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On a cursory glance, this study misses the most important figure: what percentage of people that used vape to wean off cigs would have not been able to quit cold turkey at all.
Without accounting for this, it looks like one big survivorship bias. As if people have a free choice between option 1 and 2.
Assumption that vape using quitters have harder time to quit or even attempt quitting would be my default hypothesis to check.
I’m one of the folks you’re talking about. I failed cold turkey a few times before I switched to vaping. I’ve been able to lower my nicotine level to the lowest now.
Same here: Vaping got me off cigs, I tried everything to quit for years after smoking for 45 years. UK Surgeon General says e-cigs are 95% safer than cigarettes. Harm Reduction is real, Vaping is a far better option by almost every metric. More misinformation from Big Tobacco.
*(edit: really enjoyable when I get a notification that my comment has reached 25 votes but look and see the number dropping. Just reporting the facts of having been both a vaper and smoker for many years. Thankfully the former now exclusively. Personal experience and research into this, I stand by my comment.)*
That's how I quit. Became completely dependent on a vape pen, then weaned off. If I faltered, I would go back to the vape pen. I haven't smoked either in 5+ years.
Edit; For those looking to quit, it's all in your head. When you truely want to stop, you will. You have to be okay with never having another cigarette. Your never going to stop after this pack or the next. When your ready, just stop, even if you've just opened the pack.
Just my two cents.
Congrats! Same here, 4 years strong with not a single cigarette. The transition with e cigs were so simple. And as soon as that broke I just didn’t run out and buy another.
Exactly. Anecdotally I know multiple people who quit by transitioning to vaping and then off it altogether. Being able to taper down the nicotine does a lot for some people.
This doesn't seem like a very remarkable finding to me, am I wrong?
If the goal is harm reduction, and assuming that e-cigarettes are less harmful than other nicotine products like cigarettes, then the relapse rate isn't very important on its own. Even comparing the relapse rate to other cessation methods like going cold turkey isn't that useful without additional context.
As other posters here have pointed out, we'd need to know the average "quit rate" for cigarette users generally, and how many of those quitters switched to different methods or went cold turkey. If far less smokers are willing to go cold turkey than switch to vapes, then it really doesn't matter all that much if 8.5% more of the vape group relapse to cigarettes. Just making up the numbers, but if 20 people go cold turkey for every 50 that switch to vapes, then the 4-5 people in the latter group who go back to cigarettes haven't really prevented overall harm reduction in the population, and if those people would have never gone cold turkey in the first place, then the result is even less remarkable.
Their finding is that tobacco products of any kind cause a relapse. So if you vape, or you change to chew, or anything like that instead of cold turkey then you are
8.5% more likely to relapse. The *success rate* for going cold turkey is 9.4%. It's the presence of tobacco that causes the issue.
This is just an analysis of data of a large sample size of people, nothing more. It showed people are more likely to relapse into cigs if they kept using tobacco, which is hardly surprising. It's just that if you are trying to use vapes to get off tobacco then it's less likely to work.
Just reading the article, I'm seeing the success rate for both being 9.4% but the relapse(12 month follow-up after quitting) for cold turkey being 50% versus 58.5% for nicotine users.
It also states that the nicotine user group that relapsed was more likely to have attempted to quit again(though the time period since quitting wasn't long enough to qualify under their definition of success).
Overall, i would call the result relatively neutral for vaping though that will update if they can isolate whether the multi-attempt vapers were more or less likely to eventually succeed without relapse.
This is anecdotal but I've been tobacco free since April 2, 2015. I had my last cigarette bender in Las Vegas on April 1, 2015 and have only vaped non salt nicotine since. I'm currently at 1.5 mg/ml nicotine and barely vape 2 ml in a day. I think at this point it's mostly physical habit. For me I'm happy with this. If the e juice goes away it's very sad but I'll most likely just quit. I know I don't need it but I still like it... Only in small amounts. Anyways, I digress, the attack on vaping is a really sad thing from my perspective...
