Doctors wonder if traditional smoking cessation methods will help people quit vaping

Inspired and scared by the recent spate of hospitalizations and deaths from a mystery respiratory illness linked to vaping, young people can be seen throwing out their e-cigarettes on social media, vowing to quit. Just as there’s a lot to learn about e-cigarettes – a relatively new trend, especially popular among young people – doctors say there’s also not a lot known about how to successfully quit.

“Are we going to use the same techniques and medications (used for quitting traditional cigarettes), or are there unique features?” said Andrea King, professor of psychiatry and director of the Courage to Quit program at the University of Chicago. “As these products have come on the market and been rapidly adopted, we just haven’t had time” to develop specific treatment programs for those looking to quit vaping.

Because the basis of a vaping addiction is nicotine, King said, it’s possible that traditional methods for quitting could work. Those use a combination of counseling on changing behaviors, along with medications that quell nicotine cravings, and are proven to be more effective than someone going “cold turkey,” quitting on their own.

But experts wonder if the higher levels of nicotine inhaled during vaping, compared with traditional cigarettes, could make quitting more challenging. “It’s almost going to be easier to get people off traditional cigarettes than e-cigarettes because of the dose (of nicotine),” said Dr. Sana Quddus, a pulmonologist at Loyola University Medical Center in Maywood.

And there are other factors that make vaping unique – users may also vape THC, the ingredient in marijuana that creates a high, and they tend to be younger, even adolescents, a group that hasn’t been studied when it comes to medications and other resources that help people kick smoking.

In King’s program and others, the strategy is to use a combination of techniques. The program educates and helps change behaviors with individual, group or phone line counseling, King said, and also uses medication like Chantix that interferes with the brain’s response to nicotine. Nicotine patches or gum also can help ease the symptoms of nicotine withdrawal.

But dosing is an issue for those looking to quit vaping, said Lori Wilken, a clinical pharmacist at the University of Illinois at Chicago who runs a tobacco dependence clinic. For patches and gum, which deliver smaller, slower amounts of nicotine to ease withdrawal symptoms, dosing is based on how many cigarettes someone smokes each day, Wilken said.

When patients come to her hoping to quit vaping, she said, she has to estimate a dose based on how many pods they vape, which usually have higher amounts of nicotine that enter the system faster. Wilken and others who run quitting programs say they often see adults, but adolescents could benefit from seeing other peers quit, in addition to traditional cessation methods.

“A traditional smoking group isn’t exactly the right fit,” said Jim Brunetti, clinical director at the Elgin-based Renz Addiction Counseling Center, who is developing a new program geared toward teens who want to quit vaping.

The center would like to partner with school districts to offer the program, which refers students caught vaping at school to a “psychoeducational group,” where they learn about the harmful effects of e-cigarettes and nicotine withdrawal alongside their peers, he said. Then they break into groups for individual counseling, while their parents also receive education on vaping. Then the students and parents come together.

“It’s really important for parents to be a part of this and have knowledge and also offer support,” Brunetti said. “It also opens up a conversation where they can show they’re invested, interested and they care.” Parents and teens alike are becoming more aware of vaping after reports emerged this summer of otherwise healthy patients who regularly vape requiring hospitalization after they struggled to breathe.

The respiratory illness still mystifies public health officials, who continue to investigate the cases. The Centers for Disease Control and Prevention has confirmed 380 cases thus far across the country. Seven of those patients have died, including one in Illinois.

Dr. Kiran Bojedla, a family medicine physician at Advocate Christ Medical Center in Oak Lawn, said he’s had patients and friends come to him asking how to cut back on vaping, “similar to the cigarette panic that slowly happened over decades.” But with vaping, “It feels like it’s all at once.”

He said traditional smoking cessation programs, like smokefree.gov, now address vaping but use traditional smoking cessation philosophies. Bojedla said he’s also concerned that adults who turned to vaping to quit smoking could be tempted to return to their prior bad habit. He tells them, “As much as possible, try not to do either.”