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Quitting Smoking and the Use of e-Cigarettes


The New Year heralds a flurry of resolution-making, much of which centers on improving health. One common resolution is quitting smoking—an excellent goal that promises numerous health benefits if it can be sustained long-term.

Those who have tried to quit smoking, however, can attest to the difficulty of successfully kicking the habit. Nicotine is highly addictive, comparable to cocaine and heroin, according to some research. Because of nicotine’s addictive nature, the unpleasant effects of withdrawal are usually felt within the first 24 hours without smoking. Withdrawal symptoms can include anxiety, poor sleep, depression, irritability, difficulty concentrating and restlessness. The discomfort of withdrawal often leads people back to smoking, and the vicious addiction cycle continues.

Yet, breaking the smoking habit is achievable with the help of different treatment options. One product advertised as a smoking cessation tool is the electronic cigarette (or e-cigarette). The use of e-cigarettes has risen substantially in the past few years, among adults and adolescents. But are they really the safer alternative? Understanding the risks of e-cigarettes is vital for individuals looking for the means to truly quit smoking.

What are e-cigarettes and how do they work?

  • Devices that deliver nicotine and/or other substances as a vapor
  • Consists of three components:
    • Power source (battery or USB connection)
    • Heating element
    • Solution or e-liquid composed of nicotine (some solutions labeled as nicotine-free contain nicotine), flavorings and other chemicals which may be toxic or carcinogenic

Should e-cigarettes be used for smoking cessation?

Though this issue has been debated, research does not support e-cigarettes as useful tools for quitting nicotine. One major reason is a lack of e-cigarette regulation. The FDA has found “significant quality issues” with these products, and quality control has been “substandard or non-existent.” Other concerns are the re-normalization of conventional cigarettes and the attraction of non-smokers to nicotine through the many flavors of e-cigarettes. Finally, e-cigarettes pose health risks, including exposure to carcinogens and other toxic substances.

Are e-cigarettes a gateway drug?

Among adolescents, research has shown that e-cigarette use was associated with more cigarette smoking, not less. Additionally, there is an increased risk for turning to conventional cigarettes after starting e-cigarettes. In short, research shows that e-cigarettes are far from a healthy alternative to conventional smoking and should be treated similar to regular cigarettes.

What are effective treatment options?

FDA-approved treatments for nicotine:

  • Nicotine replacement therapies: nicotine patches, lozenges, chewing gums, inhalers and nasal sprays
  • Medications: varenicline (Chantix) and bupropion (Zyban)

Other effective treatment options include counseling and behavioral management through which individuals are taught to recognize risks factors associated with nicotine use and to develop coping strategies. Many resources are available at, 1-800-QUIT NOW and you can view video Tips from Former Smokers from CDC. .

About the Author

By Seth Judd, D.O.
Psychiatry Resident, Indiana University School of Medicine
American Psychiatric Leadership Fellow


Patients and FamiliesAddiction


Comments (2) Add a Comment

  • Susan T. Haney, MD

    Have the health risks of second-hand exposure to e-cigarette smoke been studied? If so, what are these risks? If not, how/why were e-cigarettes FDA approved?

  • Prof Frank Ashall

    No- the effects of passive exposure to e-cigarette vapour have not been properly studied or elucidated. What is clear that there are toxins, nicotine and propylene glycol and other chemicals in the vapour, but just how much of a risk they pose to "passive vapers" is not clear. There is accumulating data that some chemicals, such as flavourants, are present in e-cigarette vapour and may potentially pose significant health problems to passive vapers. There are thousands of these flavourants, and they are approved for oral consumption in foods but not for inhaling into the lungs, so there may be unexpected respiratory problems with regular inhalation of these flavourants and other e-cigarette chemicals. E-cigarettes constitute yet another potential health problem unless they are regulated properly. The sole reason they are being marketed and sold out there to our children and youth in thousands of flavours, colours and styles is that they are putting money into the bank accounts of greedy e-cigarette manufacturers and sellers, most of whom really have little or no interest in the health of people.


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