One of the biggest arguments in favor of vaping is that it can help people ease themselves away from their addiction to tobacco smoking. But a new study published this week in PLoS One seems to offer a strong rebuttal to that line of thought. It suggests that people who use both tobacco and e-cigarettes are actually less likely to quit smoking than people who only stick to tobacco.
The researchers studied data from survey company GfK’s KnowledgePanel, an ongoing service that offers small cash rewards to users for every survey taken. They looked at data from more than 1,200 smokers who had been surveyed in August and September of 2015, then continued to track their smoking status. Of the 1,000 people who remained active members of KnowledgePanel a year later, around 850 answered a followup survey.
Roughly 30 percent of people at the beginning of the survey said they both smoked and vaped. But a year later, 90 percent said they still smoked. People who only smoked, however, were actually twice as likely to report quitting. The lower chances of success among users of e-cigarettes, or electronic nicotine delivery systems (ENDS), held true even if people said they turned to vaping as a way to quit. And dual users, on average, still smoked the same amount of cigarettes a day as non-vapers did a year later.
“Any smoker would tell you that quitting smoking is extremely difficult,” lead author Scott Weaver, an epidemiologist at Georgia State University’s School of Public Health, told Gizmodo via email. “But, that nicotine addiction is difficult to overcome doesn’t readily explain why smokers who also used e-cigarettes were less likely to quit than smokers who did not use e-cigarettes, even though they, the dual users, were more likely to try to quit smoking.”
Some earlier studies have suggested that switching to vaping can help cut down on smoking. According to Weaver, though, these studies might be dated or otherwise unrepresentative of how people’s habits are actually changed by these devices.
“In the ‘real world,’ the e-cigarette product landscape is highly diverse, and communications about their health effects and use for smoking cessation are inconsistent,” he said. “Most of these products do not match the nicotine delivery profile of the cigarette. Many smokers who try e-cigarettes find them insufficient at suppressing their nicotine cravings and either give them up (returning to exclusive cigarette smoking) or continue to smoke and vape.”
Given that dual users were less likely to quit in the study, Weaver even suggests there’s something unique about dual use that hinders a person’s attempts to quit, such as higher doses of nicotine.
“Or it might be the way smokers can use e-cigarettes to complement their nicotine uptake and alleviate withdrawal symptoms in situations when they cannot smoke, possibly undermining the impact of smoke-free restrictions,” Weaver added. “Some may also continue to smoke and vape under the misperception that cutting back on cigarettes is sufficient, while uncertainty and confusion about the health risks of e-cigarettes may lead to ambivalence about making a complete switch to e-cigarettes.”
Weaver doesn’t rule out the possibility that e-cigarettes could still be a cessation aid, with changes in their design as well as how they’re marketed and regulated. But even these changes might be too slow and ineffectual on their own. He points to recent efforts by the Food and Drug Administration to lower the nicotine content of traditional tobacco cigarettes as an example of a more meaningful and immediate solution.
“We can work on these [changes] while we continue to promote evidence-based policies, education campaigns, and cessation approaches that we know are effective,” he said.
Weaver and his team plan to continue studying how perceptions of smoking and e-cigarettes affect smokers’ decisions and patterns of use of e-cigarettes, as well as how smokers are reacting to newer types of e-cigarettes and possible new tobacco and e-cigarette regulations from the FDA.