Smoking has a lot of consequences to one’s health. It can lead to cancer, heart disease, and chronic obstructive pulmonary disease—all of which are chronic diseases. This is part of the reason why the Health and Human Services agency reports that 70% of adult smokers want to quit. As a medical provider, adults looking to stop smoking will come to you for advice and treatment. One alternative smoking product you might want to recommend is an e-cigarette, given their prevalence in recent years.
In this article, let’s take a deeper look at whether e-cigarettes’ should be recommended for smoking cessation and what other treatment options to endorse to patients.
Are e-cigarettes approved for smoking cessation?
Electronic cigarettes, more commonly known as e-cigarettes, are devices that vaporize nicotine-based liquid to be inhaled by its user. It almost replicates the experience of smoking a cigarette due to the device’s shape and the vapor it produces. However, the FDA has yet to approve e-cigarettes for smoking cessation because there is currently limited research on their effectiveness, benefits, and risks for the human body.
Additionally, scientists at the University of California found harmful metals in the vapor from tank-style e-cigarettes. These e-cigarettes are equipped with high-power batteries and atomizers to store more liquid. These result in high concentrations of metals like iron, lead, and nickel in the vapor. Exposure to and inhaling metallic particles may impair lung function and cause chronic respiratory diseases. As such, medical providers should not recommend e-cigarettes for smoking cessation.
What can medical providers recommend for smoking cessation?
Smoking cessation medication
Presently, two FDA-approved prescription medicines for smoking cessation are Bupropion and Varenicline. Bupropion is an antidepressant that decreases tobacco cravings and withdrawal symptoms. It does this by increasing the brain chemicals dopamine and noradrenaline. This comes in a pill and can be used alongside other smoking cessation aids.
Varenicline also reduces cravings and nicotine withdrawal symptoms. It blocks nicotine receptors in the brain, decreasing the amount of enjoyment one gets from smoking. One thing to note about this is that it will take several days for Varenicline’s effects to take place. Therefore, it’s best to prescribe these pills 1-2 weeks before the patient quits smoking. Like Bupropion, Varenicline may be used simultaneously with other quit-smoking products.
Nicotine Replacement Therapy
Nicotine replacement therapy (NRT) is a treatment involving nicotine consumption at gradually decreasing levels. This reduces the patient’s desire to smoke without them having to quit cold turkey. NRT involves using nicotine alternatives that don’t produce smoke, such as nicotine pouches and nicotine gum.
Nicotine pouches are oral products containing ingredients like nicotine, flavoring, and plant-based fibers. These are placed between the lip and gum, where nicotine is absorbed into the bloodstream. Different variations have different strengths. On! pouches come in different strengths: 2mg, 4mg, and 8mg. Patients may start from 8mg variants and gradually decrease this dosage as their NRT progresses. Pouches also come in a wide range of flavors—including citrus, mint, and berry—to entice users.
Meanwhile, nicotine gum is chewing gum that contains nicotine. It is chewed a few times before being parked between the gums and cheek for nicotine absorption. The nicotine gums by Lucy are a significantly better alternative for tobacco users. Like pouches, this gum comes in several flavors, such as cinnamon, mango, and wintergreen, and different strengths ranging from 2mg to 6mg.
Counseling
The recommendations mentioned above—medication and NRT—are more effective when coupled with counseling. A Primary Care Respiratory Medicine study revealed that successful smoking cessation is best attained through pharmacological treatment and counseling. Sessions typically involve a patient meeting with a counselor and they discuss their smoking habits, possible causes, and how to mitigate them. Medical providers should include counseling in addition to medication and NRT.
E-cigarettes have yet to be approved by the FDA as smoking cessation aids. For now, medical providers should provide medication, NRT, and counseling to patients who want to quit smoking.
