The Society for Research on Nicotine and Tobacco has issued the first clinical guidelines for using e-cigarettes to help adults quit smoking. Published in the Journal of the American Medical Association, this medical framework positions vaping as a viable tool alongside traditional nicotine replacement therapies.
The expert panel recommends offering e-cigarettes alongside other smoking cessation strategies, such as nicotine replacement therapies (NRT) or prescription medications like varenicline and bupropion. While acknowledging that e-cigarettes are not entirely harm-free, the paper notes that vaping is less harmful than smoking and more effective than traditional patches or gums.
“This work is about correcting misperceptions that act as barriers to evidence-based care for smokers and expanding the tools clinicians can use to support smoking cessation among their patients,” said lead researcher Eleanor Leavens, an assistant professor of population health at the University of Kansas.
How E-Cigarettes Assist in Smoking Cessation
The research team’s evidence review shows that switching from smoking to vaping reduces exposure to harmful chemicals and carcinogens, in some cases by up to 90%. Although the U.S. Food and Drug Administration (FDA) has not formally approved e-cigarettes as smoking cessation devices, high-certainty evidence shows they are associated with higher quit rates than nicotine patches, gum, or nasal sprays.
The panel noted that e-cigarettes deliver nicotine rapidly, mimicking the experience of smoking a traditional cigarette. While this rapid delivery poses a risk of long-term use compared to NRT, it also makes the transition more satisfying for patients, reducing the risk of a relapse.
Clinical Recommendations for Healthcare Providers
The guidelines advise doctors to engage in shared decision-making with patients to find the best quit strategy. If a patient chooses to use e-cigarettes to quit smoking, clinicians should follow these steps:
- Guide patients toward vape products that have been authorized by the FDA.
- Instruct patients to use an e-cigarette any time they would typically smoke a cigarette.
- Advise a complete and rapid substitution of e-cigarettes for combustible smoking.
- Recommend behavioral counseling to improve the odds of successfully quitting.
“Behavioral support should focus on complete cessation of cigarettes and should include setting a quit date for cigarette use,” the researchers wrote. Once a patient has successfully quit smoking, clinicians can then discuss cutting back on the nicotine exposure from vaping, though maintaining complete abstinence from cigarettes remains the primary goal.
