Is vaping small amounts of nicotine daily still harmful after quitting smoking?

Vaping After Quitting Smoking: Health Risks and Recommendations

Vaping small amounts of nicotine daily after quitting smoking is still harmful and should be discouraged due to continued nicotine addiction and potential health risks. 1

Health Risks of Vaping

• Nicotine, regardless of delivery method, is highly addictive and affects many body systems, mediators, and metabolic pathways 1
• Nicotine has significant cardiovascular effects and may play a major role in the development of coronary artery disease, atherosclerosis, and aortic aneurysms 1
• The health risks of electronic cigarettes have not been adequately studied, making their safety uncertain 1
• Vaping products contain and emit numerous potentially toxic substances beyond just nicotine 1
• Vaping with e-cigarettes affects the cardiovascular and respiratory systems, contradicting perceptions that e-cigarette use is harmless 1

Comparison to Smoking Cessation

• While vaping may generate less tar and carcinogens than combustible cigarettes, this does not make it safe 1
• E-cigarettes are not approved as smoking cessation aids by regulatory agencies, unlike standard nicotine replacement therapies 1
• The US Preventive Services Task Force recommends focusing on proven behavioral counseling and FDA-approved pharmacotherapy for smoking cessation rather than e-cigarettes 1
• Studies on whether e-cigarettes aid smoking cessation have shown inconsistent results 1
• Continued e-cigarette use after smoking cessation indicates ongoing nicotine dependence 2

Public Health Concerns

• The Forum of International Respiratory Societies recommends that electronic nicotine delivery devices should be restricted or banned until more information about their safety is available 1
• There is concern that the availability of e-cigarettes may have an overall adverse health impact by increasing initiation and reducing cessation of combustible nicotine products 1
• The 2019 E-cigarette or Vaping Use-Associated Lung Injury (EVALI) outbreak highlighted potential acute harms of vaping 3
• Passive inhalation of vaporized droplets, particles, nicotine, and other substances into indoor air may have significant adverse health effects 1

Recommendations for Former Smokers

• Individuals with a history of tobacco use should be advised to avoid vaping and using e-cigarettes, either as an approach to stop smoking or as a recreational activity 1
• If already using e-cigarettes, individuals should be advised to have a plan to quit these as well 1
• Evidence-based behavioral strategies and pharmacotherapy should be used to support complete nicotine cessation 1
• For those struggling with vaping cessation, text message-based interventions may help more youth and young adults successfully stop than minimal support 2
• Varenicline may also help people quit vaping, though more research is needed 2

Conclusion

While quitting smoking is a significant achievement that should be commended, replacing cigarettes with vaping maintains nicotine addiction and introduces uncertain health risks. The best approach for optimal health outcomes is complete cessation of all nicotine products, using evidence-based methods approved by regulatory agencies.