Smoking is a major cause of death, disease and impoverishment which kills more than 8 million people a year worldwide. Instead of tackling the overarching topic of quitting smoking, some countries prefer to focus on quitting vaping. This is the case of Canada and more specifically of the province of Quebec which now considers vapers as real plague victims.
» Effective or Promising Cessation Interventions for Vaping Products "Is the title of a recent report presented publicly by the National Institute of Public Health of Quebec (INSPQ). As if vaping were a scourge, the report looks at " Identify key smoking cessation recommendations from national organizations for healthcare professionals and clinicians. ". A real disaster in itself when we take stock of the number of smokers who could still benefit from e-cigarettes for proven risk reduction.
The electronic cigarette has become in a few years a tool favored by Canadian smokers to give up smoking. On the other hand, more than 30% of daily vapers aged 15 and over reported, in 2019, having made at least one quit attempt during the previous year, thus demonstrating their desire to free themselves from this product. Faced with such a situation, what approach should healthcare professionals offer to patients who wish to quit vaping? The purpose of this status report is to describe effective or promising cessation interventions for vaping products.
A search of the scientific literature on the EBSCOhost and Ovidsp platforms identified seven peer-reviewed publications meeting the inclusion criteria. A gray literature search was also carried out to identify the main smoking cessation recommendations issued by national organizations and intended for healthcare professionals and clinicians.
- Barely three case studies were identified. According to these studies, the accompaniment of a health professional in association with a) a gradual reduction of vaping products, b) the use of a Nicotine replacement therapy or c) varenicline would show promise.
- Among the few ongoing initiatives identified, the text messaging program This is quitting, developed by the Truth Initiative, aimed at promoting the abandonment of electronic cigarettes among young people and young adults, seems particularly promising. If this very popular program in the United States proves to be effective, it could certainly inspire the Quebec designers of the Text Messaging Service to Stop Tobacco.
- Very few recommendations specific to giving up electronic cigarettes have been published by health organizations. Those from the American Academy of Pediatrics as well as those found on the UpToDate site are based on the results of studies on smoking cessation to propose an approach to quitting vaping products in adolescents. Professionals are encouraged to support the young person in determining a quit date, developing an abandonment plan, anticipating the difficulties that will arise and calling on available resources (counseling, telephone line, text messaging, websites).
Several questions remain unresolved, although more and more researchers are interested:
How to assess addiction to vaping products?
How to estimate the quantity of inhaled nicotine? And how do different factors (nicotine concentration of the product, potency of the device, topography of inhalation, user experience) affect the dose of nicotine absorbed?
Should nicotine replacement products be offered to decrease the intensity of withdrawal symptoms? If so, what dosages to recommend, and on what basis?
To consult the full report go to the official website de the National Institute of Public Health of Quebec (INSPQ).