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What e-cigarette alternatives are available to help you quit smoking?

Kelley-Ross Pharmacy GroupAsk The PharmacistWhat e-cigarette alternatives are available to help you quit smoking?
18
Nov
2020
QUESTION: What e-cigarette alternatives are available to help you quit smoking?
ANSWER: Those who want to quit smoking are encouraged to try FDA-approved products first. E-cigarettes are not FDA-approved for smoking cessation because of the limited evidence on the safety and effectiveness.

Examples of FDA-approved smoking cessation products:

  • Nicotine replacement therapy (NRT) – Nicorette, NicoDerm (nicotine gum/lozenges and patch), as well as Nicotrol (spray).
  • Chantix (varenicline) – Can help reduce the cravings for nicotine and its pleasure effects on the brain.
  • Zyban (bupropion) – A medicine for depression but can also help people quit smoking.

Talk with your provider about the best treatment plan for you. It is important to discuss all the medicines and supplements you take with your doctor and understand their desired effects and possible side effects. Never stop taking a medication and never change your dose or frequency without first consulting your doctor.

If you would like to find out more information about e-cigarettes, please see below.

 

 

What are e-cigarettes?

Electronic cigarettes (e-cigarettes) are battery-operated devices that heat a liquid usually containing nicotine, producing an aerosol (a vapor) that the user inhales. E-cigarettes are sometimes called e-cigs, vaping, dripping and electronic nicotine delivery systems (ENDS). They are available both online and in retail stores. The most sold e-cigarette in the US is a brand called JUUL, which looks like a USB flash drive. They can also look like everyday items, such as highlighters and pens.

The e-cigarette liquid component contains nicotine and other ingredients, some with cancer-causing chemicals.

Who smokes e-cigarettes and why?

Most adult e-cigarette users are traditional cigarette smokers, the majority of whom perceive that e-cigarettes will help them quit or reduce their smoking habit. E-cigarette usage by adults has steadily declined over the past decade.

At the same time, usage has sharply increased among middle and high school students. Many in this group who were previously non-smokers reported that they tried e-cigarettes out of curiosity.

Are e-cigarettes less harmful than regular cigarettes?

E-cigarettes do not contain as many dangerous chemicals as regular cigarettes, but the difference is not significant enough to deem them safer than traditional cigarettes.

Smoking e-cigarettes has the following potential adverse health effects:

  • Nicotine exposure – E-cigarette use can increase the risk of cardiovascular effects ranging from abnormal heart rate to heart attack.
  • E-cigarette or vaping product use associated lung injury (EVALI) – The CDC reported over 2000 cases of EVALI, an acute respiratory illness that can be severe and life-threatening. In most cases, one of the substances inhaled was nicotine, tetrahydrocannabinol (THC) and vitamin E acetate.
  • Nicotine dependence – Potential to renormalize smoking behavior in youths and risk of dependence. However, dependence appears to be lower than for conventional tobacco cigarettes.
Consequently, we advise against e-cigarette use, especially for non-smoking youths.

Prepared by Sharon Koh PharmD Candidate 2021

Resources:

  1. Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, Prokopowicz A, Jablonska-Czapla M, Rosik-Dulewska C, Havel C, Jacob P 3rd, Benowitz N. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014 Mar;23(2):133-9. doi: 10.1136/tobaccocontrol-2012-050859. Epub 2013 Mar 6. PMID: 23467656; PMCID: PMC4154473.
  2. Bao W, Liu B, Du Y, Snetselaar LG, Wallace RB. Electronic Cigarette Use Among Young, Middle-aged, and Older Adults in the United States in 2017 and 2018. JAMA Intern Med. 2020 Feb 1;180(2):313-314. doi: 10.1001/jamainternmed.2019.4957. PMID: 31609399; PMCID: PMC6802265.
  3. Hartmann-Boyce J, McRobbie H, Bullen C, Begh R, Stead LF, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2016 Sep 14;9(9):CD010216. doi: 10.1002/14651858.CD010216.pub3. PMID: 27622384; PMCID: PMC6457845.
  4. Steinberg MB, Zimmermann MH, Delnevo CD, Lewis MJ, Shukla P, Coups EJ, Foulds J. E-cigarette versus nicotine inhaler: comparing the perceptions and experiences of inhaled nicotine devices. J Gen Intern Med. 2014 Nov;29(11):1444-50. doi: 10.1007/s11606-014-2889-7. Epub 2014 May 15. PMID: 24830741; PMCID: PMC4238186.
  5. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products https://www-cdc-gov.offcampus.lib.washington.edu/tobacco/basic_information/e-cigarettes/severe-lung-disease.html (Accessed on October 25, 2020)

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