If you're a smoker in 2018 who is thinking about quitting, your first thought will likely be to switch over to e-cigarettes. After all, some e-cig companies market their products to smokers specifically, if they don't outright claim to be the safer, less harmful alternative to conventional cigarettes. And the CDC states that e-cigarettes are a viable substitute for regular cigarettes (although it remains unclear how effective they are as quitting aids).
For all the risks that e-cigarettes may pose, Scott Sherman, MD, MPH, professor and co-director of the section on tobacco, alcohol, and drug use in the department of population health at NYU Langone, says that he'd rather see a current smoker choose an e-cigarette over a conventional cigarette. "That would be a really big reduction in their risk," he says. "You can't eliminate risk in life, so you pick and choose which risk you accept."
Of course, reducing harm isn't the same as kicking the habit. For longtime smokers who have struggled to quit, e-cigarettes might be the less harmful option, so quitting them probably isn't their number one concern. As Dr. Sherman puts it, "I would be happy to have them on e-cigarettes for a few years before they think about getting off."
But e-cigarettes are still habit-forming devices that contain addictive nicotine. So, when teens and people in their early 20s start using e-cigarettes without any previous history of smoking, that's obviously not great. (The FDA announced earlier this month that it's taking major strides toward combating the rapid increase in e-cigarette use among teens, so there's hope that this trend loses momentum.)
"That’s not harm reduction. That's harm increase, because they went from nothing to something," Dr. Sherman says. He adds that it's unclear at the moment how many young people end up with a long-term addiction to e-cigarettes after trying them, but it remains troubling that they're picking up a habit with a device that contains nicotine at all. Luckily, he suggests that quitting an e-cigarette habit may be easier than quitting conventional cigarettes.
With many varieties of e-cigarettes, the user can choose the nicotine content in their vape's liquid. If their e-cig of choice contains less nicotine than the average conventional cigarette, there's a chance that their withdrawal period won't be as intense. "If you’re an eight-cup-of-coffee-a-day drinker and you stop abruptly, your withdrawal is going to be way worse than somebody who drinks three cups of coffee a day," Dr. Sherman explains. In other words, slowly tapering your nicotine intake could be a good first step to easing off e-cigs.
Beyond that, quitting e-cigarettes will likely look a lot like quitting conventional ones, which can be difficult and present risks of relapse. Dr. Sherman explains that there are two sides to a cigarette addiction: the physical addiction to nicotine and the ritualistic aspect of cigarette use, which can be even trickier to overcome. "We're creatures of habit," he says. "For most people the habit is the harder part to break...and that is going to apply to e-cigarettes, as well."
In addition to tapering your nicotine intake, you'll need to focus on the ways in which e-cigarette use has become ingrained in your daily routine. Say you've grown accustomed to vaping first thing in the morning with your coffee — you may need to switch your coffee out for tea while you're trying to quit, so that that habit doesn't feel incomplete without the e-cigarette, Dr. Sherman says.
Every e-cigarette user's smoking history, habitual use, and reasons for starting in the first place is specific to them, so the "when" and "how" of each person's approach to quitting will naturally vary, too. The key is to seek out support if you need it and, above all, to be patient with yourself when the time comes.