A new study published in Nicotine and Tobacco Research examined “dual users”—people who both smoke traditional cigarettes and vape e-cigarettes—and found that people who predominantly vape were vaping instead of smoking, a process called “substitution,” and that this substitution might be sustainable long term, a way to help people wean off smoking traditional cigarettes.
“This particular study started with Dr. Anne Buu and her team,” said Dr. Doug Jorenby, a UW-CTRI researcher on the project. “She does incredibly sophisticated data analysis work and, with this particular dataset, we saw trends that spurred our research.
“We wanted to oversample dual users, conduct a study that looked at the same group of participants over a long period of time, and see if we could learn anything about cigarette smokers and people who smoked both cigarettes and e-cigarettes.”
The study included 227 participants who were surveyed 13 times over two years. These 227 participants were then split into four groups based on their behavior: people who are light dual users, predominantly vapers, heavy dual users, and predominantly smokers.
Researchers then examined and charted each group’s cigarette and e-cigarette consumption, as well as their cigarette and e-cigarette dependence.
“When we designed the study,” said Jorenby, “we were seeing people getting stuck once they started vaping, becoming dual users instead of completely quitting. So we asked ourselves, ‘what’s really happening?’”
The study found that heavy dual users, by smoking at either a daily or weekly level, were able to considerably reduce their cigarette use, even though their cigarette dependence didn’t drop as drastically.
People who predominantly vape both smoked less and were more dependent on e-cigarettes, a behavior the researchers characterize as “substitution.”
This substitution appeared to be a result of smoking restrictions, as they were more likely to live in places with strict smoking policies.
“In America, the FDA has never allowed health organizations or e-cigarette brands to call e-cigarettes a proven way to quit smoking,” said Jorenby, “and yet when talking to smokers, they think of it as a quit aid.
“We know e-cigarettes have a lot of appeal, but it does not seem that dual use is harm reduction strategy; when people are using combustible tobacco at any amount, they are exposed to health risks. It looks like you either quit smoking and vaping entirely, or switch to only vaping.
“These things together make a compelling case for aiding people who are trying to quit smoking. When people want to go the route of substitution, how can we help them succeed?”