By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Are you or a loved one vaping with electronic cigarettes (e-cigarettes or e-cigs), to quit smoking? If so, you should probably re-think your plan because these devices may not be the solution you’re hoping for.
Let’s get right into why that’s true, as well as what you can do instead…
E-Cigarettes Are Not Proven Cessation Tools
Despite some clever positioning by e-cig makers, e-cigs are not proven to be effective tools for helping people quit smoking – nor are they approved as such by the U.S. Food and Drug Administration (FDA).
What e-cigs claim is that they give vapers more control over the amount of nicotine they use. In theory, this enables you to titrate yourself down to the point where you’re using very small amounts, until ultimately you’re using none at all.
Does this work? At this point, the research is all over the map. Some studies show e-cigs are helpful, some show they’re not. Others suggest that e-cig vaping can actually increase cigarette smoking, rather than reduce it. What they all agree on, though, is that more data is needed. Given that, I think it’s best to look at other nicotine replacement therapies that don’t include some of the health hazards of e-cigs.
A big selling point of e-cigs is their so-called “safety” relative to old-school cigarettes and cigars. While it’s true that e-cigs do protect you from exposure to the tobacco toxins linked with cardiovascular disease, respiratory dysfunction, cancer, and more, they’re not exactly good for you, either. Case in point: In 2014, a group of Saudi researchers analyzed 28 published studies relating to the health dangers of vaping with e-cigarettes. Through their analysis, they learned that e-cig use is associated with adverse health effects, including “headache, chest pain, nausea, and cough, and major adverse events, such as hospitalizations for pneumonia, congestive heart failure, seizure, rapid heart rate, and burns related to routine use. Case reports of lung disease attributable to the use of e-cigarettes have also been published.”
Speaking of cancer: While e-cigarettes don’t contain tobacco, they do contain nicotine, with varying concentrations of the drug per puff and per cartridge. Nicotine carries huge health risks.
For one thing, it’s dangerous for your heart. It causes blood platelets to stick together, contributing to plaque formation and increasing the risk of a blood clot to the heart. Nicotine also constricts blood vessels, making it harder for your heart to do its job, therefore raising risk of elevated blood pressure.
Nicotine is also a major carcinogen. It stimulates new blood vessel growth in tumors and thus encourages them to grow, explains a report in the Journal of Cellular Biochemistry. Tumors depend on a reliable blood supply to grow and survive. Various tumors and cancers are linked to nicotine consumption: non-small cell and small cell lung cancer; head and neck tumors; gallbladder tumors; and bladder, stomach, kidney, breast, and colorectal cancers.
Finally, nicotine is habit-forming, making e-cigs a delivery system for a drug on which you can get hooked. Nicotine activates pleasure centers in the brain, making smokers feel good, even euphoric and craving more of the drug.
Worth mentioning too, is that in 2009, the FDA issued one of the first reports on e-cigarettes. It identified the carcinogens and toxic chemicals found in them – including diethylene glycol, a harmful ingredient in antifreeze. The report noted, too, that the many flavoring agents offered in e-cigarettes contain chemicals that can cause respiratory disease.
E-Cigs Also Dangerous as Gateway Devices
If you’ve seen the news lately, you know that e-cig use among teens is surging. According to the 2018 National Youth Tobacco Survey – a survey funded by the FDA and Centers for Disease Control and Prevention (CDC) – there was a 78 percent increase in use among high school students between 2017 and 2018. The growth has been so pronounced, in fact, that the FDA has proposed new regulations for e-cig sales, in hope to reduce the number of young people who experiment with the devices and wind up getting hooked.
Parent and grandparents should beware of this trend. Multiple studies now have shown that kids who smoke e-cigarettes are more likely to move on to the real thing. In this case, the best way to stop is to never start in the first place.
Better Ways to Quit Smoking
Folks, if you think I’m coming down hard on electronic cigarettes, I am. They are anything but a healthy alternative to nicotine-addictive cigarettes. They don’t help most people quit smoking, and they only compromise your health. There are much better and proven ways to quit smoking – and stay quit, as I also mention in Ways to Quit Smoking. Here’s how:
- If you don’t want to quit cold turkey, start delaying that first cigarette of the day as long as you can – to after work or after dinner, for example. This will start changing your daily habit for the better.
- Set a date when you will stop smoking altogether, and verbalize it to friends and family. A good date to select is over a weekend, when you’re not subject to regular daily demands that could trigger your urge to smoke.
- Look into whether pharmacotherapy is right for you. Although I dislike many prescription drugs because of adverse side effects, varenicline (Chantix) has been shown in research to be more effective than nicotine patches or gum in helping people abstain from smoking.
- Get moving (and quitting) with yoga. Yoga-based interventions have shown success for smoking cessation.
- Set your environment up for success. Remove all smoking supplies (ashtrays, lighters, cigarettes, and so forth) from your house, car, workplace, etc. to reduce visual reminders that could trigger cravings.
- Stop worrying about weight gain. Every time I counselled women in my practice to stop smoking, they’d counter with, “But I’ll gain weight!” It turns out this may be a myth. A recent study published in the journal Appetite revealed that young women who are smokers actually gain more weight than non-smokers. If you’re still concerned about weight gain, my advice is to stock your refrigerator with plenty of fresh fruits and vegetables to munch on (like carrot sticks, apple slices, sliced melon, grapes, celery sticks, etc.) when hunger or the need to put something in your mouth strikes.
- Lean on support. Let you closest confidantes know you’re quitting, and ask them to help keep you accountable. If you feel like lighting up, call one of these friends so he or she can talk you down if cravings get strong. Tap into online support too. Smokefree.gov offers an app called quitSTART, designed for teens and adults who want to quit. It offers personalized tips, inspiration, and challenges to help you become smoke-free.
- Reward yourself: for every pack of cigarettes you would have smoked, put the money saved in a jar and treat yourself to something nice.
- If you slip up on your first quit smoking attempt, or have caved in a few times before, don’t throw in the towel. In my clinical practice, I’ve seen that it sometimes takes smokers multiple times before they quit for good. Everyone’s path to smoke-free living is different, so it’s important to keep trying and know that you’ll eventually be successful.
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© 2015, 2019 Stephen Sinatra, M.D. All rights reserved.