Some smokers who take up vaping may give up tobacco cigarettes altogether -- without ever intending to, a new study suggests.
The researchers see this as a hopeful sign that daily use of e-cigarettes can play a role in helping people quit smoking.
"Our study focused on smokers who were not planning to ever quit smoking -- a group of smokers who are usually addicted to nicotine so much that it's hard for them to think about going even one day without smoking a cigarette -- and we found that they had eightfold higher odds of quitting smoking when they took up daily vaping," said lead researcher Karin Kasza.
Committed smokers often have smoked heavily over a long time and, as a result, have the highest risk for lung cancer and other health problems caused by smoking, said Kasza, a research scientist in the department of health behavior at Roswell Park Comprehensive Cancer Center in Buffalo, N.Y.
"Vaping may give hope to this group of smokers to break out of this cycle and eventually become a former cigarette smoker," Kasza said.
It's not clear why smokers in the study switched to e-cigarettes or if some went back to traditional smokes. But the researchers speculate that some diehard smokers who try vaping will see they can go a day without a cigarette, because vaping feeds their nicotine habit.
"This is the first and most important step to change how these smokers think about their smoking and that it might just be possible for them to make that first cigarette-free day the start of a cigarette-free lifetime," Kasza said.
E-cigarettes were introduced in the United States in 2006, the researchers said in background notes. Studies have shown that people use e-cigarettes for many reasons, including trying to move away from cigarette smoking, as well as using them to keep smoking in places that don't allow cigarette smoking, Kasza said. Results of real-world studies on e-cigarettes as a means to quit smoking have been mixed.
For this study, Kasza and her colleagues collected data on 1,600 people who took part in the Population Assessment of Tobacco and Health Study from 2014 to 2019. These participants had no intention of quitting smoking when the study started and had not yet started vaping. Most were male, white, middle-aged and many were poor with little education.
Overall, 6% stopped smoking tobacco cigarettes. And rates were dramatically higher among those who became vapers -- 28% of those who vaped daily quit traditional cigarettes, the researchers said.
E-cigarettes may be a way smokers can begin to give up nicotine altogether, Kasza said.
Smokers should talk with their doctors, who can help them craft a quit-smoking plan that works for them, she said. FDA-approved medications like nicotine patches, gums and some prescription medications can boost the chance of success, she added.
"It usually takes more than one quit attempt to get off cigarettes completely. In our own experience with the tens of thousands of people we help quit smoking each year, some smokers tell us they've tried everything, and nothing worked until they tried vaping," Kasza said.
Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New York City, found the study hopeful.
"I was a bit encouraged by the study, because I thought, "Well, maybe you are trading one habit for another, but you're eliminating a whole lot of harmful chemicals,'" he said. "Which is not to say that e-cigarettes are without harmful propellants and things that you'd rather not put in a patient."
Horovitz agreed that for some patients, vaping may be a gateway to kicking the nicotine habit.
"E-cigarettes are a good transition from smoking cigarettes. Then from vaping, I would suggest the patch as a way of decreasing the nicotine level over time and getting the person to successfully get off nicotine and whatever else there is in the vape," he said. "It's definitely best to just breathe air."
The report was published online Dec. 28 in the journal JAMA Network Open.
For more on e-cigarettes, see the U.S. Centers for Disease Control and Prevention.
SOURCES: Karin Kasza, PhD, research scientist, department of health behavior, Roswell Park Comprehensive Cancer Center, Buffalo, N.Y.; Len Horovitz, MD, pulmonologist, Lenox Hill Hospital, New York City; JAMA Network Open, Dec. 28, 2021, online