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FAQs about Electronic Cigarettes

Dr_Hays
Mayo Clinic
2 34 1,707

As we field questions on a daily basis about electronic cigarettes, vape pens, vapor systems, etc. from our patients at the Mayo Clinic, I’d like to share our current knowledge of these devices with the Ex community and what we recommend at the Nicotine Dependence Center.   

What are E-cigarettes?

This question is not as easy to answer as one might think.  There are more than 450 devices that are called e-cigarettes, and more than 7500 different solutions that have been developed to be vaporized in these battery-powered products.  However, e-cigarettes do have a few things in common.  They all have a heating element, a cartridge or tank to hold a liquid solution that can be heated and vaporized, and they are all designed to allow a user to puff and inhale the vapor.  As e-cigarettes are designed to mimic the experience of smoking, it is understandable why some are experimenting or becoming daily users.

 

In fact, there has been a dramatic increase in the use of e-cigarette devices.  Between 2010 and 2013 the percentage of adults who report trying an e-cigarette has jumped from 2.7% to 12.3%.  Among high-school students, an alarming 13.4% report that they currently use e-cigarettes.  This is an increase from 1.1% in 2011.  The Centers for Disease Control estimates that 2.4 million middle and high school students use e-cigarettes.  It is not clear at this time if the use of e-cigarettes by young people will reverse the important progress that has occurred during the past 15 years in preventing young people from starting to smoke.

Are they safe?

Safety concerns about e-cigarettes are brought up almost daily byour patients at the Mayo Clinic.  While e-cigarettes are likely less harmful than cigarettes, there is debate on exactly how ‘safe’ they are.  Currently there are no standard manufacturing processes or FDA regulation of these products.  Short-term research available shows some flavorings and solutions have been found to contain various toxins.  Propylene glycol, the main solvent and ingredient responsible for creating the vapor, has minimal research on its long-term effects when vaporized and inhaled. 

Do they help people quit?

Research to date has not found that the e-cigarettes are any more effective in helping people stop smoking than the nicotine patch, a nicotine replacement product that has been proven to be safe and effective.  Other studies have found some people become “dual users” in that they vape in places in which they cannot smoke but continue to be daily tobacco cigarettes users. The bottom line—there is no reliable evidence to support the use of e-cigarettes as an effective smoking cessation aid.

What do you recommend?

Many healthcare organizations embrace a concept known as integrative medicine - combining complementary treatments with best practice, evidenced based care – as long as it is considered to be safe.  As e-cigarettes have not been thoroughly researched and new studies continue to reinforce a cautionary approach, we do not recommend them to our patients.  The most effective treatment option is behavioral counseling and medication used in combination. .  You can learn more about these research-based strategies here at BecomeAnEx and from the Mayo Clinic

34 Comments
JonesCarpeDiem

Common sense says that by continuing the motions of smoking one might never unlearn the psychological addiction connected to the hand to mouth and inhale motion done upwards of hundreds of thousands of times a long term smoker lit up.

I would be interested in a study of how many people who used the e-cig to quit smoking were ever able to stop using an e-cig?

Is there anything being done to provide statistics on this?

Mike.n.Atlanta

Agreed Dale. These things were never intended by the manufacturer to be anything other than a replacement for cigarettes. I don't get why people are so pumped up about using them as a quitting aid. Oh yeah I forget...they're addicts.

KOKO,

M n @

JonesCarpeDiem

It amazes me when I stop at an intersection and see the entire car beside me completely FILLED with a cloud of vapor. The funny thing is the vapor is supposed to make people think they are smoking. Seems kind of counter productive if you are trying to let it go

Eric_L.
Member

even if, and i do emphasize if, someone is legitimately trying to use it to quit, i'd argue that its still white knuckling it without a support group, doctors supervision or legitimate quit plan which is indicated on the box of patches.  so, it's the same addict mind trying to become powerful over nicotine which they have proven they are powerless over.

Thomas3.20.2010

Good Blog! Thank You, Doctor!

Vaping is definitely not the answer to Nicotine Addiction!

linda258
Member

I guess they do not have information on not using "medication" to quit.  I have yet to hear a doctor suggest that you could consider going cold turkey to quit.  Everyone wants to give you nictine...

All I did was mention that I was having some pretty big craves the first couple of days and the instructor in my quit smoking class kept telling me to slap on a patch.    Why would I have done that when I was ending day 3... duh... nicotime was leaving my body. 