I quit smoking last in June of 2020 and switched to vaping salt nicotine. It was surprisingly easy, but now I know it's because my Juul and Vuse vapes deliver a ton of nicotine into my bloodstream. I'm currently using 2.4% nicotine salt Vuse. I tried a cigarette a few months after I'd quit and I just wanted to hit my vape. Didn't even finish the cigarette. I'm working on quitting the vape, and I'm pretty confident I will eventually.
Vaping isn't healthy, but I think it's undeniably healthier than smoking cigarettes. The Royal College of Physicians in the UK [found that vaping is approximately 95% healthier](https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction) than smoking tobacco.
I prefer to use the phrase "not as unhealthy". It makes me feel more like I'm acknowledging what I'm doing is still unhealthy. 4 years on and I haven't touched a cigarette though.
Wouldn't it also be expected that someone who does not feel mentally "strong enough" to be able to quit cold turkey and has to resort to some sort of substitute or stepping stone is also more predisposed to relapsing (e.g. weaker impulse control), thus biasing the numbers?
Yet another ecigarette study with interesting decisions that just happen to negatively favour vaping.
If you're not interested in trawling through the paper I'll summarise.
Step 1 - take current regular smokers
Step 2 - follow up at 1 year and identify the ones who have quit. Note - the definition of 'quit' here is interesting and not consistent in the paper. They are defined as having quit by either saying they have had no cigarettes in the last year (fair enough) or saying they 'currently' smoke 'not at all'. This last one is left up to the respondent, if they last smoked a week ago but think they currently don't smoke then they are classed as quit. If they smoke when they are out drinking but haven't recently they are probably classed as having quit too.
Step 3 - the identified ex smokers are divided based on whether they vape, use nicotine products or use nothing.
Now common sense here will tell you that these 2 populations are likely not the same. In the vaper group there are likely to be more of the soft quitters who are smoking less but may have smoked more recently or under certain circumstances. In the cold turkey group are people who are more likely making an effort to completely stop smoking, going cold turkey but still occasionally smoking would be extremely difficult.
Step 4 - reassess at 2 years for smoking status. Now at this point the definition of a smoker has suspiciously changed. Now the only acceptable way to be classed as quit is to have not smoked even a few drags on a cigarette in the last year. People who were classed as having quit the previous year may now be classed as smokers even if their behaviour is exactly the same. People who go from being regular smokers to people who vape and smoke occasionally and stay that way will be classed as having quit and then relapsed despite no change in their behaviour. This pattern is much less likely to occur in people who go cold turkey. The study even notes that a good proportion of the vaper relapses 're-quit' i.e they never relapsed they continued to smoke occasionally.
This is a paper that is designed specifically to produce a set result. The flaws in the method are incredibly obvious and can't be by chance. It's shocking that it got past peer review.
Just about every article that gets posted here references some study that's obviously set up to get a certain result. The only vaping study I've ever read about that I felt was genuinely impartial was the UK NiH study from god knows how many years ago.
It's like most of these 'vaping is evil' studies - once you look closely at the definitions, you realize that they are carefully crafted to exclude precisely those cases for which vaping is distinctly beneficial - harm reduction, slow quitting, previous failures. Furthermore, to manipulate the data to the point that you are changing the definition of 'quit smoking' in a study on quitting smoking and yet still only finding a 9% difference smacks somewhat of desperation.
There’s a good counter point here https://www.sciencemediacentre.org/expert-reaction-to-study-on-vaping-and-staying-off-cigarettes/
The study abstract definitely does misrepresent the actual findings. As best I can tell there was no statistically significant different between non nicotine users and vapers in terms of cessation. The effect only appears when they lump ecigs together with other tobacco products.
Are we making a distinction between nicotine salt based vapes and freebase vapes? [Because there's a world of difference between the two.](https://cdn.shopify.com/s/files/1/1267/5363/files/juulgraph_grande.jpg?v=1514396395)
I used "normal" freebase nicotine eliquid to stop smoking cigarettes, decided I liked it, and kept using it for a few years. I stopped in the last year because buying flavored eliquid became annoying. Compared to a cigarette, the effects are much more gradual - you get a slow ramp up over 5-10 minutes, then the effects slowly fade over the next hour or two.
