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Article | An Exploration of Smoking-to-Vaping Transition Attempts Using a “Smart” Electronic Nicotine Delivery System

This study used novel smart technology to explore smoking-to-vaping transitions and suggests vaping is a complicated process and that some vapers may need additional cessation support to become smoke-free.

In collaboration with the University of California San Francisco and Johns Hopkins University, ASPIRE2025 researchers, led the feasibility study trialling “smart” technology, including a “smart” e-cigarette and smartphones to track 11 participants’ real-time vaping and daily smoking during an eight-week smoking quit attempt. The results were published in the international journal Nicotine & Tobacco Research.

See media release: Novel smart technology explores smoking-to-vaping transitions

Abstract

Introduction

Electronic nicotine delivery systems (ENDS) are used to aid smoking cessation attempts; however, many smokers continue to smoke while using an ENDS (dual use). Although uncertainty remains regarding whether specific ENDS patterns hinder or support successful smoking cessation, recent advances in “smart” technology allow passive and active recording of behaviors in real time, enabling more detailed insights into how smoking and vaping patterns may coevolve. We describe patterns of ENDS initiation, and subsequent use, including any changes in cigarette consumption, among daily smokers using a “smart” ENDS (S-ENDS) to quit smoking.

Method

An 8-week long mixed-methods feasibility study used Bluetooth-enabled S-ENDS that passively recorded real-time device use by participants (n = 11). Daily surveys administered via smartphones collected data on self-reported cigarette consumption.

Results

All 11 participants were dual users, at least initially, during their quit attempt. We observed three provisional vaping and smoking patterns: immediate and intensive ENDS initiation coupled with immediate, dramatic, and sustained smoking reduction, leading to smoking abstinence; gradual ENDS uptake with gradual smoking reductions, leading to daily dual use throughout the study period; and ENDS experimentation with return to exclusive smoking. For six participants, the patterns observed in week 1 were similar to the vaping and smoking patterns observed throughout the rest of the study period.

Conclusion

Technological advances now allow fine-grained description of ENDS use and smoking patterns. Larger and longer studies describing smoking-to-vaping patterns, and estimating associations with smoking outcomes, could inform ENDS-specific cessation advice promoting full transition from smoking to exclusive ENDS use.

Citation

Blank, M., Hoek, J., George, M., Gendall, P., Conner, T., Thrul, J., Ling, P., Langlotz, T. (2018) An Exploration of Smoking-to-Vaping Transition Attempts Using a “Smart” Electronic Nicotine Delivery System, Nicotine & Tobacco Research, , nty093, https://doi.org/10.1093/ntr/nty093

For more information please contact:
Mei-Ling Blank
University of Otago
email meiling.blank@otago.ac.nz