Weekly Wellness 12-2-19
COLUMBIA- The debate is ON. Which is better? Vaping or traditional cigarettes? Well, if you’re going to ask a health coach personal trainer like me, the answer is NEITHER! But if you are truly curious, here’s some science to back up my claim.
The CDC states there are more than 1,000 cases of vaping-related lung injury across 48 states (including 18 deaths). And our youth are the victims with 80% of those affected are under 35, and about 20% are between the ages of 18 and 21. So what’s the lung injury that’s occurring? A new study in the New England Journal of Medicine found that the lung injuries in 17 patients look more like chemical burns rather than the result of inflammation due to inhaling fats in vape liquid.
In addition to the vaping-related lung illnesses, there are other risks associated with vaping nicotine. It can cause withdrawal symptoms, including mood changes and difficulty concentrating.
According to the CDC, smoking causes about 480,000 deaths in the U.S. every year. Smoking strongly raises your risk for many serious diseases, including lung cancer, chronic obstructive pulmonary disease (COPD), stroke, and heart disease. What about vaping? There is some evidence that vaping nicotine can increase your risk for cardiovascular issues (albeit nowhere near as much as traditional cigarettes).
Some people have been using e-cigarettes to try to quit smoking cigarettes. So this whole debate is totally frustrating. These folks are really trying to do the right thing. But here’s the thing: e-cigarettes were not really designed or regulated for that.
Recent large-scale studies about vaping as a form of nicotine replacement therapy are somewhat encouraging but also flawed. One study, published in 2013 in PLOS One, was a yearlong randomized controlled trial involving 300 smokers who weren’t interested in quitting. The participants were broken up into groups of 100 people. The first group got e-cigarettes with 7.2 milligrams of nicotine cartridges for 12 weeks. The second group got e-cigarettes with 7.2-milligram cartridges for six weeks, followed by six weeks of lower-dose cartridges. The third group got cartridges with no nicotine for 12 weeks. All participants then came in for nine visits to report their cigarette use per day and get carbon monoxide breath testing.
Results showed that all groups reduced their consumption of tobacco cigarettes over the course of the study. At week 52, 13% of participants in the first group, 9% in the second group, and 4% in the third group had quit. But here’s the problem with this study: First off, because the participants weren’t intending to quit, it’s kind of hard to call this a smoking-cessation study. Also, a considerable chunk of participants (40%) didn’t make it to the final follow-up. And as with most e-cigarette studies, the model of vape tested here isn’t current anymore, so we don’t know how well the results would generalize to other devices.
Another study, this one published later, in 2013, in The Lancet, followed 657 participants over six months. Participants were randomized to receive e-cigarettes, nicotine patches, or placebo e-cigarettes without nicotine. After six months, researchers concluded that “e-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar achievement of abstinence as with nicotine patches, and few adverse events.”
There’s also some evidence to suggest that vaping is actually more difficult to quit than smoking based on the amount of nicotine in the product and measures including the number of attempts users have made to quit, how long they’re able to go without a craving, and the severity of their withdrawal symptoms.
The CDC’s recommendation for anyone who vapes right now is to stop vaping entirely, including avoiding e-cigarettes and THC-containing products.
The tools meant to be used for smoking cessation (which can be used for cigarette and e-cigarette cessation) are gums, patches, and lozenges (which are FDA-approved for smoking-cessation purposes and designed to be used for a few weeks at a time.)
And if you’re frustrated with the lack of clear guidelines and lack of information about a product you might be addicted to, you are not alone. This is not a simple problem. Talk to your doctor and the FDA so we can get the research and regulations we need to make actual recommendations based on evidence.