We all know the kinds of people who vape to look cool, but you probably know just as many others — if not more — who use e-cigarettes to quit smoking. And while some studies suggest that using non-combustible nicotine products like e-cigarettes can help people quit smoking, there are just about as many showing that they have little to no effect on whether someone quits smoking. This week a team of scientists marked a point in the latter column, showing evidence that electronic nicotine delivery systems may not actually help smokers quit.
In a paper published Monday in the journal PLOS One, public health researchers at Georgia State University recruited over a thousand smokers — including smokers who vape — and followed up with them for after a year. By analyzing the survey data of the 858 subjects who completed a follow-up interview, the study’s authors showed that 90 percent of smokers who vaped at the beginning of the study were still smoking a year later. The subjects who vaped at the beginning of the 1-year study period were about half as likely to quit smoking by the end as their peers who did not vape. Only 9.2 percent of the study subjects reported that they’d quit smoking at the end of one year.
In short, vaping doesn’t seem to help.
“Our study finds no evidence that [electronic nicotine delivery systems], as they were marketed and used in the US during the study, were effective at helping smokers quit at a population level,” Scott Weaver, Ph.D., an assistant professor of epidemiology and biostatistics at Georgia State University and the paper’s first author, tells Inverse. “This finding suggests that [electronic nicotine delivery systems] have not been fulfilling the promise of helping many US smokers give up smoking, which remains the leading cause of preventable death and disease in this country.”
The researchers did find that people who use electronic nicotine delivery systems are more likely to attempt to quit than people who don’t use them, but nonetheless, these individuals are no more likely to be successful than people who quit without vaping.
It’s not totally clear why this is the case, as the authors of the new study didn’t dig down into the possible causes for the trends they identified, but previous research on the history of nicotine replacement therapies suggests that an over-emphasis on nicotine’s role in addiction could be hurting people’s chances of quitting. As Inverse previously reported, a paper from earlier this year showed that major tobacco companies relied on a chemical explanation for cigarette addiction as a way to sell non-tobacco nicotine products, excluding a number of other factors:
While Philip Morris publicly acknowledged nicotine’s addictiveness in 2000, the study’s authors suggest that the company scapegoated the chemical as the solitary driver of addiction. By placing the blame on nicotine, company scientists drew attention away from a potential public health focus on biological, social, psychological, and environmental factors that could help people quit smoking.
So it’s possible that the failure of electronic nicotine delivery systems that this new study highlights is simply an extension of that trend, which began in the 1990s: If smokers simply use a nicotine replacement to quit smoking, rather than engage in behavioral therapy or other interventions, they’re taking a narrowly limited approach that doesn’t really account for all of the factors that can contribute to addiction. The fact that manufacturers don’t really seem interested in helping people quit could explain why major tobacco companies continue to invest in e-cigarette products and research.
“We need more research to understand why smokers who vaped were less likely to quit than smokers who did not vape,” Weaver says. “Because [electronic nicotine delivery systems], as well as how they are marketed to and used by smokers, continue to change, ongoing research will be needed to evaluate their potential impact on population health, including how they might be used to help smokers quit.”
Weaver points out that people don’t need to wait for the results of new research to quit smoking, though. This ongoing research can continue to happen at the same time that public health officials continue to help expose people to methods that have been proven to be effective. Along with smoking cessation programs, he emphasizes the need to make smoking less attractive and less addictive.
In the meantime, Weaver and others in his field will continue to investigate the big question raised by this paper and others: Why doesn’t vaping seem to help people quit smoking?