Want to quit vaping? Compared with cigarette smoking, it might be even harder

Inspired and scared by the recent spate of US hospitalisations and deaths from a mystery respiratory illness linked to vaping, young people can be seen throwing out their e-cigarettes on social media, vowing to quit.

Just as there is a lot to learn about e-cigarettes – a relatively new trend that is especially popular among young people – doctors say there is little known about how to successfully quit.

“Are we going to use the same techniques and medications [used for quitting traditional cigarettes], or are there unique features?” says Andrea King, professor of psychiatry and director of the Courage to Quit programme at the University of Chicago.

She adds that as these products have come on the market and been rapidly adopted, there just hasn’t been enough time to develop specific treatment programmes for those looking to quit vaping.

Because the basis of a vaping addiction is nicotine, King says, it’s possible that traditional methods for quitting could work. Those use a combination of counselling on changing behaviours together with medications that quell nicotine cravings, and are proven to be more effective than someone going “cold turkey” or quitting on their own.

But experts wonder if the higher levels of nicotine inhaled during vaping when compared with traditional cigarettes could make quitting more challenging.

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“It’s almost going to be easier to get people off traditional cigarettes than e-cigarettes because of the dose [of nicotine],” says Dr Sana Quddus, a pulmonologist at Loyola University Medical Centre in Maywood, Illinois.

There are other factors that make vaping unique. Users may also vape THC, the ingredient in marijuana that creates a high, and they tend to be younger, even adolescents, a group that hasn’t been studied when it comes to medications and other resources that help people kick smoking.

In King’s programme and others, the strategy is to use a combination of techniques. The programme educates and helps change behaviours with individual, group or phone counselling, King says, and also uses medication such as Chantix that interferes with the brain’s response to nicotine. Nicotine patches or gum can also help ease the symptoms of nicotine withdrawal.

But dosing is an issue for those looking to quit vaping, says Lori Wilken, a clinical pharmacist at the University of Illinois at Chicago who runs a tobacco dependence clinic.

For patches and gum, which deliver smaller, slower amounts of nicotine to ease withdrawal symptoms, dosing is based on how many cigarettes someone smokes each day, Wilken says. When patients come to her hoping to quit vaping, she has to estimate a dose based on how many pods they vape, which usually have higher amounts of nicotine that enter the system faster.

Wilken and others who run quitting programmes say that while they often deal with adults, adolescents could benefit from seeing other peers quit, in addition to traditional cessation methods.

“A traditional smoking group isn’t exactly the right fit,” says Jim Brunetti, clinical director at the Renz Addiction Counselling Centre in Elgin, Illinois, who is developing a new programme geared toward teens who want to quit vaping.

The centre would like to partner with school districts to offer the programme, which refers students caught vaping at school to a “psychoeducational group” where they learn about the harmful effects of e-cigarettes and nicotine withdrawal alongside their peers, Brunetti says. Then, they break into groups for individual counselling, while their parents also receive education on vaping. Afterwards the students and parents come together.

“It’s really important for parents to be a part of this and have knowledge and also offer support,” Brunetti says. “It also opens up a conversation where they can show they’re invested, interested and they care.”

Parents and teens alike are becoming more aware of vaping after reports emerged in the US earlier this summer of otherwise healthy patients who regularly vape requiring hospitalisation after they struggled to breathe.

The respiratory illness still mystifies public health officials, who continue to investigate the cases. The US Centres for Disease Control and Prevention has confirmed 380 cases across the country. At least seven of those patients have died.

Dr Kiran Bojedla, a family medicine doctor at Advocate Christ Medical Centre in Oak Lawn, Illinois, says he has had patients and friends come to him, asking how to cut back on vaping, “similar to the cigarette panic that slowly happened over decades”. But with vaping, “it feels like it’s all at once”.

He says traditional smoking cessation programmes now address vaping but use traditional smoking cessation philosophies.

Bojedla says he is also concerned that adults who turned to vaping to quit smoking could be tempted to return to their prior bad habit. He tells them “as much as possible, try not to do either”.