Can vaping help you quit smoking? | BU today

Teen vaping fell sharply in 2021, the second year in a row to experience a sharp decline. As research and debate continues on whether the use of e-cigarettes can actually help a person quit smoking traditional cigarettes, BU today spoke with Andrew Stokes, assistant professor of global health at the BU School Public Health.

You can also find this episode on Apple Podcasts, Spotify, Google Podcasts, and other podcast platforms.

Take away food

  • As an alternative for those who have tried other FDA-approved measures, such as nicotine replacement, and failed, in theory, e-cigarettes may help some smokers quit.
  • The problem: most people in the United States who adopt e-cigarettes switch to using both cigarettes and Electronic cigarettes
  • While the FDA decided to take vaping flavors off the market, Andrew Stokes and other public health players are still extremely concerned about the appeal of flavors to young people.


Dana Ferrante: It is Question of the week, of BU today.

Can vaping help you quit smoking? In this episode, Doug Most, BU today editor-in-chief, chats with Andrew Stokes, assistant professor of global health at the BU School Public Health, about the recent FDA clearance for e-cigarettes and whether vaping can actually help adult smokers quit smoking . While the FDA has rejected flavored vaping products, Stokes is examining how FDA clearance for e-cigarettes could impact vaping and e-cigarette use among young people.

Doug Most: Andrew, thank you for being with us. The FDA has for the first time authorized the sale of an electronic cigarette in the United States. The agency reported that the help that some vaping devices offer smokers to quit traditional cigarettes outweighs the risk that these vaping devices will attract a new generation of smokers.

We’ll settle this with Andrew Stokes. Can vaping help you quit smoking?

Andrew Stokes: Well, thank you for having me, it’s a real pleasure to be here. In theory, electronic cigarettes can help some smokers to quit. In particular, it can be an alternative for people who have tried other FDA approved measures, such as nicotine replacement, and have failed with those solutions.

The problem is that today, at the population level in the United States, most of the people who adopt e-cigarettes are switching to dual-use cigarettes and e-cigarettes. While they can reduce their cigarette consumption, we see very few people in the cigarette smoker population who switch completely from device to device.

More: What was your reaction to the FDA’s announcement that they believe it can help people quit smoking traditionally. Were you surprised by this decision?

Stokes: I was a little surprised, but to be honest the FDA is kind of stuck in a difficult position. The FDA must balance the significant harms of smoking in adults with the epidemic of e-cigarette use in youth and young adults.

So they really had some tough decisions to make here. And honestly, whatever the decision, there will be a lot of unhappy parties. Overall, it is difficult to say what this decision will mean for public health; time will tell us. But there are certainly many potential issues with their decision. And we are extremely concerned about what that means for the youth and young adults of this country.

More: Do you think the FDA’s decision may have been influenced by [some] by the study that was published that showed how much vaping has declined in the past year after the peak of the pandemic? Do you think the FDA could have been influenced by this?

Stokes: Well, that’s a great question. I think most reasonable analysts see this trend as some kind of an anomaly in the context of long-term increases since about 2015, 2016. So I would say that most of us expect a rebound in e-cigarette use among youth and young adults as they go back to school and have more independence. and are able to take control of their lives.

So I don’t think that was an important part of the decision.

More: What are your concerns and what has your research revealed regarding the idea that mainstream smokers are using vaping as a way to try something different? Or is it the feeling that it really is a desire to quit smoking and that they see vaping as some sort of first way forward?

Stokes: Another big question. There are clearly several phenotypes of cigarette smokers in the country in terms of electronic cigarettes. You see some cigarette smokers buying electronic cigarettes for convenience, because of course, smoking is prohibited in many places, especially indoors, in stadiums, etc. So for some people it’s just a matter of convenience, for others they have tried some FDA approved devices and therapies and they have a hard time quitting, and they resort to e-cigarettes because of the satisfaction they feel with these products.

But what we are seeing is that a lot of people who adopt e-cigarettes use both products, so very few have made the switch to e-cigarettes. But notably, in terms of the public health implications for those who can switch to e-cigarettes entirely, we believe there is some potential for harm reduction.

More: And the flavors? What impact the aroma[s] have on the appeal of e-cigarettes? Is this something that worries you, especially among younger people?

Stokes: A lot. We are extremely concerned about the flavors. And we’re delighted that the agency has ordered thousands of vaping products on the market, including puff bars, that are fruit and candy flavored and appeal to young people.

So, it looks like the FDA has decided to take the flavors off the market. The caveat to this is that ultimately all devices are flavored in one way or another. You could say that even the flavors of tobacco will appeal to young people. And in that sense, we are certainly not clear even with these new decisions that have been made.

More: Where do you see the FDA going from here? Do you see this as a one-time decision, or do you think it is the first of several other decisions on e-cigarettes and vaping? [devices] which could come from the FDA which [allow] a little more leniency on [the circulation of e-cigarettes]?

Stokes: The big next step is to strengthen the strict regulations on traditional cigarettes. Remember, traditional cigarettes still kill 400,000 adults each year in the United States. It is one of the main causes of death in this country. And so I think the FDA will be very focused on what we can do more regulation to reduce the consumption of traditional cigarettes, and have those users switch to either e-cigarettes or other FDA approved therapies.

we will have to see with [electronic cigarette company] JUUL; we don’t know what’s going to happen with JUUL. We know they go through certain types of authorization processes, but we’ll see what happens.

Ferrante: Thanks to Andrew Stokes for joining us on this episode of Question of the week.

If you enjoyed the show, subscribe wherever you listen to podcasts and never miss an episode. I am Dana Ferrante; See you next week.

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