I appreciate the information on e-cigs.  Thanks you.  

Barbara145
Member

@ Linda.  Of course they have information on cold turkey.  It is Mayo Clinic.  For people who do not need nicotine they are all for it.  The majority of us CANNOT do it.  I appreciate them.

Terri103
Member

I do not believe for one minute that e-cigs were created to be a different NRT.  If that was the case, they would be very plain and basic.  I see people with asst e-cigs and some are decked out like hot rods, in fancy sparkly colors.  

They were created to lure and entrap young, hip cool non smokers and to trick smokers who wanted to quit.  There are as many ecig stores now as there are those title loan companies.  

It is all marketing and money.  It makes me so angry esp about the young people that think its hip.  

Mike.n.Atlanta

I would argue that anyone can quit cold turkey. The public is blasted with ads 24/7 that it CAN'T be done without an aid & people believe it. You just have to get your mind right.

KOKO,

M n @

linda258
Member

@ Barbara... I appreciate that not everyone can go cold turkey... that being said I don't think most doctors even talk about this as a possible way to quit.  Go back and read the link to Mayo.... they advocate for combination of medication and counseling.  When mentioning cold turkey they imply less success.   All I am saying is that I think this method is underrated and not suggested.   Allen Carr is the only one I hear saying hogwash go for it.    From my persepective if you can't make it that way there is always the medication.

Dr_Hays
Mayo Clinic

@Dale: This is an important question, do people who try to switch from tobacco cigarettes to e-cigarettes transfer addiction, or do they eventually stop using e-cigarettes?

Unfortunately we don’t have definitive answers to this question. There are studies underway taking the long term view and following people over time to track the course of e-cigarette use.  Results for studies like this will take some time.   It does seem that most people who move from cigarettes to e-cigarettes become dual users, using both e-cigarettes and continuing to use tobacco cigarettes.  

Thanks for the comments,

Dr. Hays

barb103
Member

My pulmonary doctor has suggested the e-cigarette, he states it is better than the cigarettes and you can buy liquid nicotine in different levels of nicotine in them.....I failed with it because I have smoked 2 packs a day for years and I started out with lowest dosage available. He said I should start out with a higher nicotine solution and wean off of it gradually. I am going to use that and the patch if my doctor says it is okay!

jhalberstein
Member
Until you have walked a mile in someone else's shoes, please do not judge. It is hard enough to quit smoking. Do we need to post negative comments? Everyone will do what is best for them. Let's congratulate them for their hard work.
reggie
Member

I have tried and have an e-cig and I don't believe they are helpful to quit for me but I needed to find out if the could help but no, not for me.  Everyone has their own path to quit and we are all not the same.  With that being said go the path that is best for you.

ellobo5150
Member

I have used the ecigs and really didn't get much from them.  It was the tobacco and nicotine I was beginning to dislike.  I think i finally hit my bottom with cigs.  I do vape but not for the sensation to duplcate smoking.  I only vape ocasionally and not when I first get up or right after a meal or all the other times I was triggered to smoke.  I can go days with out vaping where when I was smoking I bearly could go an hour..  To me this is a huge success.  

I do not wish to be judged here. I came for support.  I am happy to see people say everyone has their own path. cudos to Reggie for stateing that.  I will probably lay the vape pipe down soon as it is not an addiction as ciggs were.  I am 66 yrs old and had been smoking since I was 17.  do the math!  Anything that helps quit is a miracle.  I have tryed the patch, nicotine gum, nicotine losenges and last but not least was hypnotised only to realize I could not stand the voice of my hypnotist so the followup cds were nothing but annoying ($500 later)  

So if vaping works for me please do not judge me.  I am nicotine and tobaco free.  I only vape fruit and desert and coffee and chocolate flavors.  I can not stand the smell of tobaco any more.  

thenunn2
Member

Well said Ellobo . I know quite a few people who have used them to help quit and it did help them. But I also know people who use them and are continually sucking on them ,and most of them are still usuing nicotine containing ones ,so must be getting loads nore nic then when they smoked..but they arent getting the rest of the chemicals ,so thats something.

I used one when the craving got very bad..sadly for me it was counterproductive,its just reminded me of smoking too much,so i wont be usuing it any more.