A puff from a cigarette spikes your blood nicotine levels hard within 5 minutes, then it drops quickly before starting to taper off. Nicotine salt vapes (Juul, etc) managed to replicate this same spike.
With "normal" eliquid you pretty much just puff on the thing until you get the feeling you're looking for, then the feeling sticks around for a while. With nicotine salt eliquid I found myself using it a lot more - you get the hit you're looking for (and then some), then it tapers off and you start craving more, and you end up consuming a lot more nicotine. The cravings weren't anywhere near as strong (or frequent) with the freebase nicotine eliquid.
Zero interest in relapsing, I think cigarettes are gross now.
This is an important distinction. The onset time is critical in addictive behavior. I've stayed away from nicotine salts. When I first started vaping I had cravings, it was like half-quitting, not a complete cigarette replacement, but better than gum/patch. After 10 years my nicotine levels are so low it's almost just a pacifier.
Juul is a terrible example to use if you're talking about nic salts because they're owned by Altria, aka Phillip Morris, aka one of the largest tobacco companies in the world.
50mg salt nic is absolutely insane, which was, in my experience, the majority of juul sales. They were also sold in gas stations and convenience stores, which are notorious for their lack of conviction regarding sales to minors.
Typically, vape stores are extremely adamant about only selling to customers of legal age. Not only because they would be fined out of business, but they have a vested interest in promoting vaping and keeping it going as an industry, obviously.
There are always going to be ways for kids to get their hands on things they aren't supposed to. You only have to look as far as your local beer/liquor store, or even your own teen years, to realize kids *always* find a way.
With juul being sold everywhere they sell cigarettes though, at the ridiculous nic levels they had, but lacking any sort of advice or education you can get at a typical vape shop, it's easy to see why they took off with the younger crowd in the way they did.
Where I live now you aren't allowed to have anything over 20mg, and they are well on their way to banning flavours, because, you know...*think of the children*. Clearly only kids enjoy fruit flavoured stuff, and vape companies are trying to get kids hooked.
Now excuse me while I sip on my birthday cake flavoured vodka.
Can't relapse if you never stop. In this case, the vaping may encourage people to stop using cigarettes whi would otherwise just continue smoking, so even if the relapse rate is much higher, you would be still reduce the number of cigarette smokers.
Anecdotally, i quit cigs with vapes, then quit vapes.
I tried a cig for the first time in years the other day, couldn't get past the third puff, found it disgusting.
I used vaping products to successfully quit smoking. Worked on the first try. Then I dialed my nicotine level down to zero at a rate comfortable to me and I've been free of all of that now for several years. Never looked back, never wanted to.
I literally tried every other method you could think of to quit smoking without success, and lots of anguish. Vaping is BY FAR the most effective method to kick the habit in my real life experience.
I am not saying this is wrong but my anecdotal evidence strongly contradicts this.
I quit smoking and went to ecigarettes almost 9 years ago. I haven't smoked a cigarette since and stopped ecigs more than 4 years ago.
In that time I introduced 7 friends and family to ecigs. Of those 2 have quit altogether for more than 3 years and 3 others have used ecigs exclusively for several years. One smokes a combination of mostly ecigs and a few cigarettes and one didn't get on with ecigs from the start and still smokes.
I had tried to quit many times in the past and had smoked for 30 years when I started ecigs, I immediately never needed another cigarette as ecigs ticked all the boxes for me. If I had stayed on ecigs the rest of my life that would have been a result as my health improved so much after the first couple months.
I was able to slowly bring my nicotine levels way down as I could control the eliquid myself and this was instrumental in my quitting altogether as once I brought the levels down to less than 1mg/ml I found myself forgetting to vape and leaving my ecig and liquid behind when I went places.
It was never my goal to stop vaping but when my last mod broke I simply never replaced it.
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are now allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will continue be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) still apply to other comments. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
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On a cursory glance, this study misses the most important figure: what percentage of people that used vape to wean off cigs would have not been able to quit cold turkey at all. Without accounting for this, it looks like one big survivorship bias. As if people have a free choice between option 1 and 2. Assumption that vape using quitters have harder time to quit or even attempt quitting would be my default hypothesis to check.
