The vape debate
Featured Products Promotional FeaturesPosted by: Dental Design 15th November 2023
E-cigarettes have been widely promoted as an effective cessation tool, helping smokers kick the habit and improve their health. However, as often happens with any new technology, there are various concerns surrounding their use. As professionals, it’s important that we consider all eventualities and review the evidence of claims made before we decide where we stand and change our professional recommendations.
The good
As opposed to normal cigarettes, the electronic versions do not burn tobacco and do not produce tar or carbon monoxide. These are widely acknowledged to be two of the most harmful elements of smoking tobacco cigarettes. The NHS advocates for e-cigarette use to support smoking cessation, stating that while it’s not risk-free, it causes less damage than smoking cigarettes.[i]
A Cochrane Review paper[ii] found that people are more likely to quit smoking for 6 months using nicotine e-cigarettes than using nicotine replacement therapy or nicotine-free e-cigarettes. There was also evidence that vapes could be more successful than behaviour support alone, with low numbers of unwanted side effects reported.
Another study[iii] found that the daily use of e-cigarettes increased the chance of a smoker kicking the habit by 8 times, more compared to not using e-cigarettes. This research was conducted with daily smokers who had no intention of quitting and did not vape already, demonstrating the potential power of the devices in cessation.
The still in question
Even the aforementioned Cochrane Review was inconclusive with regards to the number of unwanted effects of nicotine-containing e-cigarettes compared to behavioural support.i The report also highlighted that more evidence was needed to determine the severity of unwanted side effects and the impact on vaping recommendations.
Another study[iv] from 2019 found that e-cigarette use did not lead to higher rates of smoking cessation or to lessen the risk of relapse to cigarette smoking compared to other methods. Conflicting evidence is common in new areas of healthcare so we’ll have to wait for more to become available before making our final decisions.
I was also interested to read that the latest potential concern circulating is that of ‘vape tongue’. This is said to involve the loss of taste, dry mouth and dehydration, culminating in bad news for oral health. The severity of symptoms seems to relate to the frequency of vaping, but research is needed in the area to better inform our professional advice.
Applications in dentistry
As a relatively new field, fresh information, anecdotes and research about vaping are frequently being shared. For dental professionals, it is important that we promote a science-based approach and anything that supports patients in smoking cessation is bound to be a good thing. Whether e-cigarettes are the best method of achieving this is yet to be seen and may well depend on the individual. All we can do is present the facts and ensure patients are informed so they can make the right decisions for themselves.
[i] NHS. Using e-cigarettes to stop smoking. https://www.nhs.uk/live-well/quit-smoking/using-e-cigarettes-to-stop-smoking/ [accessed August 2023]
[ii] Hartmann-Boyce J, Lindson N, Butler AR, McRobbie H, Bullen C, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Fanshawe TR, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews 2022, Issue 11. Art. No.: CD010216. DOI: 10.1002/14651858.CD010216.pub7.
[iii] Kasza KA, Edwards KC, Kimmel HL, et al. Association of e-Cigarette Use With Discontinuation of Cigarette Smoking Among Adult Smokers Who Were Initially Never Planning to Quit. JAMA Netw Open. 2021;4(12):e2140880. doi:10.1001/jamanetworkopen.2021.40880
[iv] Chen R, Pierce JP, Leas EC, et al. Effectiveness of e-cigarettes as aids for smoking cessation: evidence from the PATH Study cohort, 2017–2019
Tobacco Control 2023;32:e145-e152.
