Tag: quitting

Searches For Quitting Smoking Nearly Triple, Research Reveals

Credit: Mathilde LMD
The number of people quitting combustible cigarettes seems to be growing in the UK during the coronavirus lockdown, new research reveals.
The study by smoking cessation advocates Vape Club shows that the average annual Google searches increasing from 37,200 to 100,440 since restrictions began, according to a story in Talking Retail.
‘How to quit smoking’ is Googled an average of 37,200 times per year in the UK, but since 26 April the number of average monthly searches has pushed the yearly average to 100,440, an increase of 62,800.
The similar phrase ‘how to stop smoking’ has seen a comparably sharp increase of 40 percent in the past month in the UK. There are 31,200 searches on average per year, which has increased to an average of 43,680 with last month’s search figures.
In addition, searches for ‘NHS stop smoking service’ have increased by 120 percent in the same period.
Dan Marchant, director at Vape Club and member of the UK Vaping Industry Association, said: “The volume of people turning to Google searches for advice suggests that greater support and clearer information should be made available. I’d like to see stop smoking services reaching out to the most vulnerable and hard-to-reach in society, as there’s clearly a desire to quit with the right support. With vaping being the most effective form of smoking cessation, it’s important that it is presented as an effective quitting tool.”
June 5, 2020
Location Matters
Where you buy your e-cigarettes may determine if you will be a successful quitter.
By Marina A. Murphy
The popularity of e-cigarettes these days means that you can buy them almost anywhere: online, in general retail or in specialist vape shops. But new research shows that where you buy your e-cigarettes may not only determine the price you pay for them or what selection you have to choose from, but also the likelihood that you will be a successful quitter—that is, whether you’ll be successful at quitting smoking if you are a smoker.
Scientists at the University of California conducted a two-year survey¹ of vapers and concluded that those who buy their e-cigarettes from vape shops or online are far more likely to give up smoking than those who get their e-cigarettes in general retail. This proved to be true regardless of how heavy a smoker they had previously been, whether they had intended to give up smoking in the first place and their willingness to use medicinal products like nicotine-replacement therapies.
The researchers say that given the influence the place you purchase your e-cigarettes may have on your ability to quit, regulators should consider how the rules they make might impact smokers’ access to different options for vapor products. For example, in March this year, the U.S. Food and Drug Administration (FDA) said that it was going to ban the majority of e-cigarette flavors in general retail but not online or in specialist vape shops.
The question then becomes whether limiting the choices of vapers who shop in general retail puts these vapers at a disadvantage in terms of their likelihood to quit smoking, compared with those who buy in specialist shops or online (who have more choices).
The University of California study involved 1,600 vapers and was conducted between 2014 and 2016. During this time, researchers collected information on smoking and quitting behavior and primary choice of place of purchase.
Survey results revealed a number of differences between vape shop customers and retail customers. Vape shop customers were more likely to use open systems. Retail customers were more likely to use FDA-approved cessation aids. A total of 92.8 percent of vape shop customers used open systems compared to only 17.3 percent in retail customers.
Vape shop customers were also more likely to vape daily. More than half of vape shop customers were daily vapers whereas only one in five retail customers were daily vapers.
Previous studies found a correlation between daily vaping and using open systems with smoking cessation. This would seem to be borne out here, as vape shop customers were also more likely to have quit smoking. Among those smoking 12 months prior to the survey, smoking cessation rates were higher for vape shop and internet customers at 22.2 percent and 22.5 percent, respectively, than for retail customers at 10.7 percent.
The researchers point out that previous studies have depended mainly on data from retail stores, which accounted for only 30 percent of purchases in 2016. They say that further studies must therefore include a broader range of purchase channels.

Marina A. Murphy
Marina A. Murphy is head of scientific media relations at British American Tobacco.
1. Researchers investigated a number of reasons why this should be the case. “A Comparison of E-Cigarette Use Patterns and Smoking Cessation Behavior Among Vapers by Primary Place of Purchase” Int. J. Environ. Res. Public Health 2019, 16(5), 724; doi:10.3390/ijerph16050724 [↩]
June 25, 2019
Better Options
In the struggle against underage vaping, restricting access to flavored e-cigarettes should be the last resort.
By Chris Howard
Put yourself in the shoes of a smoker who is trying to quit. You’ve tried various quit-smoking products, such as nicotine patches, gums and prescription medications. None have worked. Your friend tells you how vaping with flavors works, so you decide to give e-cigarettes a try.
