This is the third a part of a four-part series.
April 27, 2023 – In 2014, after smoking cigarettes for 40 years, Kati Markowitz decided to change to vaping. She had heard that the newer electronic cigarettes may be less harmful. And on the time, she said, she didn't know of some other ways to quit smoking.
She vaped day by day for seven years.
Then Markowitz received news she had never hoped to listen to: She had lung cancer. A lump discovered on a CT scan had grown. She was to undergo treatment—removal of a complete lobe of her right lung. But first, she said, her surgeon told her to had to stop vapingwhich reduces the risk of postoperative complications and enables a healthy recovery.
Markowitz believed that switching to vaping could be less harmful than smoking cigarettes. But she not believes that.
“Did I deceive myself by hoping to get lucky and not have bad consequences? Yes, I did,” she said, adding that she wonders whether vaping contributed to their lung cancer or whether other negative health effects are likely in the future.
Researchers disagree on whether e-cigarettes are as effective as other smoking cessation Nicotine replacement therapies such as gum and lozenges. They also say more research is needed on the long-term health effects of vaping to ultimately determine whether e-cigarettes are a safe substitute for cigarettes.
“There is scientific research supporting vaping as a method of smoking cessation, but we’d not use it as a primary line of defense because we still need longitudinal studies to know the long-term risk of e-cigarettes,” said Monica HannaDeputy Director of Nicotine and tobacco withdrawal program at the RWJBarnabas Health Institute for Prevention and Recovery in Eatontown, NJ “We also need to research exactly how we can use e-cigarettes as a means of smoking cessation.”
Quit vaping
The first prototypes of e-cigarettes were developed in the Nineteen Thirtiesalthough what’s now often called vapes was not sold by manufacturers within the United States until the 2000s, after a Invention of a former health official in China. Over the years of its development, the e-cigarette device has been touted by both researchers and manufacturers as a means of quitting cigarette smoking.
The Consumer Advocates for Smoke-free Alternatives Association (CASAA), a nonprofit group that supports vaping and accepts donations from the e-cigarette industry, has more than 13,000 testimonials from individuals who say vaping helped them quit smoking.
But, anecdotes aside, research studies show mixed results on whether using vapes might help traditional smokers quit.
A Cochrane Library review in November 2022 The study found “high certainty of evidence that individuals using e-cigarettes or 'vapes' usually tend to quit smoking traditional cigarettes for a minimum of 6 months than those using nicotine alternative therapies comparable to patches and gum.”
The analysis examined 78 studies with more than 22,000 participants. And a 2019 study with 886 participants who were in The New England Journal of Medicine The study found that smokers who tried to quit smoking by vaping were twice as likely to quit cigarette smoking after one year than those who used nicotine replacement therapy.
“In terms of worldwide research, it's pretty clear that vaping might help smokers quit,” said Dr. Peter Shields, a professor in the department of internal medicine at Ohio State University College of Medicine who specializes in lung cancer treatment.
But one Study published in 2013 In Thelancet, and another from 2020found only a modest improvement in smoking cessation rates when people used e-cigarettes paired with patchesin comparison with patches alone.
“For a disruptive technology designed to finish flamable tobacco use, there appears to be little or no disruption on a big scale,” said Dr. Thomas Eissenberg, co-director of the Center for the Study of Tobacco Products at Virginia Commonwealth University in Richmond.
Michael Joseph Blaha, MD, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore, pointed to research This shows a Percentage of people who start vaping to quit Smokers end up consuming both products – they become so-called dual consumers.
“I believe there may be pretty high-quality evidence that vaping can result in more cessation, but on the expense of more long-term dual users and overall greater nicotine addiction,” Blaha said. “Vaping stays a third-line clinical tool after nicotine alternative therapy and FDA-approved cessation medications.”
The FDA has not approved any e-cigarette or vaping device to help people stop smoking, as is the case with patches and chewing gum, which means that manufacturers cannot market their products as smoking cessation aids.
