Treating Dual Nicotine Users with Smoking Cessation Therapy

Researchers at the University of Washington School of Medicine, led by Louis, have found that as smokers attempt to quit smoking, some turn to e-cigarettes. However, these individuals often become dual nicotine users, simultaneously smoking traditional cigarettes and e-cigarettes. The good news is that researchers have found that smoking cessation treatments that focus on nicotine replacement and counseling can help these dual users quit smoking.

The majority of the 40 million smokers in the United States admit to wanting to quit smoking. Some are turning to e-cigarettes as a step towards that goal. However, an increasing number of people are becoming dual nicotine users, smoking both traditional cigarettes and e-cigarettes.

Researchers have found that many people who try to quit smoking end up increasing their intake of nicotine instead. However, there is good news: a smoking cessation treatment that focuses on nicotine replacement and counseling, which has been approved by the US Food and Drug Administration (FDA), can help dual users quit smoking. In fact, this treatment appears to be effective for both dual users and those who only smoke traditional cigarettes.

The research findings were published in the "Thorax" journal on July 21st.

We suggest FDA-approved treatment methods such as nicotine replacement therapy, medication such as varenicline, and counseling for smokers. However, we are aware that an increasing number of people are using both cigarettes and e-cigarettes. The good news is that tobacco treatment can still help these individuals quit smoking and overcome their nicotine addiction." - Dr. Xunchen Li, Medical Doctor and Senior Researcher and Associate Professor in Psychiatry.

On average, about 70% of smokers attempt to quit smoking. Another 20% claim they want to smoke less. However, among those who have not received any treatment such as nicotine replacement therapy or counseling, only about 5% successfully quit smoking.

A review of the electronic health records of over 110,000 smokers who visited Barnes Jewish Hospital between 2018 and 2020 found that the number of electronic cigarette users had doubled. While some individuals may have started using e-cigarettes as a potential step towards quitting smoking, many seem to have become trapped. Rather than quitting, they began using electronic cigarettes while continuing to smoke traditional cigarettes.

In the course of the research, a growing number of relatively small but dual users of smoking were identified. Approximately 0.8% of individuals reported dual smoking in the first year of the study, but by the end of the data collection process, this figure had increased to 2.3%. The authors note that the actual number of dual users may be higher.

Researchers have discovered that around one in five (20.8%) dual users quit smoking within 12 months. In comparison, the quit rate for those who only smoke traditional cigarettes is 16.8%.

Treatment appears to still be the key for dual users. When they receive smoking cessation therapy, nearly one-third (29%) become non-smokers after 12 months. Among dual users who do not receive treatment, only about 17% are able to quit.

The first author, Dr. Brendan T., who is a surgical resident and thoracic surgery researcher, stated that although dual users have a higher quit rate, approximately two-thirds of individuals still smoke a year later, even after treatment. Additionally, due to limited knowledge regarding the long-term health effects of e-cigarette use, he advises against using e-cigarettes as a means to quit smoking.

Hayden stated that the current scientific consensus is that using both traditional cigarettes and e-cigarettes is detrimental to one's health. Although current guidelines do not recommend using e-cigarettes as a way to quit smoking, it has been found that among those who use both products, traditional tobacco treatments approved by the FDA, such as nicotine replacement therapy and behavioral support therapy, can help them quit smoking.

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