Vaping To Help Quit Smoking: Is It Safe? Is It Effective?

Is Vaping OK to Help Quit Smoking?

Dear Dr. Mahler:

I have a question about vaping. Is it ok to use a vape when you have COPD when trying to quit smoking?

Daniel from Albuquerque, NM

Dear Daniel:

Your question is a frequent one that I have been asked in my practice. Please read my March 1, 2016, post in response to a question similar to yours, “Can e-cigarettes help to quit smoking?” At the time I wrote that, “The World Health Organization takes the view that there is not enough evidence to recommend e-cigarettes for quitting smoking. In one review, there was no difference in quit smoking rates between those using e-cigarettes and those using nicotine replacement products (as examples, gum and patches).”

Vaping e-cigarette may cause e-cigarette explosion

A person vaping e-cigarette.

To provide an up-to-date answer to your question, I searched PubMed, the online search site for published medical articles. Here is what I found:

Current Perspectives of E-cigarettes in Patients with COPD

A recent review was published in the November 2017 issue of the International Journal of COPD (volume 12; pages 3202-3210) on the topic of your question. The battery of an e-cigarette heats an element that vaporizes a solution of glycerol, propylene glycol, and flavoring with and without nicotine.The authors emphasize that e-cigarettes do not contain tobacco and do not rely on combustion to operate.  However, they can deliver nicotine that closely matches the rate and level of tobacco cigarettes.

Of interest, the US Food and Drug Administration consider both glycerol and propylene glycol as Generally Recognized as Safe.

In one study, those with COPD who stopped smoking  or considerably reduced tobacco consumption by using e-cigarettes were followed for two years. Over this time period, flare-ups of COPD were reduced by 50% and there was an improvement in general health status.

The authors concluded that although e-cigarettes are not risk free, they are much less harmful than smoking tobacco cigarettes.

Advice From Former-Smoking E-cigarettes Users to Current Smokers  

4,192 individuals who quit smoking using e-cigarettes were surveyed online. They were asked to provide advice to current smokers who were considering vaping as a way to help them quit. Their advice covered four themes: 1. Find a combination of vaping device, flavor of e-liquid, and nicotine strength that “works for you”; 2. It is OK to continue to smoke for a while after starting to vape; 3. It is common for people to fail to quit smoking using approved aids (like nicotine patch) before success with e-cigarettes; and 4. Many respondents noted an awareness of improved health and hygiene since switching to vaping.

This reports was published online on August 3, 2017, in the journal Nicotine Tobacco Research (doi: 10.1093/ntr/ntx176

My Comments

As your have COPD, the most important thing that you do is to quit smoking cigarettes. I advise patients in my practice to quit any way possible. This includes quitting “cold turkey,” use of nicotine patch or gum or lozenges, acupuncture, hypnosis, and prescription medications.

I also support the use of e-cigarettes as a substitute for tobacco cigarettes. Why? Cigarette smoke contains over 4,000 chemicals, including 43 known cancer-causing (carcinogenic) compounds and 400 other toxins. In contrast, vape smoke contains only three (nicotine, glycerol, and propylene glycol) along with possible flavoring.

Good luck on quitting. Please note, the advice provided is not a substitute for asking your health care professional about your specific situation.

Donald A. Mahler, M.D.

Help to Stop Smoking

Dear Dr. Mahler:

Do you have any advice on helping me stop smoking?  I have quit many times, and have used the patch, gum, Chantix, and finally tried hypnosis. The longest time that I quit was for 3 weeks, but then I craved a cigarette after going out with my friends for dinner. Now I smoke a pack most days. My doctor diagnosed me with COPD six months ago, and I take an inhaler twice a day. My father had emphysema and died of a heart attack.   Carl from Bend, OR

Dear Carl,

As you know, nicotine in cigarette smoke can be addicting for my people. This addicting feature is evident at many medical centers where you can see employees standing outside in the rain, snow, and/or cold while smoking in designated areas. In the United States, about 18% of adults smoke cigarettes daily.

Two women smoking outdoors during winter

Two women smoking outdoors during winter

Man smoking outdoors in the winter

Man smoking outdoors in the winter






Here are parts of a letter sent to me from a friend and former patient. He grew up in the United Kingdom, and now lives in the US. His comments provide a message for anyone facing the challenge of quitting smoking. He gave me permission to share what worked for him in the hope that it may help others.

“As one who smoked from an early age in my teens in England, I made various attempts to give up this very addictive, legalized, tax generating, drug. When in 2000 I finally did after 40+ years of smoking, I tried an approach which may be helpful to pass on, via you, to others.

My previous attempts to stop were all based on stopping ‘tomorrow.’ All failed. With the tomorrow approach, the addict usually smokes heavily the night before trying to stop smoking. Even using patches, he “needs” his tobacco fix next morning, usually upon waking, that is when the withdrawal starts of course.

  I was to head off on two flights to the U.S. West Coast and I had decided to enjoy my last morning pipe/fix before the taxi came to take me to the airport and the ‘no smoking’ environment that entails. Taxi arrived, pipes consigned to the trash bin, I set off.
At the airport, I learned at the pharmacy there, that it would likely cost me around $400 in patches to give up the native American weed. No way was I going to spend that sort of money, however good the cause was, that’s a lot of golf balls !
Instead, every time I reached for my pipe, I said to myself, sometimes aloud, ” I don’t smoke do I!” Breaking my journey in Newark Airport, NJ, I refrained from accepting my traveling colleague’s tempting offer to wait for me, if I wanted to use the then available smoking bar. Instead I boarded the flight to San Francisco, muttering to myself through gritted teeth, ‘I don’t smoke do I!!’
Once on the West Coast almost a day had past and ready for bed I went smoke free, day one. By staying for the most part in non smoking environments, I continued as the cold turkey effects came one , but remembering to say, I don’t smoke, when the urge for my soothing pipe grew strong. Having the odd strip of sugar free gum helped too.
 It was not easy, but day by day it became normal to be a non smoker, my sense of smell and taste became more pleasingly acute, and then, secondhand smoke became abhorrent to me. About that time I too realized that as even a pipe smoker, one smells akin to an ash can to non smokers. Saving lots of money by not buying expensive, highly taxed tobacco in the UK, then paid for my annual dues at a local golf club, and my health was improving too.
To stop smoking and save money and your health ; The secret being, get the morning fix, then get into a non smoking space to stop smoking forever. Remember, ‘I don’t smoke do I.’ After all, we were not born as nicotine addicts.”
I hope that these comments are helpful.
Donald A. Mahler, M.D.