When clinicians have a patient who asks whether they should try vaping to quit smoking, those clinicians should ask the patient if they believe it will work.
That’s because it may be a key factor in whether dual users of combusted tobacco and e-cigarettes will continue to vape, according to Exhale Study results UW-CTRI researchers published in Drug and Alcohol Dependence.
“We found that, if participants expected that their vaping would alleviate urges as well as a cigarette, that predicted whether they would continue dual use,” said lead author and UW-CTRI Researcher Dr. Jen Betts. These attitudes, along with e-cigarette craving, frequency of vaping, and e-cigarette dependence relative to combusted cigarette dependence, were all factors that predicted persistent vaping after one year in dual users.
So it could be that, if clinicians were to recommend a smoker try vaping, see how they respond to it and if they believe that, based on that trial, that vaping will work to help relieve cravings, then it’s worth having those patients give switching from smoking to vaping a try.
However, if they try vaping and they don’t find that e-cigarettes help as much with cravings, then clinicians shouldn’t recommend it because switching to vaping exclusively probably won’t work in the long term.
“Thoughts really do matter sometimes and influence our behavior,” Betts said. “And those beliefs are influenced by other people’s experiences, but also our previous experience. So, if you have a patient who has tried nicotine replacement medications before and it didn’t help, how adherent are they going to be the next time around? How much can you really blame them for not using something that, in their experience, hasn’t been helpful?”
That’s key information because, not only is smoking dangerous, but Ohio State University recently found that extended dual use can quadruple lung cancer risks.
“If extended dual use is an outcome we want to avoid, this study helps us identify who is at risk for that sustained dual use,” Betts said.
These analyses from the Exhale Study included a subset of 47 participants who only smoked and 88 dual users. Participants had 10 minutes alone in a room to either smoke (if they only smoked) or vape (if a dual user). Researchers assessed withdrawal before and after the session and video-recorded the session.
Both groups puffed about the same amount on their products. Betts said that could be because participants who dual used tended to smoke first before becoming dual users, so it could be that they use a vape like they’ve always used a cigarette, but more research is needed.
“What drives people to continue vaping or dual use is multifactorial and inter-related,” Betts said.
But the belief that vaping relieves cravings, and does so as well as smoking combustible cigarettes might be one key piece to the puzzle.
Betts JM, Cook JW, Kobinsky KH, Baker TB, Jorenby DE, Piper ME. Understanding the Motivational Mechanisms for Smoking and Vaping Among Dual Users and Exclusive Smokers. Drug and Alcohol Dependence. Online September 23, 2024.