“While vaping has potential as a smoking cessation tool, the evidence thus far is just too limited to say with certainty that vaping is a simpler smoking cessation tool than others,” said Hanna, of RWJBarnabas Health's Institute for Prevention and Recovery.
Reduce damage and improve health?
Vapes are also touted as a boon to individual and community health, as cigarette smoking is the leading cause of preventable disease and disability in the United States, accounting for more than 480,000 deaths per year in the United States.
Quitting smoking reduces the chance of varied varieties of cancer, heart disease, strokes and other serious diseases. The aim of Nicotine replacement therapy is designed to help smokers quit smoking by gradually delivering smaller doses of nicotine to the body over time without exposing it to the toxic chemicals found in cigarettes.
“No one should say e-cigarettes are protected, but in comparison with cigarettes, the information is consistent: They aren’t as harmful, and if a smoker switches, they’re higher off,” Shields said. “As with other nicotine alternative therapies, if someone is liable to quitting vaping and starting smoking again, I would favor that they proceed vaping long-term, because it is mostly considered less harmful than flamable tobacco.”
The FDA has allowed a handful of companies to market their electronic nicotine delivery systems as safer than traditional cigarettes by granting approval by the Pre-market applications for tobacco products Process. In 2021, the agency announced its first electronic cigarette approval to RJ Reynolds for three of its tobacco-flavored vaping products. Regulators approved additional products from three other companies in 2022.
But the The FDA has also otherincluding two RJ Reynolds products in 2023, and stated that “the applications didn’t contain sufficient evidence that authorising the marketing of the products could be appropriate to guard public health.”
Some researchers still have doubts about the effects of vaping with long-term use. Data on the health effects of e-cigarettes are just beginning to emerge and come primarily from animal or cell studies. Measuring the health effects in e-cigarette users will take decades, as Americans only began to gain access to the products in the 2000s.
Eissenberg said that vaping probably does not cause the same diseases as cigarette smoking, but that does not mean that it is not harmful. Ingredients found in e-cigarettes, such as heated propylene glycol, vegetable glycerin and flavorings, have previously only been used as food ingredients. The potential diseases caused by e-cigarettes are still unknown because inhaling these heated ingredients is new. He also said he has “no problem” with an adult smoker using e-cigarettes to quit smoking – as long as they only do so for a short period of time.
“I’m very concerned that long-term use in adults could lead on to significant illness and death,” Eissenberg said. “Simply put, the human lung evolved for one purpose: gas exchange of oxygen in and carbon dioxide out. Anything else that enters the lungs is a challenge to the organ.”
But Kenneth Warner, PhD, dean emeritus of the University of Michigan School of Public Health in Ann Arbor, said ending addiction to traditional cigarettes could reduce the high lung cancer rates in poorer communities where smoking rates are comparatively high.
Around 3 times In 2021, as many Americans smoked (12.6%) as vaped (4.7%), but those living in lower-income households are more likely to smoke. According to the CDCTobacco use is higher among adults without health insurance (27.3%) or with Medicaid insurance (28.6%) than among those with private insurance (16.4%). People with an annual family income of less than $12,500 are also more likely to develop lung cancer than people with a family income of $50,000 or more. Public health researchers attribute these differences This is partly due to higher smoking rates in lower-income households.
Warner said many low-income Americans and other income groups may never quit smoking because they believe switching to e-cigarettes would not benefit their health. A 2022 study published in American Journal of Preventive Medicine found that the percentage of Americans who thought vaping was more harmful than smoking quadrupled between 2018 and 2020, from 6.8% to 28.3%. A third of respondents thought vaping was as harmful as smoking.
“We have convinced a big portion of the American public that vaping is as harmful as smoking, though it would help people quit smoking,” Warner said.. “People are dying right now.”
Markowitz did indeed quit smoking by vaping, but now she wonders if her lung cancer diagnosis would have been delayed or even avoided if she had tried a traditional method like lozenges or gum instead. For most of the seven years she used the devices, she vaped once an hour.
“For individuals who need to quit smoking, I might recommend something just like the patch as an alternative,” she said.