Smokers who switch entirely to vapes choose products with a lower strength of nicotine than those who both smoke and vape, a new study has found.
The research, published in the journal Tobacco Prevention and Cessation, tracked a group of adult smokers in Switzerland who used vapes to help them quit.
It found that six months after their ‘quit date,’ those who exclusively used vapes opted for a lower strength of nicotine on average than dual users (6.3mg/ml compared to 8.2 mg/ml).
The study said: “..Exclusive e-cigarette users and dual users reduced their e-liquid nicotine concentration over time, but exclusive e-cigarette users reduced their nicotine concentration even more.
“Exclusive e-cigarette users reduced their total nicotine equivalent (TNE). In contrast, dual users increased their TNE over time, so smokers quitting with the help of ENDS (electronic nicotine delivery systems) and wanting to reduce their nicotine intake should be encouraged to switch to ENDS completely and avoid dual use.”
Fruit flavours most popular for exclusive vapers
The exclusive vapers also chose more fruit-flavoured e-liquids – which are set to be banned in many countries – than dual users, suggesting they are an important factor in helping ex-smokers quit for the long term.
The study said: “..we found that participants initially experimented with different flavours and then stuck with their preferred flavour, continuing its use over time.”
Researchers followed 622 adult smokers in Switzerland who were given free vapes and a choice of six e-liquid flavours in four nicotine strengths to help them quit smoking. They were also given smoking cessation counselling.
Their choices of flavour and nicotine strength were tracked at one, two, four and eight weeks and again at six months. The choices of participants who reported only vaping were then compared to those who vaped and smoked.
At the six month mark, exclusive vape users reported opting for a significantly lower strength of nicotine on average than dual users (6.3mg/ml compared to 8.2 mg/ml).
Mean nicotine concentration used by participants over time:
At the same time, the smokers who switched exclusively to vapes reported using more fruit flavoured e-liquids than dual users by 31 per cent to 22 per cent.
Proportional use of vape flavours over time:
The study concluded that vapes are effective in helping people to quit smoking, but not to quit nicotine. However, the smokers who switched entirely to vapes reduced their nicotine intake far more than those who also continued to smoke.
Lower nicotine strengths ‘may cause relapse’ to smoking
The researchers said: “We found that most ENDS users continued to use e-cigarettes with nicotine-containing e-liquids after they quit smoking.
“However, exclusive e-cigarette users and dual users reduced e-liquid nicotine concentrations over time. There is evidence that initial low nicotine concentrations may not meet smokers’ needs when switching to e-cigarettes and thus may increase the likelihood that they start smoking again.
“Higher nicotine levels such as >15 mg/mL may better help smokers quit initially, and nicotine concentration used is likely to drop among tobacco cigarette quitters over time.
“As in other studies, we found a decrease in self-reported use of nicotine concentrations over time. Also, we found a lower total nicotine exposure measured in urine at 6 months after the target quit date in exclusive e-cigarette users.
“This contradicts the argument that exclusive e-cigarette users could also use their device more frequently with an e-liquid containing less nicotine and thus use lower nicotine concentrations.”