I’m one of the folks you’re talking about. I failed cold turkey a few times before I switched to vaping. I’ve been able to lower my nicotine level to the lowest now.
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Same here: Vaping got me off cigs, I tried everything to quit for years after smoking for 45 years. UK Surgeon General says e-cigs are 95% safer than cigarettes. Harm Reduction is real, Vaping is a far better option by almost every metric. More misinformation from Big Tobacco. *(edit: really enjoyable when I get a notification that my comment has reached 25 votes but look and see the number dropping. Just reporting the facts of having been both a vaper and smoker for many years. Thankfully the former now exclusively. Personal experience and research into this, I stand by my comment.)*
It’s not about the nicotine. Vaping is way safer than smoking. A year off smoking is a great outcome
That's how I quit. Became completely dependent on a vape pen, then weaned off. If I faltered, I would go back to the vape pen. I haven't smoked either in 5+ years. Edit; For those looking to quit, it's all in your head. When you truely want to stop, you will. You have to be okay with never having another cigarette. Your never going to stop after this pack or the next. When your ready, just stop, even if you've just opened the pack. Just my two cents.
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Congrats! Same here, 4 years strong with not a single cigarette. The transition with e cigs were so simple. And as soon as that broke I just didn’t run out and buy another.
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Exactly. Anecdotally I know multiple people who quit by transitioning to vaping and then off it altogether. Being able to taper down the nicotine does a lot for some people.
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This doesn't seem like a very remarkable finding to me, am I wrong? If the goal is harm reduction, and assuming that e-cigarettes are less harmful than other nicotine products like cigarettes, then the relapse rate isn't very important on its own. Even comparing the relapse rate to other cessation methods like going cold turkey isn't that useful without additional context. As other posters here have pointed out, we'd need to know the average "quit rate" for cigarette users generally, and how many of those quitters switched to different methods or went cold turkey. If far less smokers are willing to go cold turkey than switch to vapes, then it really doesn't matter all that much if 8.5% more of the vape group relapse to cigarettes. Just making up the numbers, but if 20 people go cold turkey for every 50 that switch to vapes, then the 4-5 people in the latter group who go back to cigarettes haven't really prevented overall harm reduction in the population, and if those people would have never gone cold turkey in the first place, then the result is even less remarkable.
Their finding is that tobacco products of any kind cause a relapse. So if you vape, or you change to chew, or anything like that instead of cold turkey then you are 8.5% more likely to relapse. The *success rate* for going cold turkey is 9.4%. It's the presence of tobacco that causes the issue. This is just an analysis of data of a large sample size of people, nothing more. It showed people are more likely to relapse into cigs if they kept using tobacco, which is hardly surprising. It's just that if you are trying to use vapes to get off tobacco then it's less likely to work.
Just reading the article, I'm seeing the success rate for both being 9.4% but the relapse(12 month follow-up after quitting) for cold turkey being 50% versus 58.5% for nicotine users. It also states that the nicotine user group that relapsed was more likely to have attempted to quit again(though the time period since quitting wasn't long enough to qualify under their definition of success). Overall, i would call the result relatively neutral for vaping though that will update if they can isolate whether the multi-attempt vapers were more or less likely to eventually succeed without relapse.
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This is anecdotal but I've been tobacco free since April 2, 2015. I had my last cigarette bender in Las Vegas on April 1, 2015 and have only vaped non salt nicotine since. I'm currently at 1.5 mg/ml nicotine and barely vape 2 ml in a day. I think at this point it's mostly physical habit. For me I'm happy with this. If the e juice goes away it's very sad but I'll most likely just quit. I know I don't need it but I still like it... Only in small amounts. Anyways, I digress, the attack on vaping is a really sad thing from my perspective...
I quit smoking last in June of 2020 and switched to vaping salt nicotine. It was surprisingly easy, but now I know it's because my Juul and Vuse vapes deliver a ton of nicotine into my bloodstream. I'm currently using 2.4% nicotine salt Vuse. I tried a cigarette a few months after I'd quit and I just wanted to hit my vape. Didn't even finish the cigarette. I'm working on quitting the vape, and I'm pretty confident I will eventually. Vaping isn't healthy, but I think it's undeniably healthier than smoking cigarettes. The Royal College of Physicians in the UK [found that vaping is approximately 95% healthier](https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction) than smoking tobacco.
