Vaping and withdrawal
While the debate regarding the safety of e-cigarettes continues, another issue has emerged: Does vaping cause withdrawal?
"Electronic cigarettes are currently the fastest-growing tobacco harm-reduction product," says international tobacco use and addiction expert John Hughes, M.D., who is leading a new study to determine whether or not stopping e-cigarettes will lead to withdrawal symptoms.
A professor of psychiatry at the Larner College of Medicine at the University of Vermont and researcher at the Vermont Center on Behavior and Health (VCBH), Hughes says "It is very unclear whether e-cigarettes would cause withdrawal. E-cigarette users obtain nicotine levels that are higher than those from nicotine replacement products like gums and lozenges (which Hughes has previously found are not addicting). On the other hand, the nicotine levels are usually smaller than those from tobacco cigarettes, plus e-cigarettes do not produce as rapid an increase in nicotine as tobacco cigarettes."
Hughes' Burlington, Vt.-based lab, in partnership with Battelle Public Health Center for Tobacco Research Laboratory in Baltimore, Md., is in the process of recruiting 120 long-term users of e-cigarettes for the National Cancer Institute-funded study. Participants will use their own e-cigarette as normal for the first week and then enter a week of e-cigarette abstinence.
Participants will report symptoms of nicotine withdrawal nightly via telephone. They will also visit the lab three times each week to provide breath and urine samples to verify use or abstinence, and complete brief surveys. Participants will obtain extra reimbursement if they remain abstinent.
If the study finds significant withdrawal, labeling may be needed to warn purchasers of e-cigarettes of this possibility, plus withdrawal problems should be included in risk/benefit assessments of e-cigarettes. On the other hand, if the current study shows that stopping e-cigarettes does not cause withdrawal, this would make it easier for the FDA to approve them as a way to quit smoking or as a less harmful way of smoking.
Hughes has served as a consultant on tobacco policy to the World Health Organization, the U.S Food and Drug Administration, and the White House.