Quitting smoking after many years is a big thing,it requires a total rewire,a change in behaviour and getting rid of the chemicals,all of which upset the balance we've known. So I think anything that helps someone through quit can be useful. We are all so different and require different tools to do it. Sites like this work if they stay supportive and not judgemental and if we think before we write something that might cause upset to someone and possible derailment from their quit. Afterall we are all here for the same reason ..to kick butt 🙂

wishing everyone strength,peace and inner calm

jan

Florflor
Member

The best way to quit is to become an ex member. It has a psicological "hook or tie".  I can't hardly explain it. No e-ciggs, no patches and don't stay alone with your efforts to away from smoke. Become a member of a community that have had the same strugle is realy the best way and do not let you to slip so easily. Thanks ex friends.

purplepoetry
Member

I smoked three packs a day for over 10 years and tried to quit unsuccessfully over 40+ times in the last three years. I finally did quit - through the use of a patch and a eCig with a 12 mg vapor. I needed both...the patch resolved my phyisical cravings and the eCig helped me get through my oral fixation cravings. Interestingly, I learned through the process

It took time, but after a month on the patch, I dropped the patch and went to just the eCig...then gradually dropped my vapor nictoine levels down to 0 mg...then no eCig. 

This process helped me learn a very important fact about myself - I am a pretty extreme introvert who used smoking to get quiet time outside away from people so I could recharge. Once I realized that, dropping the eCig was easily when I replaced it with walks around the parking lot when time in the office overwhelmed my introvert energy levels. 

I realize that my story may be unique but I know several people (also fellow introverts) who successfully quit smoking cigarettes and eventually eCigs through similar techniques. 

I still use a eCig occasionally during high stress times...but it sure beats smoking the three packs a day I smoked for years. My doctor has confirmed this...my bloodwork is normal for the first time in over 25 years. 

All of us are the same and different. What is important is that we really committ to changing our lives...even if it takes the baby steps of using a eCig temporarily as part of that journey.

intervention
Member

In the addiction treatment world vaping is considered an evidence-based tool for smoking cessation, and there is research to back this up. It is not safe, just 99 times safer than smoking. While total abstinence is clearly the best way it is not the only way, and harm reduction through vaping is saving millions of lives.  Why not "live and let live" and "whatever works"?

raymondhale22
Member

I agree with you

AshMustQuit
Member

We are all different and different people use different approaches. Every website I have visited say the same thing ;"not enough scientific research on the subject of vaping". What is clear is that the vape does not contain the tar and carbon monoxide and 5000 other poisons as the cigarette. In fact Forbes Magazine published an intersing piece on this some time ago.....in which researchers and doctors sadi that "nicotine was not the villain". In my view the opposition to vaping comes from a sponsored and collaborated attack from companies who make cigarettes because their profits are threatened. Sad to say even some doctors may have been hired to back that theory. I quit smoking....I use the vape pen on occasions and in quick time bodily function has improved.

You read the Forbes article here....https://www.forbes.com/sites/sallysatel/2015/06/19/nicotine-can-save-lives/

JonesCarpeDiem

      Forbes doesn't have a clue what makes people go back to smoking after 9 months of being nicotine free. I can tell you it's not the nicotine. The receptors that turn that nicotine into dopamine have normalized after a few months.  It's the ritual of smoking, the old routine that you miss.

       The only way to quit smoking is to unlearn it. How can you expect to do that if you're still going through the same hand to mouth and inhale ritual? (and still getting nicotine)

      If you want to be an active nicotine addict and  vape forever it's your choice. It doesn't affect me unless you blow it in my face. 🙂

PS There's a lot of things nicotine does that are damaging. Example: Constricts the vessels in your gums and damages them. Hardens your arteries by constantly constricting your blood vessels.

Lots of explosions from those Li Ion batteries too.

AshMustQuit
Member

Perhaps you didn't read my post well or you didn't comprehend my point. I never proposed to be an active nicotine addict as you have so skilfully propagandised. I said I use it on occasions. Didn't think the English was difficult there. There is no substance on earth that the body can handle if used in excess. Not just nicotine: Salt, sugar, coffee, alcohol, oil in foods and the list goes on. As for explosions of batteries, well guess we should all stop using cell phones as well.

Thomas3.20.2010

It sounds to me that you are doing your best to be a smart consumer AshMustQuit‌. I realize how mixed the research has been on e-cigarettes both because they are relatively new and because there's a lot of money at stake here. I would like to point out that Big Tobacco is not fighting e-cigarettes - they are buying into the industry big time and supporting research which promotes harm reduction as well with their new heat-not-burn devices. As to safety, we all do have to make choices. The responses here are not to propagandize - what do we have to gain? - but to show all sides of the know facts. Here is an article I hope you will read. 

