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Help and advice on quitting smoking

Quitting with electronic cigarettes: how it’s done

Many smokers use electronic cigarettes as a way to quit their smoking habit, although there is a lack of clear scientific evidence on the efficacy of this method of quitting. How can you successfully give up smoking with an e-cigarette? Advice from Dr Philipe Presles, specialist in tobacco-related illnesses, author of the book, “The Electronic Cigarette. An easy way to give up smoking at last” (La cigarette électronique. Enfin la méthode pour arrêter de fumer facilement).

Quitting smoking with electronic cigarettes, some studies

Few studies have tested e-cigarettes as a tool for quitting smoking (1, 2, 3). Siegel et al. (4) reported that 31% (69 out of 216) of people questioned gave up smoking after having used e-cigarettes for six months. Among those who had quit, 57% still used e-cigarettes, 9% used tobacco products containing nicotine and 34% had overcome their nicotine dependence. Polosa et al. (5) discovered that 22.5% (9 out of 40) of participants had not touched a cigarette for six months. In this cohort, 67% were still using e-cigarettes compared to 33% who were no longer vaping. The Bullen study, published in The Lancet in 2013, showed that electronic cigarettes were at least as efficient as patches in the quitting of smoking and considerably better than patches in reducing tobacco usage (6). However, this study was carried out with a type of electronic cigarette available before 2012, which was not as efficient in its release of nicotine.

A very recent study seems to suggest that, on the contrary, electronic cigarettes are no help in giving up smoking. (7) However, this study has some weak spots, particularly with regards the statistics used, as even its authors have admitted.  Barbeau et al. (8) reported that electronic cigarettes, compared to substitutes such as chewing-gum, patches and inhalers had fewer disturbing side-effects and were more likely to avoid a relapse.

There is, therefore, currently no study on quitting smoking over the long-term and using a more recent model of electronic cigarette, which would answer the two key questions: can electronic cigarettes provide a tobacco substitute, comparable to other nicotine substitutes? Can it be even more effective than these other alternatives?

Quitting smoking with electronic cigarettes: in practice

 “You don’t have to stop smoking tobacco before starting to vape” explains Dr Philippe Presles. He recommends that in the first month of trying e-cigarettes, you find the model and flavour that suits you best. With regards the model, the easiest is to start with a kit that has two whole electronic cigarettes and an automatic feed. The doctor recommends that new vapers choose a device like eGo which suits most people, and to leave the smaller models to those smoking fewer than five cigarettes a day.

There are three main criteria when choosing the e-liquids: the level of nicotine, the ratio of propylene glycol to vegetable glycerine, and the flavours. “The important thing is to feel good, so it’s worth trying out different doses” Dr Presles insists. The one that best suits you is the one that gives you the best feeling, the best “hit” (feeling in the throat) and which above all avoids you getting nicotine withdrawal symptoms (strong urge to smoke, irritability, anxiety, impatience, depression, mood swings, difficulties in concentration, insomnia, increased appetite, weight gain). Similarly, you should try different flavours in order to find the one, or ones, that you like best. Finally, choose the amounts of propylene glycol and vegetable glycerine which suit you best in terms of taste, “hit” and vapour density.

“Electronic cigarettes will generally replace other kinds of cigarettes after a month of vaping” says Dr Presles. If you’re not satisfied, you will have to look for a better model, try a stronger nicotine dose or a different flavour” the doctor adds. Should you gradually reduce your nicotine intake in order to be able to quit? “No, not necessarily” replies Dr Presles, who says that about half of people spontaneously reduce their nicotine dose after a month of vaping. If you still continue to vape after quitting tobacco it’s not a problem. “The most important thing is the goal of having one year without tobacco” he confirms. You need to vape with a sufficient level of nicotine and as long as necessary to avoid withdrawal symptoms and to avoid starting to smoke again.

Further advice from Dr Presles in order to quit smoking with e-cigarettes :

- don’t hesitate to use a 21 mg patch if you still need to smoke four to five cigarettes a day, as well as vaping. “That will remove the residual craving” he explains.

- make sure you have extra emergency supplies to ensure you don’t run out of refills, for example, and to avoid having to buy cigarettes. You can always keep a supply of disposable electronic cigarettes as a “safety cushion” for example.