Cigarette smoking continues to be one of the top causes of preventable deaths globally. In more prosperous countries, such as the United States, smoking cessation programs play an important role in helping smokers who want to quit achieve their goals for better health. However, these programs aren’t maximizing their potential because they completely disregard e-cigarettes as a viable option for those who have a more difficult time with the current abstinence-centric approaches.
Each state varies in its approach to smoking cessation programs. But there is a nearly universal strong anti-vaping stance across states that considers e-cigarettes to be just as undesirable as traditional cigarettes. It’s atypical for a national health organization or individual cessation program to include vapes in their official guidelines. Still, many have endorsed them as a valid option for those looking to quit.
Contrary to widespread belief, there is substantial proof that e-cigarettes are a viable and successful cessation tool. The Cochrane Review, a well-regarded research institution that prides itself on evidence-based healthcare guidance, concluded that those who used nicotine-containing e-cigarettes in their quitting attempts were 60% more likely to succeed than those who use standard nicotine replacement. Another bout of misinformation would also lead most to believe that vaping and smoking are comparable in the harm they inflict on the individuals who use them. The Institute of Psychiatry, Psychology, and Neuroscience (IoPPN) at King’s College London finds vaping to be at least 95 percent less harmful than cigarette smoking.
The United Kingdom’s National Health Service (NHS) recognizes vaping as a successful smoking cessation strategy and has included e-cigarettes in its official guidelines. However, it emphasizes that quitting smoking entirely provides the most health benefits. This strategy balances educating and respecting individuals who smoke by providing them with the most current information possible.
The New England Journal of Medicine (NEJM) has also taken a significant step toward changing the present social paradigm, publishing an editorial urging American healthcare professionals to reassess their negative opinions of e-cigarettes as a harm reduction tool. Providing holistic and current data is the only way to ensure that we are putting our best foot forward in public health efforts.
Traditional cessation programs based on abstinence principles and behavioral intervention have been found ineffective for many smokers, yielding a mere 7-16% success rate. States need a shift in program design and approach. By incorporating e-cigarettes as a smoking cessation option, programs will be more inclusive of those who are unable or unwilling to quit via nicotine replacement therapy, total abstinence, or other means. A complicated problem involving individuals with varying degrees of addiction needs a broader range of treatment options and equitable access to more effective quitting aids.
To better achieve their smoking reduction goals, state health departments should update their smoking cessation guidelines to reflect the latest research and consider new tools or strategies that can be used in their programs. This culture shift would be so different from the present messaging that specialists leading these programs must be appropriately informed on the value of e-cigarettes as a quitting strategy for adult smokers.
While state smoking cessation programs are beneficial, they must shift from an abstinence-based definition of success to one that includes harm reduction techniques as well. Substantial evidence supports the inclusion of e-cigarettes in treatment programs and recommendations. Including these harm reduction measures in our toolkit will provide a thorough and successful path to quitting, lowering overall death and disease rates.