Dear CHIFA colleagues,
Are there any pros to vaping? I would like to forward a message from Jenna Butner from our sister forum HIFA, and a comment from me below.
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Hello, I’m Jenna Butner, a member of the HIFA working group that is facilitating this discussion. I’d like to introduce question #5: “What are the pros and cons of electronic nicotine delivery systems (ENDS, vaping) as an aid to stop smoking or alternative to smoking among adolescents and young adults?”
Electronic nicotine delivery systems (ENDS) also referred to as vaping has increased exponentially during the last several years. The rise in E-cigarette or vaping product use-associate lung injury (EVALI) and acute respiratory illness related due to ENDS has risen. Among adolescents, ENDS poses a serious health risk, and little is known on the long-term effects. In a recent publication by Delnevo, et al. physicians may recommend usage of E-cigarettes for smoking cessation, particularly to older patients with a history of severe tobacco use disorder (TUD), however there is ambivalence regarding the safety of ENDS as a treatment for TUD, as there remains the belief that ENDS and cigarettes are equally harmful. In Hartmann-Boyce’s systematic review, of 78 completed studies, there was strong evidence that quit rates were higher in people randomized to ENDS than in those randomized to nicotine replacement therapy. Consideration of ENDS as a harm reduction approach in high risk populations with high rates of TUD, such as those with schizophrenia, schizoaffective disorder and bipolar disorder, whose life expectancy is 10-20 years shorter than that of the general population, may be an alternative treatment approach in the right direction.
As a primary care physician and hospitalist, recommendation for use of ENDS is something I have become more accustomed to. It is my opinion that the use of nicotine without the other chemicals found in cigarettes, is “safer” and I approach it from a philosophy of harm reduction.To that end, having limited knowledge on the contents and quantities of newly developed vaping solutions is unsettling. More education and evidence-based studies on the safety and efficacy of it as a cessation option for TUD is urgently needed.
HIFA profile: Currently pursuing an MPH at Yale School of Public Health, Jenna Butner is a medical doctor, Researcher and Educationalist at APTP. With a key interest in Substance Use Disorders among forced migrants, she is currently collaborating with the US Embassy in Jordan to fill critical gaps in SUD identification, knowledge, prevention, and treatment that exist in refugee populations in humanitarian settings. Dr. Butner holds an MD from Ross University School of Medicine and completed her Residency in Family Medicine at Bronx Lebanon Hospital Center. She then completed a fellowship at Mount Sinai Beth Israel Hospital in Hospice and Palliative Medicine, followed by an Addiction Medicine Fellowship at Yale. Email: jenna.butner AT yale.edu
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Comment (NPW): "Physicians may recommend usage of E-cigarettes for smoking cessation, particularly to older patients with a history of severe tobacco use disorder (TUD)... Consideration of ENDS as a harm reduction approach in high risk populations with high rates of TUD... may be an alternative treatment approach in the right direction." There seems no doubt that vaping can help some smokers to quit.
As Jenna points out, the use of vaping by children and adolescents is another matter. Here, the only conceivable pro for vaping that I can think of would be *if* it led to fewer children taking up smoking. I don't have the data on this but it is well known that some children start vaping, become addicted to nicotine, and subsequently take up smoking.
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and here (HIFA): https://www.hifa.org/rss-feeds/17
CHIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
