Will vaping help smokers quit?

Vaping is the act of inhaling and exhaling vapours of nicotine mixed in a liquid medium through a personal vapouriser that is delivered through a battery operated e-cigarette.

Towards de-addiction

Dr Konstantin Farsalinos, MD, Research fellow at the Onassis Cardiac Surgery Centre, Athens, who has done research on the subject and is teaching at the University of Patra, Greece and at the National School of Public Health, Greece, is a strong supporter of vaping as a solution towards smoke addiction reduction.

Speaking to Gulf News from Athens, he said: “I welcome the UAE government’s decision to lift the ban as it is evidence and research-based.

“Eventually, cessation of smoking is the objective. But there are three lines, or methods, to reach this. The first option is to quit smoking without any aid, which only 5 per cent of smokers achieve; the second is to use aids like patches, gums lozenges or prescription medication which research has shown achieves success in only 20-25 per cent of smokers. The quit rates are disappointing. Smokers need a third line or option to slowly help them wean off the habit. Introducing [vaping] option to the UAE residents might help the cause of smoking de-addiction,” said Dr Farsalinos.

Citing the case of UK, Dr Farsalinos said: “Legalising vaping has proved to be helpful in UK. Today, that country has historically an all-time low figure of smokers. Following that example, New Zealand and Canadian health ministries too have lifted ban on vaping. The evidence in the role of e-cigarettes helping the cause of de-addiction is overwhelming,” he added.

Smokers in UAE

In a survey conducted by Dr Farsalinos in 2014 on 19,441 e-cigarette users worldwide, it showed minimal adverse effect on smokers’ health. When compared to smoking, the impact was 1/100th to 1/20th.

According to the 2013 report of the World Health Organisation (WHO), 19 per cent men and two per cent women in the UAE are smokers.

The UAE National Health Agenda 2021 has set a goal of reducing this figure to 16 per cent in men and 1.7 per cent in women.

A 2016 report of the Tobacco World Atlas indicated that over 900,000 people in the UAE use tobacco by way of cigarettes, medwakh or other such nicotine products that resulted in the death of 2,900 people in one year and cost the country $569 million (Dh2.05 billion) by way of lost productivity and health care costs.

Lung cancer features among the top five cancers in the UAE and about 3.7 per cent of the UAE residents suffer from Chronic Obstructive Pulmonary Disease (COPD), which is a progressive disease mainly caused due to the damage the lungs suffer with the use of tobacco containing nicotine and other harmful chemicals inhaled with the combustion of cigarettes.

In favour of vaping

Those who support vaping argue that it can help thousands of smokers in nicotine de-addiction. A survey conducted on the toxicology and chemistry and safety of e-cigarettes in comparison to actual paper filled with shredded tobacco cigarettes indicated that while conventional cigarettes contained 4,000 deadly chemicals like tar, ash and carbon mono-oxide that a smoker inhaled with the combustion of nicotine, vaping involved no combustion and the vaper had a safer alternative and better control over his addiction.

Dr Farsalino added: “Evidence has shown that after a smoker reaches a desired level of brain stimulation with nicotine, he can automatically stop. In vaping, he is able to do that and switch off nicotine inhalation. [On the other hand], a smoker usually smokes a complete cigarette and does not usually stop halfway. Vaping helps the smoker work towards lesser and lesser brain stimulation with nicotine.”

Counterpoint

Those who believe in quitting smoking through specific smoke cessation clinics beg to differ and think vaping can lead to an addiction to e-cigarettes and also attract a large section of the younger adolescent population to vape.

Christine Kuun, the founder of the Smokenders Clinic, Middle East, told Gulf News: “We have been dealing with the smoking addiction for many years and believe that nicotine addiction is just one of many elements that need to be dealt with in terms of the addiction.

“In fact, as more research is being done, it appears that vaping comes with its own set of risks and side-effects, and many people end up transferring their smoking addiction to a vaping addiction. Because of this, they also end up trying to find ways to kick their vaping habit.

“This has prompted our US franchise to start working on a programme to help vapers kick the habit too [this should be available shortly after summer].

“Therefore, we believe vaping alone is not the best smoking cessation solution but could be used jointly with another more comprehensive smoking cessation programme to help a smoker kick the habit for good.”

It is worthwhile to note that despite the hype about e-cigarettes, the WHO is yet to give its stamp of approval to e-cigarettes as a safe alternative towards smoke de-addiction.

What are e-cigarettes?

E-cigarettes refers to a group of Electronic Nicotine Delivery Systems (ENDS) available in the market. These could be vape pens, vaporises or battery operated glass pipes and other such devices. The latest third generation e-cigarettes are Variable Wattage Battery (VWB) battery devices that give the smoker the choice of switching flavours.

The generic structure of an e-cigarette consists of four parts. These include :

■ a mouthpiece, or cartridge that contains the nicotine.

■ a heating element or atomiser that helps dissolve nicotine in the liquid propelene glycerol solution that is food grade and approved by FDA. The atomiser can be a fixed button, a changing port to help switch flavours or a power coil that heats up with the suction action.

■ a rechargeable battery that helps heat the atomiser.

■ electronic circuits are sensors that heat up the device to vaporise the liquid.

The price of a puff: Comparative costs of smoking devices

E-cigarette device

■ Price: Dh90 for 5 pods (one pod lasts a week; Dh12 or less per week).

■ Nicotine content: 1 pod = 20 cigarettes worth of nicotine.

Regular cigarettes

■ Price: Pack of 20 from Dh6-20.

■ Nicotine content: Average amount in 1 cigarette: between 8-20 milligrams.

Cigars

■ Price: Dh150-Dh3,000 (box of 5, 10 and 25 cigars).

■ Nicotine content: 1 cigar typically contains between 100 to 200mg of nicotine.

Maheen Mohammad, founder of a travel agency

Smoked 15 cigarettes a day for 40 years and was able to kick the habit for 1.5 years using an e-cigarette. 

I bought an e-cigarette online because I hated coming down 11 floors for a smoke when at work. I realised vaping helped me control my nicotine intake and I was able to reduce that progressively. Compared to regular cigarettes, I always felt lighter and better with vaping. I was able to wean myself off cigarettes completely.

- Maheen Mohammad

Urvashi Kadam, PR consultant

Using the smoke cessation programme at a clinic, Kadam was able to quit her habit of smoking a pack of cigarettes for 40 years. 

When I signed up, I had strong doubts whether it would work — especially since I had smoked for over 40 years. However, the programme allowed me to smoke for a period of time while systematically tracking my patterns and triggers and breaking all of them. When my quit date came, I was able to kick the habit comfortably. I have been smoke-free for a few months already and have no desire to go back.

- Urvashi Kadam

Satyajeet Bhattacharjee, businessman

Smoked up to 30-40 cigarettes for 22 years; quit four years ago

My friends challenged me in December 2014 [to quit smoking] when I visited Mumbai. On January 1, 2015, I gave up smoking. Initially, I had a lot of trouble and had to have half a nicotine gum a day for six months. I would ask my friends to smoke to take a sniff. However, I never went back to smoking. Now, I cannot stand the smell of cigarettes.

- Satyajeet Bhattacharjee