You stop at a convenience store, seeking a vapor product that meets your needs. Surprisingly, the flavors that seemed so appealing are nowhere to be found. You never liked menthol, and tobacco reminds you of the cigarettes you hope to avoid. Like many smokers, you’re anxious about leaving cigarettes behind and your ability to quit. This latest obstacle makes quitting seem impossible (again). What happens next? You buy another pack of cigarettes and promise to try again another day.
The reality is that smokers don’t get to count on “another day.” Each cigarette increases the smoker’s risk of developing a smoking-related illness that will inevitably lead to a lower quality of life or worse—premature death.
The vapor industry shares the U.S. Food and Drug Administration’s (FDA) goal of ensuring e-cigarettes are used only by adults. That said, the FDA should consider a variety of more reasonable options to curb youth access without jeopardizing e-cigarettes’ harm reduction potential.
Codify marketing standards: Many adult-oriented industries employ voluntary codes of conduct to govern marketing practices. The FDA should seek consensus standards prohibiting marketing practices directed at youth. The Vapor Technology Association (VTA), which advances the interests of 800-plus manufacturers, wholesalers, small-business owners and entrepreneurs of the vapor industry, has already enacted such standards (see https://bit.ly/2Ozbfyn), which are mandatory for membership. Most, if not all, vapor companies would likely embrace objective, FDA-accepted parameters as reasonable ways to reduce youth e-cigarette access.
Revamp enforcement scheme: Undoubtedly, the FDA is resource-constrained and overwhelmed by age-verification requirements for vapor products. That said, even if the FDA could act on every violation, the current scheme allows a retailer to sell tobacco products to a minor five times within a 36-month period before the FDA can stop them from selling tobacco for 30 days. Revamping the current enforcement policy to provide for stricter and more consistent penalties would enable the FDA to use agency resources more effectively and deter bad actors from breaking the law.
Enhance restrictions for online purchases: Some online retailers are already implementing two-factor authentication and other measures to curb youth access to vapor products—measures rightly considered by the FDA. Such online purchase restrictions should continue to be developed, strengthened and exercised in order to eliminate youth access to vapor products.
Work with schools: Nearly every anecdotal news report involves a teenage student’s exposure to e-cigarettes. Given that schools are also seeking tools to combat this issue, the FDA should work more closely with school districts to provide resources and training that helps teachers identify the signs of youth e-cigarette use and how to stop it. The FDA’s current “The Real Cost” campaign is the right approach to assist teachers and educate youth, but unfortunately the messaging is riddled with inaccuracies about health effects that could deter smokers of combustible cigarettes from switching to vapor products.
Analyze the impact of higher minimum purchase age: Some states have increased the minimum purchase age for e-cigarettes to 21. The FDA should analyze purchase and use patterns in these states to assess any reduction in straw sales and youth usage rates resulting from increased purchase age requirements.
The decisions the FDA makes affect millions of adults who rely on vapor products for harm reduction. Restricting the availability of flavors is a radical measure that places unnecessary obstacles for adults obtaining products of their choice. In many ways, the proposed restrictions may actually help combustible cigarettes.
For these reasons, the FDA’s proposed flavor ban should be a last resort.

Chris Howard
Chris Howard is vice president, general counsel and chief compliance officer at E-Alternative Solutions.
April 30, 2019
Best Buddies
Want to quit smoking? Hang out with a vaper!
By Marina A. Murphy
Smokers who hang out with vapers are about 20 percent more likely to try to quit tobacco, according to research that puts paid to the idea that e-cigarettes and vaping renormalize smoking.
The study, which was conducted by researchers at University College London (UCL) over a period of 3.5 years and involved almost 13,000 participants, found that smokers who regularly spend time with vapers are likely to have tried an e-cigarette themselves. They are also highly motivated to quit and are likely to have already made attempts to stop smoking. By contrast, smokers who hang out with other smokers are not motivated to stop smoking.
While there is a lot of support for e-cigarettes, given that they are likely to be significantly safer than smoking and do not harm bystanders, some skeptics still believe that the sight of people puffing away on their e-cigarettes is likely to encourage smoking.
This is the first study to assess the impact of other people’s vaping on smokers’ desire to quit and the likelihood that they will try to do it.
The authors of this study say that their findings offer no evidence that spending time with vapers discourages smokers from quitting and should offer reassurance in terms of the public health impact of e-cigarettes.
