand out vaping starter kits free of charge to one million smokers.
Regarding the Swap to Stop program, The UK’s Department of Health and Social Care announced:
“As part of the world-first national scheme, almost 1 in 5 of all smokers in England will be provided with a vape starter kit alongside behavioral support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smoke-free by 2030 – reducing smoking rates to 5% or less.”
In the United States, electronic cigarettes are not approved as aids for giving up smoking.
Carpenter, Matthew J., Amy E. Wahlquist, Jennifer Dahne, Kevin M. Gray, K. Michael Cummings, Graham Warren, Theodore L. Wagener, Maciej L. Goniewicz, and Tracy T. Smith. “Effect of unguided e-cigarette provision on uptake, use, and smoking cessation among adults who smoke in the USA: a naturalistic, randomised, controlled clinical trial.” EClinicalMedicine. Part of THE LANCET Discovery Science, 2023, https://doi.org/10.1016/j.eclinm.2023.102142.