Is vaping a good alternative to smoking?

It makes cents: Smokers who quit have good reason to switch to vaping

Ina Skosana, Amy Green
Many smokers find quitting impossible, but vaping can reduce tobacco-related harm.

For almost 20 years, Johannesburg resident Justin Adan smoked more than a pack of cigarettes a day. Three months ago he started using an e-cigarette and noticed a difference in his health and in his pocket. 

Now he smokes a cigarette only now and again, "like when I forget my vaper in the office and I’m outside with the smokers, or when I need to recharge it or run out of juice. But I no longer have a burning desire to smoke." 

E-cigarettes deliver nicotine in the form of a vapour, which is inhaled. They are battery-operated and the vapour comes in a variety of flavours. 

Research by the Royal College of Physicians in the United Kingdom, which was published in April 2016, found that e-cigarettes are safer than conventional cigarettes and are suitable for smokers "who are trying to reduce harm to themselves or others from smoking, or to quit completely". 

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E-cigarettes are relatively new and one of the biggest concerns raised about the safety of using these devices is the long-term effect. According to the Royal College study, the health hazard from the long-term use of e-cigarettes is "unlikely" to be more than the harm caused by cigarettes. 

But South Africa’s health department argues that this has not been proved. 

"I realise that the safety is unknown at this time. But my personal experience is that it’s a lot better than actually smoking," says Adan. 

A keen gym-goer, he says his physical improvement was almost immediate. "I feel better and am able to train a lot harder now than before." 

Another upside to vaping, says Adan, is the cost. He started using e-cigarettes three months ago and spends about R900 a month on them. He was spending R1500 a month on cigarettes. 

But that is not why he started. 

"The main reason I switched over is because of my wife. She hates the smell of cigarettes." 

For Adan, the e-cigarette has made him feel healthier, helped him to save money and improved his relationship with his wife. But what does the research say?

Are e-cigarettes safer than normal cigarettes?  

Tackling nicotine addiction
In 2014 the Cochrane Library, a peer-reviewed healthcare research platform, published a scientific review of the evidence for and against the use of electronic cigarettes to either help a smoker quit cigarettes or reduce tobacco smoking. The review included the two best studies out of almost 600. The studies involved more than 600 people. 

The findings include: 

  • Almost half the people who try to quit "cold turkey" don’t manage to stop smoking for even a week. 
  • Less than 5% of people who try to quit without support are tobacco-free for up to a year. 
  • After one year the average quit rate for a widely used antidepressant medication, bupropion, marketed as Zyban, was between 18% and 30%.
  • After one year the average quit rate for nicotine replacement therapy, which includes patches and gum, was 15%. 
  • One of the reasons the quit rates remain low is that "none adequately addresses the sensory and behavioural aspects of smoking that smokers miss when they stop smoking". 
  • Tobacco is primarily addictive because of the ingredient nicotine, which activates the reward system in the brain. But research has shown that "sensory and behaviour cues" such as holding a cigarette and the sensation of inhaling smoke "over time become almost as rewarding as nicotine". 
  • Just under 10% of people who use e-cigarettes that contain nicotine quit smoking tobacco after a year. 
  • But people who use an e-cigarette are more likely "to cut down the amount [of tobacco] they smoked by at least half" – a greater reduction than people who use the nicotine replacement patch. 
  • Electronic cigarettes with nicotine seem to help smokers who are unable to quit altogether reduce the amount of harmful tobacco they consume, more so than electronic cigarettes that do not contain nicotine, and more than nicotine replacement patches. 
  • There was no evidence that "short-term [e-cigarette] use is associated with health risk".

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