Vaping as a smoking cessation tool
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Effectiveness of Vaping as a Smoking Cessation Tool
Clinical trials and real-world studies suggest that vaping, or the use of electronic cigarettes (e-cigarettes), can be effective in helping some smokers quit. Several clinical trials have shown that vaping is associated with higher smoking cessation rates compared to traditional nicotine replacement therapies (NRTs), and is generally linked to fewer adverse events than combustible cigarettes 16. Real-world survey data also indicate that positive experiences with vaping—such as flexibility, fewer side effects, and social acceptance—are associated with greater success in quitting smoking . In specific populations, like those receiving opioid agonist treatment, vaping was found to be a more acceptable and less stigmatizing alternative, with many participants reporting that it helped them quit smoking .
Safety, Risks, and Concerns of Vaping for Smoking Cessation
While vaping is considered less harmful than smoking traditional cigarettes due to lower levels of toxic chemicals, concerns remain about its long-term safety. The long-term health effects of e-cigarettes are still unknown, and some studies highlight the potential for severe cardiopulmonary symptoms and carcinogenic risks 13. There is also concern about the risk of dual use—where individuals continue to use both cigarettes and e-cigarettes—which may not significantly reduce health risks and could even increase the risk of respiratory illness 26. Additionally, the addictive nature of nicotine in e-cigarettes and the possibility of users simply replacing one nicotine delivery device with another is a significant concern 237.
Regulatory and Clinical Guidelines for Vaping as a Cessation Aid
In some countries, such as Australia, vaping products are regulated and only available for smoking cessation under medical supervision. Clinical guidelines recommend that therapeutic vapes be considered only for those who have not succeeded with first-line therapies, and that their use should be closely monitored with regular follow-ups and an attempt to wean off vaping after a set period 56. There is consensus among stakeholders that effective interventions should combine product support with behavioral counseling, and that quitting vaping should not necessarily be the immediate goal, but rather a stepwise approach to reducing nicotine dependence .
Vaping and Youth: A Double-Edged Sword
A major concern is the increasing use of vaping products among adolescents and young adults. Evidence suggests that vaping can lead to new nicotine addictions in these groups, potentially undermining decades of progress in reducing youth smoking rates 238. Strict regulation and targeted interventions are recommended to prevent non-smokers, especially teenagers, from starting to vape while still allowing access for adult smokers seeking to quit .
Vaping Cessation and Harm Reduction
For those who become dependent on vaping, interventions similar to traditional smoking cessation strategies may be needed. Recent meta-analyses show that vaping cessation interventions can increase short-term abstinence rates, but more high-quality research is needed to guide clinical practice . The maximum health benefit is achieved when smokers completely switch to vaping and then eventually quit vaping as well, rather than using both products .
Conclusion
Vaping can be an effective smoking cessation tool for some adults, especially when combined with behavioral support and used under medical supervision. However, concerns about long-term safety, dual use, and youth uptake highlight the need for cautious, regulated use and ongoing research. The best outcomes are seen when vaping is used as a step toward complete nicotine abstinence, rather than as a permanent substitute for smoking.
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