DUAL USE

    Data continues to pour in about the serious respiratory consequences due to the use of e-cigarettes.  We now know that e-cigarette use, just by itself, i.e. independently, is associated with an increased risk of respiratory disease.  One of the original claims about e-cigarettes was that they would be a safer alternative to combustible tobacco.  This claim was made without any scientific data or studies to support it.

    In a recent analysis of the above hypothesis, it was found that the most common pattern for e-cigarette users is so-called “dual use”, i.e. using both e-cigarettes and combustible tobacco.  The odds of developing a respiratory disease was 3.3 fold higher in those who used both e-cigarettes and combustible tobacco.  We know that adolescents who use e-cigarettes are 4 times more likely to go on to smoke regular tobacco.  Therefore, although switching from combustible tobacco to e-cigarettes theoretically could reduce the rate of developing a respiratory disease, current data indicates that there is a high prevalence of dual use which is associated with an increased risk of lung disease beyond combustible tobacco alone.

    Real-world observational studies have shown that, on average, tobacco smokers who use e-cigarettes are less likely to quit smoking and people who stop tobacco smoking but use e-cigarettes are more likely to relapse to tobacco smoking than those who do not use e-cigarettes.  

    Stopping smoking is hard.  There is no easy way to quit.  Patches, gums, and medications will help some, but expect withdrawal symptoms no matter what you use.