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Tuesday, 7 February 2017

Can Vaping Really Help You To Stop Smoking?

Quitting is the best thing you can do for yourself and the people you love. Smoking harms almost every tissue and organ in the body, including your heart and blood vessels. Smoking also harms nonsmokers who are exposed to second-hand smoke. If you smoke, you have good reason to worry about its effect on your health, your loved ones and others. Deciding to quit is a big step, and following through is just as important. Quitting smoking isn’t easy, but others have done it, and you can too.

Professor Robert West, the lead author of the study, commented “E-cigarettes appear to be helping a significant number of smokers to stop who would not have done otherwise – not as many as some e-cigarette enthusiasts claim, but a substantial number nonetheless.”

The Analysis – How They Came Up With the Estimate

Robert West and colleagues Lion Shahab and Jamie Brown used data from the Smoking Toolkit Study, basing the analysis on 2014 data because it’s the most recent year for which full statistics are available. The full paper gives a run-down of the various steps in the calculation – and is only short, if you’re interested in reading it – but basically involves using known statistics on the number of people who attempted to quit by vaping and on the success rates of e-cigs to come up with the figure.

First, they worked out the number of smokers who attempted to quit in 2014, which was 3.16 million. Of these, about 28 percent attempted to quit by vaping without using prescription medicines or behavioral support – equating to about 891,000 people. If they’d tried to quit cold turkey or using nicotine replacement therapy bought over the counter, about 5 percent of them would have been successful, but vaping increases quit-rates by about 50 percent, so the total quit-rate for these smokers would be about 7.5 percent. This means that 2.5 percent of them quit by vaping who wouldn’t have stopped otherwise, or about 22,000 people.

However, the rise in vaping has been accompanied by a decline in smokers using prescription medicines and behavioral support in their quit attempts. The authors note that the decline doesn’t perfectly match up to the rise in vaping, but if you assume that vaping is responsible for about 80 percent of the decrease, then the estimate can be updated to account for this. Using both counseling and medication is the best method of quitting, according to the evidence, so if vaping has taken some smokers away from this approach, then it would detract from the additional positive effect of vaping. With this taken into account, the number of extra quitters thanks to vaping reduces to 16,000.

Is 16,000 to 22,000 Too Low?

The authors note that the estimate of 16,000 to 22,000 is much lower than the estimate of 560,000 ex-smoking vapers in England, but present plenty of reasons for this difference. The calculated figure is only for quitters in the past year, so many of the additional ex-smoking vapers (who quit longer than a year ago) won’t be included, and about 9 percent of recent ex-smokers started vaping after quitting smoking (probably to avoid relapsing).

The biggest points that reduce the estimate are the fact that only about one-third of vapers who’ve quit smoking wouldn’t have been expected to quit cold turkey or using NRT, and finally, about 70 percent of recent ex-smoking vapers will relapse to smoking in future (this figure is based on existing knowledge about quitting smoking, not something specific to vaping). When these factors (and similar ones) are taken into account, the estimates are roughly in agreement with each other.

The assumptions do seem reasonable, although the idea that 70 percent of smokers to recently quit by vaping will return to smoking is questionable – after all, we’re still getting nicotine through a similar delivery mechanism, so you’d hope this would reduce that percentage a little.

In a blog post from the New Nicotine Alliance, they also point out that the success rates used as part of the study are probably (or at least hopefully) a bit of an underestimate compared to what would be expected with modern devices. They also point out that the decline in use of other quitting approaches could have been to do with something other than e-cigarettes, so in reality a larger proportion of the vapers might not have quit if it wasn’t for e-cigs.

These last few points are ultimately speculation, though, so they should be taken with a pinch of salt. In any case, an extra 20,000 or so quitters thanks to vaping is hardly something to balk at.

No matter how much or how long you’ve smoked, when you quit smoking, your risk of heart disease
and stroke starts to drop. In the year after you quit smoking, your excess risk of coronary heart disease drops by 50 percent. After 15 years, your risk is as low as someone who has never smoked. While you may crave a cigarette after quitting, most people feel that quitting is the most positive thing they’ve ever done for themselves.

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