- Talk about e-cigarettes positively
There is growing evidence to support the use of e-cigarettes as a safer alternative to smoking.1 Simply put, switching to vaping from smoking tobacco can reduce exposure to toxic chemicals that can lead to cancer in cigarette smokers. Public Health England estimates that vaping is 95% less hazardous than smoking, so don’t be afraid to view vaping as a viable replacement to tobacco for long-term smokers.2
- Encourage e-cigarettes as a part of a quit attempt
Approximately 1.5 million people (and counting) have stopped using tobacco products as a result of taking up vaping.3 But we often have smokers who are worried about incorporating vaping into their quit attempt. To put the risks of vaping into perspective we use Leicester GP Dr Paul Danaher’s analogy: ‘The risk of smoking compared with the risk of vaping is like a skyscraper next to a doorstep.’
- Advise vapers that they are not alone
Many smokers who use e-cigarettes in an attempt to stop smoking don’t realise that they can join a stop smoking programme. In fact, combining vaping with a structured programme is one of the most effective ways to kick the habit.
- Get the nicotine strength right
If a smoker has a social smoking habit and wants to vape when, for example, they’re drinking, they do not need a high level of nicotine. Advise them to ask a reputable vape shop for an e-liquid, or ‘juice’, with nicotine content similar to their current consumption.
- Inform that inhaling from an e-cigarette is different than ‘dragging’ on a cigarette
The correct technique to inhale vapour from an e-cigarette will differ from device to device, and will be different than smoking tobacco. New vapers will need to experiment and learn how to use their device effectively. For example, some devices require longer ‘drags’ and some require ‘short, sharp puffs’.
- Champion harm reduction
If the initial goal of a smoker is it to cut down, advise them that e-cigarettes along with tobacco can be used as a method for harm reduction. Referencing tip three, tell them that with the help of a stop smoking programme a harm reduction plan can be put in place.
- Endorse vaping and nicotine replacment therapy (NRT)
Combining an e-cigarette with a more traditional nicotine patch is a suitable solution to stop smoking and is growing in popularity.
- Advise using an e-cigarette for no more than three months
Vaping is a transition tool to cessation and not a permanent one. However, there is no need to rush a vaper to stop using their unlicensed nicotine replacement in the first three months of quitting. An ex-smoker is more likely to relapse in the first three months of quitting, so encouraging them to stop vaping during this period could result in a relapse.4
- Recommend vaping for forced abstinence
There are many scenarios when vaping can support a temporary need to stop smoking. In pregnancy and prior to operations are two urgent times that we recommend vaping to eliminate tobacco usage.
- Warn about the amount of e-cigarette options on the market
It’s likely a smoker has stuck to the same brand of cigarettes while smoking. So when they’re confronted by the amount of choices of e-cigarettes they must decide which device and ‘juice’ to use and whether to purchase a ‘starter pack’. It’s common to become discouraged. A reputable vape shop will allow a customer to try a range of devices and flavours, as well as answer their questions, to help them make an informed choice.
Kevin Kennie is a stop smoking nurse specialist at Chelsea and Westminster Hospital
- Shahab L, Goniewicz ML, Blount B, et al. Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study. Ann Intern Med 2017;166:390-400
- McNeill A, Brose LS, Calder R, et al. Evidence review of e-cigarettes and heated tobacco products 2018. London;Public Health England:2018
- NHS. Smokefree – E-cigarettes. London;NHS:2017
- Rademacher L, Prinz S, Winz O, et al. Effects of Smoking Cessation on Presynaptic Dopamine Function of Addicted Male Smokers. Biological Psychiatry 2016;80:198-206