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Smokers who try to quit tend to end up vaping and smoking, medical study says

Smokers who try to quit tend to end up vaping and smoking, medical study says

2022-07-22

As smokers try to quit, some turn to e-cigarettes, but these people tend to become dual nicotine users, smoking both traditional cigarettes and vaping, researchers at Washington University School of Medicine in St. Louis found.


The good news is that researchers found that smoking cessation treatment focused on nicotine replacement and counseling can help these dual users quit smoking.


Of the 40 million Americans who smoke, most say they want to quit, with some turning to e-cigarettes as a step toward quitting. However, researchers at Washington University School of Medicine in St. Louis found that an increasing number of such people are becoming dual nicotine users: they smoke traditional cigarettes and e-cigarettes.


Instead of stopping the addiction, many people end up dramatically increasing the amount of nicotine they consume. The good news is that FDA-approved smoking cessation treatments that focus on nicotine replacement and counseling can help such dual users quit smoking, the researchers found. In fact, the treatment appears to be effective for dual users as well as people who only smoke traditional cigarettes.


The findings could be published July 21 in the journal Chest.


"We recommend FDA-approved treatments, such as nicotine replacements, varenicline, and counseling for smokers," said Lixian Chen, PhD, senior investigator and associate professor of psychiatry. "But we know that more and more people are using cigarettes and e-cigarettes at the same time. The good news is that tobacco treatment can still help these people quit smoking and eliminate nicotine addition."


On average, about 70% of smokers try to quit smoking every year. Another 20% said they wanted to smoke less. But only about 5% of people who do not receive any treatment (such as nicotine replacement therapy and counseling) successfully quit smoking.


In a review of de-identified electronic health records from more than 110,000 smokers who attended outpatient clinics at Barnes-Jewish Hospital between 2018 and 2020, Chen and her colleagues found that the number of e-cigarette users tripled. Some people apparently started using e-cigarettes as a potential step to quit smoking, but many seemed to be stuck. Instead of quitting smoking, they started vaping, while continuing to smoke traditional cigarettes.


During the course of the study, a small percentage of the smokers studied became dual users. About 0.8% reported dual use in the first year of the study, but that number had grown to 2.3% by the time data collection ended.


The authors note that the actual number of dual users may be higher.


The researchers found that about one in five (20.8%) dual users quit smoking within 12 months. By comparison, those who smoked only conventional cigarettes had a 16.8 percent quit rate.


Treatment still appears to be the key to dual users. When they received smoking cessation treatment, almost a third (29%) became non-smokers after 12 months. About 17% of untreated dual users were able to quit.


Despite higher quit rates among dual users, about two-thirds still smoked after one year, even after treatment, said first author Brendan T. Heiden, MD, a surgical resident and cardiothoracic surgery fellow. in this way. Combined with the fact that little is known about the long-term health effects of e-cigarette use, it means that he and Chen do not recommend vaping for people who want to quit smoking.


"The current scientific consensus is that using cigarettes and e-cigarettes together is bad for you," Hayden said. “While current guidelines do not recommend the use of e-cigarettes for smoking cessation, we did find that FDA-approved traditional tobacco treatments—such as nicotine replacement therapy and behavioral support therapy—can help in the increasing use of both products. They quit."


This work was supported by the National Heart, Lung, and Blood Institute, the National Cancer Institute, and the National Institute on Drug Abuse of the National Institutes of Health (NIH).


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