“It is becoming increasingly more commonplace for smokers to come into contact with vapers, and some concerns have been raised that this could ‘renormalize’ smoking in England and undermine smokers’ motivation to quit,” said lead author Sarah Jackson of the Institute of Epidemiology & Health Care at UCL.
Kruti Shrotri, a tobacco control expert at Cancer Research U.K., which funded the study, said, “So far, there hasn’t been much evidence about whether e-cigarettes might make smoking tobacco seem normal again. So it’s encouraging to see that mixing with people who vape is actually motivating smokers to quit. As the number of people who use e-cigarettes to quit smoking rises, we hope that smokers who come into contact with them are spurred on to give up tobacco for good.”
The study, which was published in BMC Medicine, used data from 12,787 smokers who participated in the Smoking Toolkit Study, which analyzed smoking patterns in England between November 2014 and May 2018. Participants were asked whether anyone other than themselves used an e-cigarette regularly in their presence, whether they were motivated to quit smoking and whether they had made any attempts to quit.
The results showed that smokers who were regularly exposed to vapers (as opposed to other smokers) were around 20 percent more likely to report both a high current motivation to quit and to have made a recent attempt to quit.
Around one-quarter of smokers in the study said they regularly spent time with vapers. Of these, around one-third had tried to quit smoking in the previous year—a higher rate than was observed among smokers who did not regularly spend time with vapers.
It is thought that a key driving factor in the differences between smokers who hang out with vapers and those who don’t is that smokers who spend time with people who vape are simply more likely to give vaping a try themselves.

Marina A. Murphy
Marina A. Murphy is a scientific communications and engagement expert with more than 20 years of experience, including 10 years in the tobacco sector.
February 18, 2019
Truth Be Told
A viable New Year’s resolution for vapor industry regulators and antagonists is to start being more honest.
By George Gay
I’m not somebody who usually makes or even thinks about New Year’s resolutions, but I recently spoke to an acquaintance and something she said got me thinking. The more you think about such resolutions, the more you come to realize that they and their outcomes are not quite as simple as they are often made out to be.
For instance, the first thing I started to wonder was how many readers of this magazine would have given up reading this piece by now, not just because they’ve made New Year’s resolutions not to read pointless stories, but because they are not touched by such nonsense—because they are part of cultures that don’t subscribe to, what I believe, is mainly a Western tradition.
That thought raises some difficult issues for somebody, such as me, who has been brought up in the West and for whom New Year’s resolutions seem natural, even though I don’t bother with them. After all, most people feel they need to make positive changes to their lives at some point, and what better time than at the start of a new year, whenever your new year begins? I simply cannot help thinking that most cultures must have developed practices that are at least related to New Year’s resolutions.
But no matter where you sit culturally, you are almost bound to question why your resolutions should be aligned to the start of the new calendar year. Would it not be more appropriate to align them with, say, the start of the “natural” year, which, in England, might be taken to be when, according to Ian Anderson, the Jacks—they are plural apparently—in the Green tap their canes on the ground to signal to the snowdrops that it is time for them to grow?
This would certainly be most appropriate, for instance, if your resolution were to tend your garden more diligently. It doesn’t take much thought to realize, also, that certain resolutions would be easier to maintain for longer if they were kicked off at the start of a particular season. Why, if you live in the Northern Hemisphere, would you resolve to go jogging from the start of January with, weather-wise, two of the most miserable months in front of you? You are simply setting yourself up for failure.
And, still on timing, if you’re into multiple resolutions, it might be advantageous to stagger their starts—so that you are not trying to cut down on your eating, drinking, smoking, illicit-drug-taking, lying, cheating, general low-level criminality and sloth at the same time. That would clearly be a tall order.
Other things that come into view as you think about such things are the possible knock-on effects of resolutions. It’s OK if you have a Kantian outlook on ethics so that you can say with confidence that you should no longer drink 10 pints of beer a night because drinking 10 pints of beer a night is not something you can “will to become a universal law.” But if your ethical outlook is based on utilitarianism, you might start to feel ethically challenged when somebody questions what will happen to the brewer who has resolved to save more money if you resolve to stop drinking 10 pints a night and manage to carry through with that resolution.
Frankly, the more you think about it, the more you realize that the whole business is fraught. Certainly, New Year’s resolutions cannot be seen as a zero-sum game. If you resolve to eat less cake, the baker’s life starts to spin out of control. And if you resolve to stop lying, you lose all your friends.
