Switching from tobacco cigarettes to e-cigarettes can be an effective way to stop smoking, but some former smokers can’t stop vaping once they’ve given up conventional cigarettes. Other smokers are unsuccessful in their attempt to quit smoking, and start using both conventional and e-cigarettes, thereby adding to the risk to their health.

More than 60 percent of e-cigarette users want to quit, but there have been no evidence-based treatments to help people who want to stop vaping, researchers from the Medical University of South Carolina’s Hollings Cancer Center report, in a new study.

There is a big difference between people who say they want to quit vaping at some point, and those who say they want to stop soon.

Many patients find it challenging to quit vaping, Benjamin Toll, the senior author on the study and Chief of Tobacco Cessation and Health Behaviors at Hollings, said. “I think we are doing patients a disservice by not having rigorous research to give them appropriate, evidence-based care.”

Doctors and other medical providers should keep an open mind when they are talking to patients who use e-cigarettes. “A lot of older adults face stigma about their e-cigarette use, when it is really a tool to help them quit smoking,” Amanda Palmer, first author on the study, told TheDoctor. Providers might think of e-cigarette use as an alternative outcome.

The responses of almost 2,000 people who reported regular e-cigarette use as part of a national survey of 30,000 people were used in the study. Participants were classified as never smokers, who never smoked conventional cigarettes, but who started using e-cigarettes for different reasons; dual users, who smoked conventional cigarettes and used e-cigarettes; and former smokers, who quit smoking conventional cigarettes more than 30 days ago, but continued to use e-cigarettes to help them avoid smoking again.

Never smokers had the highest rate of past attempts to quit vaping (about 21 percent) compared to dual users (about 15 percent) and former smokers (about eight percent). More former smokers said they planned to quit vaping (about 66 percent) compared to never smokers and dual users.

“A lot of older adults face stigma about their e-cigarette use, when it is really a tool to help them quit smoking.”

“The percentage of people interested in quitting were about what I’d expected, but there are a lot of unanswered questions in this data set,” said Palmer, a postdoctoral fellow in public health at the Medical University of South Carolina (MUSC).

One question that needs to be considered is why people want to quit vaping. The answer is likely to be somewhat specific to the person. Some people may want to quit because they have concerns about the health effects of nicotine. Others may be bothered by having a psychological dependence on e-cigarettes or are concerned about the withdrawal symptoms they experience if, for example, they have a job where they cannot vape. The expense of e-cigarettes is likely another factor in vapers' desire to quit.

“Asking the simple question ‘Why do you want to quit?’ will give providers insight into how much patients care about their health and how much work they have been doing to improve their health,” Palmer believes.

There is a big difference between people who say they want to quit vaping at some point, and those who say they want help to stop vaping soon, she added. The current study didn’t look at factors that could affect a person’s success, such as when people were planning on quitting vaping, how seriously they were thinking of quitting or what steps they were taking.

Palmer wants to see how well strategies for quitting conventional cigarettes work for quitting e-cigarettes. If people have tried to quit before, what strategies did they use? What support did they think they would need? She hopes strategies used in the quit-smoking clinic at MUSC that help people cope with stress without smoking, resist the urge to smoke and get social support while they are trying to quit smoking, might be used to help vapers quit.

“E-cigarettes are different from traditional cigarettes,” Palmer indicates. “So some of these strategies might overlap. I am curious to see if they really are helpful.”

The study is published in JAMA Network Open.