can vaping help you quit smoking?
5 minute read
despite some opinions that vaping can be a smoking cessation tool, the canadian lung association says that vaping also has significant health risks. getty
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smokers and non-smokers alike agree: it’s bad for your health. in fact, most smokers are trying, or have tried, to kick the habit. but it’s not easy. some stats claim nicotine is as addictive as heroin and cocaine, and many people try and fail multiple times, whether through cold turkey, smoking cessation medication, nicotine gum or patches, or by switching to e-cigarettes — or vaping — as a transitional tool.
what is vaping?
also called vape pens, e-cigarettes heat a liquid into an aerosol that users inhale. the liquid, sometimes referred to as e-juice, contains a combination of ingredients, usually nicotine, propylene glycol (a common food additive, but also found in antifreeze and paint solvent), vegetable glycerin (typically from soybean, coconut or palm oils) and flavouring. many of these substances are considered safe for ingestion (they contain a fraction of the 7,000 chemicals found in tobacco smoke) but when they’re heated, they create additional chemicals and contaminants, such as formaldehyde, nickel and tin, that are not so safe, according to the canadian lung association (cla).
the cla states that vaping has significant health risks, and can cause serious lung disease. it can also worsen asthma and other respiratory conditions.
health canada, however, reported just 20 cases of vaping-associated lung illness, known as vali, from september 2019 to december 2020, representing 0.9 per one million, much less than the 2019 outbreak in the u.s. of 8.5 cases per one million. the harm can usually be traced to the content of the e-juice and where it was sourced (often from underground vendors). also, the majority of american vali cases were from illicit cannabis vapes, some containing products that may have been cut with vitamin e acetate, a chemical commonly added to thc vaping liquids to thicken or dilute them. nevertheless, health canada agrees replacing cigarette smoking with vaping products from a reliable and regulated source reduces exposure to harmful chemicals found in tobacco, but that more research is needed to understand the short- and long-term risks associated with vaping.
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lesser of two evils?
darryl tempest, government relations counsel to the canadian vaping association (cva) board, says of the many methods smokers use to quit, going cold turkey has a two per cent success rate, other nicotine replacement therapies (nrt) such as patches or gum, hypnosis and cessation medications, vary from eight to 10 per cent, while vaping has a 20 per cent success rate. he also cites studies that show vaping is 95 per cent less harmful than cigarettes.
“i’ve lost my father-in-law and my grandmother to smoking-related lung cancer,” says tempest, who himself vaped to quit smoking. “if you’ve ever seen anyone die that way, you’d do everything you could to try to stop it.”
health risks of vaping
“one of our fundamental pillars for harm reduction as defined by the government itself is to first reduce harm,” says tempest. “the working premise should always be on the relative risk, [and] the only one who can make relative risk statements is health canada.”
in august this year, health canada officially declared the outbreak of vali over, and new reports of any serious health consequences are few and far between, says dr. brandie walker, respirologist and clinical associate professor with the university of calgary’s cumming school of medicine.
“it’s not a common presentation and the decrease seems to have happened at about the same time as the pandemic really spiked, so it’s hard to know if it’s just that people were distracted by other more serious illnesses,” she says. “it’s a rare enough condition that it would be easy to track, so it’s hard to say with any degree of certainty what the prevalence is.”
targeting youth
while both health canada and the cva agree using vaping responsibly as a cigarette smoking cessation tool can be effective, they are also in agreement that that’s all vaping should be used for, and that youth in particular should not be vaping because of the nicotine content.
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however, in 2019 and 2020, health canada noted the rise of e-cigarette use, particularly among young people. between 2015 and 2019, the use of e-cigarettes increased among canadians 15 years and older from 13 per cent to 16 per cent. younger age groups reported the highest frequency use: 36 per cent of youth aged 15 to 19, and 48 per cent of young adults between 20 to 24 years old.
walker theorizes that one of the many reasons young people are drawn to vaping is the flavours that are used to make them more palatable.
“in the beginning, when there were fewer flavours and more people were using e-cigarettes as smoking cessation tools, we had a different cohort,” she says, adding that now more users are adolescents and children, largely due to flashy marketing and candy-like flavours. “data has long shown that nicotine exposure has adverse consequences on brain development in children. there’s so much variability in the unregulated e-liquid, and how hot the e-cigarette burns, [and] that influences what is in the vapour you’re inhaling into your lungs. we may not know the full impact of those parts of the equation until much later.”
walker does say that if she had a patient who smoked a pack or two a day of cigarettes, vaping as a cessation tool may be an option.
“it may be a reduction in harm because it doesn’t have the same amount of carcinogenic components as a cigarette does,” she says. “that being said, the vast majority of users of e-cigarettes now are never-smokers. so it’s marketed as a smoking cessation tool, but most people who are trying to quit cigarettes aren’t going to switch to strawberry flavoured e-liquid.”
tempest counters that. “flavours are not addictive. adults like flavours,” he says. “it’s one of the success components of vaping. if you ever smoked, then quit, cheated and had one a couple weeks later, it makes you sick. [flavour] really helps with that transition for success.”
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packaging, marketing and selling
walker says she would like to see e-cigarette products sold without packaging that appeals to youth. she’d also like to see the product accessible by prescription or at least via a pharmacist, just as other smoking cessation products are, and regulated in the same way.
the cva maintains that health canada has made regulatory changes to mitigate vape experimentation, and that adult vapers feel they are being unfairly regulated due to youth experimentation, while further regulation is not occurring for industries like alcohol or cannabis which have no harm reduction or public health benefit.
“kids do stupid stuff, but that doesn’t mean that 1.2 million people who used vaping as a successful way to quit smoking are accountable to those decisions,” says tempest. “the only purpose of vaping is to get people off combustible tobacco, plain and simple.”
robin roberts is a vancouver-based writer.
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