Or rather these things happen if everyone resolves to act in a “better” way than in the past, which, I think, is generally the case. But things can be turned around if some people resolve to be naughty, or naughtier. What if one person resolves to stop drinking 10 pints a night but somebody else resolves to start drinking 10 pints a night? That way, everybody is “better off,” even the brewer who resolved to save more money, though he will have to do so with the same income.
Clearly, such balance is possible even at an individual level. If you wanted to cut down on your 10 pints a night, you could reward yourself with some extra cigarettes, or vice versa, depending on which of these indulgences you most needed to cut down.
THE PROMISE MOST OFTEN BROKEN
To me, one point that comes out of this is that New Year’s resolutions don’t have to be puritanical. They don’t have to take on a quit-or-die mentality. And one good example of this is the resolution to give up smoking, possibly one of the most often cited and most often broken resolutions.
In the past, the only option was to give up. No matter what is written above, it is clearly not possible to reward cutting down on smoking with an increase in beer intake because beer drinking leads to socializing, and socializing leads to smoking if you’re so inclined. But now, smokers have the option of quitting by switching to vaping, a habit without any of the negative effects of beer drinking, as far as I can tell.
The trouble here is that some of the people who urge smokers to resolve to quit their habit don’t really like the idea of these people switching to vaping—or to snus or any of the other smokeless tobacco products that would offer solid risk reductions. Why not? That’s a good question that would take too long to answer, but I think they rationalize their position in part by saying that vaping, at least with nicotine, is addictive and will eventually lead the vaper back to cigarettes.
At the same time, they say the very existence of vapor devices is a magnet for young people who are drawn like magpies to these gaudy baubles and take them back to their nests where they become addicted to the nicotine and move on to traditional cigarettes and end up supping with the devil, or some such.
This narrative is shot full of holes, but it has gained traction. So I was very much taken in January by a EurekAlert story that said allowing smokers to determine their nicotine intake while they are trying to quit is likely to help them kick their habit. The story, which was based on a study of 50 people and led by Queen Mary University of London, said that the results of the first study to tailor nicotine dosing based on the choices of smokers trying to quit suggested that most smokers who used stop-smoking medications could easily tolerate doses that were four times higher than those normally recommended.
Study author Dunja Przulj of Queen Mary University of London said that smokers determined their nicotine intake while they smoked but that when they tried to quit, their nicotine levels were dictated by the recommended dosing of the treatment. “These levels may be far too low for some people, increasing the likelihood that they go back to smoking,” Przulj said. “Medicinal nicotine products may be under-dosing smokers and could explain why we’ve seen limited success in treatments, such as patches and gum, helping smokers to quit. A change in their application is now needed. Our findings should provide reassurance to smokers that it is OK to use whatever nicotine doses they find helpful.”
The story went on to say that when nicotine-replacement treatment was first evaluated in the 1970s, low doses were used because of concerns about toxicity and addictiveness. “Evidence then emerged that nicotine on its own, outside of tobacco products, has limited addictive potential and that higher doses are safe and well-tolerated,” it said. “Despite this, stop-smoking medications have maintained lower nicotine levels in their products.”
There is something wrong here, isn’t there? I mean with this passive-voice rendering of what has gone on. Smoking medications don’t maintain lower nicotine levels as is suggested. People maintain those levels through regulation and/or manufacturing processes—or perhaps simple inertia.
So given that evidence has been found that nicotine on its own, outside of tobacco products, has limited addictive potential and that higher doses are safe and well tolerated, it is clearly time that those responsible for the lower levels of nicotine in these products make New Year’s resolutions to stop doing whatever it is that they are doing to maintain this situation.
And I don’t think it is unreasonable to extrapolate the university’s lessons to take in vaping. After all, the evidence is clear that, as above, nicotine on its own, outside of tobacco products, has limited addictive potential and that higher doses are safe and well-tolerated. I say this because, despite what the U.S. Food and Drug Administration may deem or dream up, vapor devices are not tobacco products.
I think that those people who claim that vaping with a nicotine e-liquid is addictive should resolve to stop doing so until they have proof that it is so. And those people, such as those at the EU Commission, who insist on maintaining unnecessarily low nicotine concentration levels in respect of e-liquids (no, it’s not the e-liquid manufacturers that maintain those levels) should quit this habit, if they can.
In fact, I think that all of this could be covered with one resolution. We should all resolve to tell the truth—even at the cost of friendships.

George Gay
February 18, 2019