Is Vaping Harder to Quit than Smoking?

The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Audrey Darville, Ph.D., Tobacco Treatment Specialist.

LEXINGTON, Ky. (Nov. 11, 2019) — Is vaping harder to quit than smoking? In a word, possibly. To answer this question it is important to put nicotine, the cause of persistent tobacco use, in context.

Tobacco companies know when nicotine is rapidly absorbed in sufficient quantities, the result is substantial profit from the sale of addictive products. Nicotine has pleasurable effects and withdrawal from nicotine is miserable. Tobacco users feel irritable, anxious, cannot concentrate, and experience other unpleasant symptoms when nicotine levels begin to fall. After smoking a cigarette, these symptoms start about 30-45 minutes after the last puff. This is why most people smoke a pack a day. We know a lot about the designed addictiveness of cigarettes.

We know less about nicotine delivery in vaping products, yet what we do know raises concerns. There are hundreds of vaping products on the market with varying concentrations of nicotine. Without current regulation or ingredient disclosure, it is nearly impossible to know how much nicotine (and other chemicals) the user is exposed to when using vaping products. We do know that early iterations of electronic cigarettes were not efficient at delivering nicotine and none is able to replicate the initial “hit” combustible cigarette users experience. This limitation has been driving the development of newer products, specifically pod-based devices, such as Juul. The nicotine found in these devices is a salt formulation, allowing higher concentrations to be more efficiently absorbed by the user. For example, a single pod can contain the nicotine delivery equivalent of 2-3 packs of cigarettes.

Other factors making it challenging to quit vaping include:

• Perception, particularly among youth, that vaping products are much less harmful than cigarettes. They are clearly not harmless as evidenced by recent lung injury cases reported. Moreover, we know youth who would not otherwise try smoking, try vaping and some then progress on to smoking cigarettes.
• Ease and discreetness of use. This can entice use at an early age, promote frequent use and expose the user to higher sustained levels of nicotine when compared to lighting/relighting cigarettes.
• Use to quit smoking. One study found that when people used e-cigarettes to quit smoking, around 80% of them were still vaping a year later. Some people who vape to quit also continue to smoke cigarettes, causing more, not less, exposure to toxic chemicals. Tobacco users are less likely to use evidence-based treatments if they vape.
• To date, evidence-based approaches to quitting vaping are limited. Healthcare providers understand the challenges and can help.

Bottom line: Nicotine exposure using ANY tobacco product, particularly pod-based devices is high. Nicotine is highly addictive and tobacco products, including vaping devices, are not safe. Engaging in evidence-based treatments is the best way to quit and reduce health risks. Contact your health care provider or the Kentucky Quitline: 1-800-QUITNOW for help.