We appreciate you and we respect your opinion and knowledge of current thinking. If e-cigs help you become nicotine free - wonderful! That's the goal! Best wishes and welcome! We're passionate about Freedom from Nicotine Addiction!

https://www.huffingtonpost.com/entry/tobacco-companies-taking-over-the-e-cigarette-industry_us_58b48... 

E-Cigarettes’ Risks and Benefits: Highlights From the Report to the F.D.A. - The New York Times 

AshMustQuit
Member

This was helpful. I quit smoking recently , used the patch a couple days then stopped that I switched to vaping with low nicotine and hopefully I can do as u did and taper off eventually. I don't use it as much as smoking. But I do. It is safer than cigarettes I think.....altho it has nicotine....certainly less dangerous.

AshMustQuit
Member

Thank you. I would read and attempt to digest. I do wish to be nicotine free, but its a struggle.

patamy1234
Member

I did stop smoking cigarettes 5 years ago but started smoking E-Cigarettes. They are just if not a wores habit. They are expensive and I always have one in my hand. Now I need to go to no more e-cigarettes. I want to stop smoking E-Cigarettes just as much as I did with tabaco cigarettes. I'm having a bigger problem trying to figure out how to quit those. If If anyone has some helpful suggestions I'm open to them.

JonesCarpeDiem

I'm happy you were able to quit smoking but sorry you can't quit vaping after 5 years.

Unfortunately, this is the outcome for the majority of people who use vaping to quit smoking.

Look at the actions involved with vaping. They are identical to smoking.

Most people who vape never stop because they don't realize how important breaking the ritual of smoking is to quitting.

Hand To Mouth And Inhale

Hand To Mouth And Inhale

Hand To Mouth And Inhale 

We got so comfortable with the ritual, that for vaper's, they never realized that feeling awkward and  being uncomfortable for awhile is the only way to quit smoking.

So, you have to figure out if you're going to use an aid or not.

You can cut a straw into thirds after you've quit if you need something to hold onto.

intervention
Member

Most vapers give up vaping after 18 months or so after quitting smoking. Even though we know that vaping is relatively harmless it sounds like you are at the point where you want to quit that as well. For most people it works best to gradually cut down on the nic levels. If you are at 12 trying going to 9 for a while, then 6, then 3, then 0 for a while. Then try the cinnamon toothpicks, baby carrots, etc. that others here suggest. Good luck!

JonesCarpeDiem

I'd really like to see your study regarding the 18 months.

thank you.

ellobo5150
Member

I have not only quit cigarettes for five years. I am now on a diet that

deals with insulin levels and became aware that vaping was increasing my

insulin level which was defeating what I was working toward in my diet. I

am now over a month off the vaping as well with no craving. For me I had to

find a reason that the vaping was harmful to me before I could let it go.

On Tue, Jul 17, 2018 at 4:45 PM jonescarp.aka.dale.Jan_2007 <

PrimeNumberJD
Member

*Just replying so I can say I had a conversation with a doctor on ecig usage.  

Truly informative, thank you for taking the time to write it; there are a lot of vaping questions that come in here!

Lindarivera
Member

Hi all !  I quit smoking cigs 68 days ago. However, I use the patch , gum and an e cig , I tend to use the e cig in the evening when I have my wine. I have been waking up anxious and nauseous . I was wondering if anyone knows if quitting smoking is why I’m anxious or is it the nrt.?  Help I hate waking up anxious

Barbscloud
Member

@Lindarivera Welcome to the Ex.   Yes quitting can make you anxious, but you only asked about quitting and the NRT  IF the e-cigarette contains nicotine , that could be  the cause. It's best  to eliminate all nicotine if you want to be a successful quitter.

"Recent studies reveal a troubling link between vaping nicotine and mental health. In fact, the nicotine in vapes can worsen anxiety symptoms and amplify feelings of depression."
 
Here's some great information to help with your quit.
 
We're here to support you so reach out anytime. 
Barb
 

 

About the Author
An expert in tobacco use and dependence, Dr. Hays has authored and co-authored over 70 peer-reviewed scholarly articles and book chapters on various aspects tobacco dependence and its treatment. Since joining the Nicotine Dependence Center in 1992, he and its staff have treated more than 50,000 patients for tobacco dependence.