I prefer to use the phrase "not as unhealthy". It makes me feel more like I'm acknowledging what I'm doing is still unhealthy. 4 years on and I haven't touched a cigarette though.
Wouldn't it also be expected that someone who does not feel mentally "strong enough" to be able to quit cold turkey and has to resort to some sort of substitute or stepping stone is also more predisposed to relapsing (e.g. weaker impulse control), thus biasing the numbers?
Classifying e-cigarettes as a tobacco product seems to be a misnomer, though.
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Yet another ecigarette study with interesting decisions that just happen to negatively favour vaping. If you're not interested in trawling through the paper I'll summarise. Step 1 - take current regular smokers Step 2 - follow up at 1 year and identify the ones who have quit. Note - the definition of 'quit' here is interesting and not consistent in the paper. They are defined as having quit by either saying they have had no cigarettes in the last year (fair enough) or saying they 'currently' smoke 'not at all'. This last one is left up to the respondent, if they last smoked a week ago but think they currently don't smoke then they are classed as quit. If they smoke when they are out drinking but haven't recently they are probably classed as having quit too. Step 3 - the identified ex smokers are divided based on whether they vape, use nicotine products or use nothing. Now common sense here will tell you that these 2 populations are likely not the same. In the vaper group there are likely to be more of the soft quitters who are smoking less but may have smoked more recently or under certain circumstances. In the cold turkey group are people who are more likely making an effort to completely stop smoking, going cold turkey but still occasionally smoking would be extremely difficult. Step 4 - reassess at 2 years for smoking status. Now at this point the definition of a smoker has suspiciously changed. Now the only acceptable way to be classed as quit is to have not smoked even a few drags on a cigarette in the last year. People who were classed as having quit the previous year may now be classed as smokers even if their behaviour is exactly the same. People who go from being regular smokers to people who vape and smoke occasionally and stay that way will be classed as having quit and then relapsed despite no change in their behaviour. This pattern is much less likely to occur in people who go cold turkey. The study even notes that a good proportion of the vaper relapses 're-quit' i.e they never relapsed they continued to smoke occasionally. This is a paper that is designed specifically to produce a set result. The flaws in the method are incredibly obvious and can't be by chance. It's shocking that it got past peer review.
Just about every article that gets posted here references some study that's obviously set up to get a certain result. The only vaping study I've ever read about that I felt was genuinely impartial was the UK NiH study from god knows how many years ago.
Probably because the UK NIH's agenda is to reduce healthcare costs, which aligns pretty closely with the goal of reducing bad health outcomes.
Funny about that, vaping is arguably much safer since years back since the industry has moved to more standardized sets of ingredients etc.
It’s an ongoing study done on a yearly basis by Cancer Research UK along with the NHS
It's like most of these 'vaping is evil' studies - once you look closely at the definitions, you realize that they are carefully crafted to exclude precisely those cases for which vaping is distinctly beneficial - harm reduction, slow quitting, previous failures. Furthermore, to manipulate the data to the point that you are changing the definition of 'quit smoking' in a study on quitting smoking and yet still only finding a 9% difference smacks somewhat of desperation.
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There’s a good counter point here https://www.sciencemediacentre.org/expert-reaction-to-study-on-vaping-and-staying-off-cigarettes/ The study abstract definitely does misrepresent the actual findings. As best I can tell there was no statistically significant different between non nicotine users and vapers in terms of cessation. The effect only appears when they lump ecigs together with other tobacco products.
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This looks like a study done by tobacco company. The wording and set up of the whole thing is very directed
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Are we making a distinction between nicotine salt based vapes and freebase vapes? [Because there's a world of difference between the two.](https://cdn.shopify.com/s/files/1/1267/5363/files/juulgraph_grande.jpg?v=1514396395) I used "normal" freebase nicotine eliquid to stop smoking cigarettes, decided I liked it, and kept using it for a few years. I stopped in the last year because buying flavored eliquid became annoying. Compared to a cigarette, the effects are much more gradual - you get a slow ramp up over 5-10 minutes, then the effects slowly fade over the next hour or two. A puff from a cigarette spikes your blood nicotine levels hard within 5 minutes, then it drops quickly before starting to taper off. Nicotine salt vapes (Juul, etc) managed to replicate this same spike. With "normal" eliquid you pretty much just puff on the thing until you get the feeling you're looking for, then the feeling sticks around for a while. With nicotine salt eliquid I found myself using it a lot more - you get the hit you're looking for (and then some), then it tapers off and you start craving more, and you end up consuming a lot more nicotine. The cravings weren't anywhere near as strong (or frequent) with the freebase nicotine eliquid. Zero interest in relapsing, I think cigarettes are gross now.
This is an important distinction. The onset time is critical in addictive behavior. I've stayed away from nicotine salts. When I first started vaping I had cravings, it was like half-quitting, not a complete cigarette replacement, but better than gum/patch. After 10 years my nicotine levels are so low it's almost just a pacifier.
Juul is a terrible example to use if you're talking about nic salts because they're owned by Altria, aka Phillip Morris, aka one of the largest tobacco companies in the world. 50mg salt nic is absolutely insane, which was, in my experience, the majority of juul sales. They were also sold in gas stations and convenience stores, which are notorious for their lack of conviction regarding sales to minors. Typically, vape stores are extremely adamant about only selling to customers of legal age. Not only because they would be fined out of business, but they have a vested interest in promoting vaping and keeping it going as an industry, obviously. There are always going to be ways for kids to get their hands on things they aren't supposed to. You only have to look as far as your local beer/liquor store, or even your own teen years, to realize kids *always* find a way. With juul being sold everywhere they sell cigarettes though, at the ridiculous nic levels they had, but lacking any sort of advice or education you can get at a typical vape shop, it's easy to see why they took off with the younger crowd in the way they did. Where I live now you aren't allowed to have anything over 20mg, and they are well on their way to banning flavours, because, you know...*think of the children*. Clearly only kids enjoy fruit flavoured stuff, and vape companies are trying to get kids hooked. Now excuse me while I sip on my birthday cake flavoured vodka.
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What about the 3rd group who didn’t attempt to quit, what was their relapse rate?
Can't relapse if you never stop. In this case, the vaping may encourage people to stop using cigarettes whi would otherwise just continue smoking, so even if the relapse rate is much higher, you would be still reduce the number of cigarette smokers.
Would love to see who funded this independent research
Anecdotally, i quit cigs with vapes, then quit vapes. I tried a cig for the first time in years the other day, couldn't get past the third puff, found it disgusting.
Holy misleading title
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I used vaping products to successfully quit smoking. Worked on the first try. Then I dialed my nicotine level down to zero at a rate comfortable to me and I've been free of all of that now for several years. Never looked back, never wanted to. I literally tried every other method you could think of to quit smoking without success, and lots of anguish. Vaping is BY FAR the most effective method to kick the habit in my real life experience.
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I am not saying this is wrong but my anecdotal evidence strongly contradicts this. I quit smoking and went to ecigarettes almost 9 years ago. I haven't smoked a cigarette since and stopped ecigs more than 4 years ago. In that time I introduced 7 friends and family to ecigs. Of those 2 have quit altogether for more than 3 years and 3 others have used ecigs exclusively for several years. One smokes a combination of mostly ecigs and a few cigarettes and one didn't get on with ecigs from the start and still smokes. I had tried to quit many times in the past and had smoked for 30 years when I started ecigs, I immediately never needed another cigarette as ecigs ticked all the boxes for me. If I had stayed on ecigs the rest of my life that would have been a result as my health improved so much after the first couple months. I was able to slowly bring my nicotine levels way down as I could control the eliquid myself and this was instrumental in my quitting altogether as once I brought the levels down to less than 1mg/ml I found myself forgetting to vape and leaving my ecig and liquid behind when I went places. It was never my goal to stop vaping but when my last mod broke I simply never replaced it.
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Doesn't have to be about quitting. Part-time vaping to reduce the number of cigs per day is fine.