WHY VAPING IS BETTER THAN THE PATCH OR GUM
Recent studies have shown that e-cigarettes are significantly more effective in helping smokers quit, with more smokers remaining abstinent at the one-year mark compared to those using other methods. The percentage who quit using e-cigarettes is around double that of those who quit using forms of nicotine replacement therapy such as nicotine gum, nicotine patch, nicotine lozenges, and nicotine inhalator.
INTRODUCTION
In the United States, around a fifth of all deaths are smoking related. It is clear that smoking presents serious health risks, and despite this being common knowledge, people still choose to smoke. Understanding why this is the case is essential to changing the huge number of smoking related deaths.
WHAT IS NICOTINE?
Nicotine is a naturally occurring insecticide in plants, and behaves as both a stimulant and depressant in humans. There are quite a few effects of nicotine on the human body - it activates parts of the brain that regulate things like our mood and cognition, and continued use results in an increase of the number of receptors that nicotine acts on. Depriving the body when it has developed this dependence leaves the brain craving nicotine to get these areas stimulated. Smoking also stimulates the release of dopamine - the body’s reward chemical - and this can give smokers the feeling of being relaxed and content.
WHAT ARE NICOTINE GUMS AND NICOTINE PATCHES?
Nicotine Replacement Therapy (NRT) is a medicinal way of replacing the nicotine you would otherwise get from smoking. These nicotine containing products come in many forms such as nasal spray, chewing gum and patches, and deliver nicotine without all the additional harmful chemicals found in traditional cigarettes.
WHAT IS NICOTINE GUM?
Nicotine gum is a chewing gum form of NRT that releases nicotine as it is chewed, the nicotine is then absorbed by the mouth lining and gets into the bloodstream, instead of being absorbed in the lungs from smoking or vaping. It also serves to keep the mouth busy, which can help the quitting process. Alongside nicotine and the chewing gum base, nicotine gum contains Polacrilin, Sorbitol, anhydrous sodium carbonate, sodium bicarbonate, glycerol, talcum and flavourings (1).
The gum is meant to be used in a very specific way, as it is the chewing that gives the doses of nicotine. The gum should be chewed until a tingling sensation is felt, at which point the gum should be placed between teeth and gum or lip until it subsides, and this should be repeated over the course of half an hour.
Many studies have been conducted to assess the efficacy of the various forms of nicotine replacement therapy, and nicotine gum has shown a significant positive effect for smoking cessation. One particular study shows the 2mg strength nicotine gum had a 16% efficacy in ‘high dependence’ smokers (2) - those craving a cigarette when they wake up - meaning 16% of the subjects had stopped smoking at one year. The 4mg strength saw the percentage of those who had stopped at 1 year rise to about 33%. Nicotine gum has been shown to be effective in quitting tobacco, providing a controlled release of nicotine to help manage cravings.
IS NICOTINE GUM BAD FOR YOU?
It is generally accepted that the risks of nicotine replacement, like nicotine gum, are much lower than the risks of smoking long-term. There are some potential side effects from nicotine gum from hiccups and wind to some more serious symptoms; including dizziness, nausea, vomiting, diarrhoea, weakness, arrhythmia, difficulty breathing, a rash, and blisters in the mouth (3). If you experience any of those symptoms while using nicotine gum, stop using it immediately and call your doctor.
WHAT IS A NICOTINE PATCH?
A nicotine patch is another form of NRT that applies nicotine transdermally (through the skin). They are available in 16 hour and 24 hour versions, and different strengths, that apply a steady supply of nicotine to the body over the stated period. Just apply in the morning and remove at the end of the stated time period. This is easy and requires no maintenance throughout the day.
Nicotine patches can cause mild itching, redness and/or burning and stinging where they are applied to the skin, but this should only be considered serious if this hasn’t disappeared after 4 days (4). Other possible side effects include nausea, dizziness, headache, heartburn and skin flushes, and the persistence or worsening of these symptoms require a consultation with a doctor or pharmacist. Serious symptoms like mood changes, numbness in the hands and/or feet and swelling of the hands, ankles or feet mean you need to stop using the medication and consult your doctor immediately.
DO NICOTINE PATCHES WORK?
The same study mentioned earlier also looked at the effectiveness of nicotine patches in relation to the nicotine gum available on the market. The study saw a 9% efficacy for nicotine patches - this means 9% of the subjects using the patches had stopped smoking at one year. This figure is a lot better than 0% of subjects being smoke-free after a year, however an efficacy of 9% leaves a lot of room for improvement.
THE LIMITATIONS OF NICOTINE REPLACEMENT THERAPY
While nicotine replacement therapy (NRT) has been a popular method to help people quit smoking, it does come with its limitations. One significant drawback is that NRT products, such as nicotine patches and gum, may not deliver enough nicotine to fully satisfy cravings, leading to potential relapse. Additionally, these products often fail to address the behavioral and psychological aspects of smoking addiction, which are crucial for many people trying to quit smoking.
Moreover, NRT products can be quite expensive and are not always covered by insurance, making them less accessible for some individuals. Side effects like mouth irritation and stomach discomfort can also deter people from using these products consistently. These limitations highlight the need for more effective and comprehensive solutions for those looking to quit smoking.
WHAT ARE E-CIGARETTES AND VAPING?
E-cigarettes are an electronic version of a cigarette that vaporizes liquid containing nicotine (called ‘e-liquid’ or ‘vape juice’) which is then inhaled. The liquid contains just vegetable glycerine (VG) propylene glycol (PG) nicotine and flavourings, eliminating the thousands of chemicals found alongside nicotine in tobacco, of which 60+ are known carcinogens.
WHAT ARE COMMON MYTHS ABOUT E-CIGARETTE AND VAPING?
There are some frustrating myths surrounding vaping and e-cigarettes, and some of this is down to the differences in regulation between different countries (or complete lack of, in some cases).
One such myth is that e-cigarettes give you what is called ‘popcorn lung’ (5) - it was given this name because it is caused by diacetyl, the chemical used to give microwave popcorn it’s flavour and smell, and was first observed among workers in a popcorn factory. This appears to be a problem found mainly in the US and hasn't been established from E-Cigarette use - in the UK diacetyl is banned as an ingredient for e-liquids, whereas the United States have yet to implement comprehensive regulation for e-liquids.
Another myth stems from the lack of regulation in the US and other countries, and this is the misconception that E-Cigarettes are not regulated and we don’t know what’s in them - in the UK we have strict regulations regarding standards of quality and safety when it comes to e-cigarette and vape products - even the packaging has requirements for labelling to ensure customers have all the relevant information and can make the right choice. Products must be tested and detailed information provided to the UK Medicines and Healthcare products Regulatory Agency (the MHRA).
There is also an assumption that because e-cigarettes contain nicotine, this means they are harmful. According to Public Health Matters, four in ten smokers (and ex-smokers) think nicotine causes tobacco related cancer. While nicotine is the chemical that keeps people addicted to smoking, there are over 60 known carcinogens in cigarettes, and thousands of other compounds that can affect things like nicotine uptake, and it is these chemicals that cause serious damage. Not to mention the carbon monoxide - a very reactive, unstable compound that damages the body’s ability to transport oxygen around.
Second hand smoke is problematic when it comes to smoking, and it is assumed that similar problems are present with vapour from e-cigarettes. Public Health England’s 2018 review of evidence found there have been no identified health risks of passive vaping to the health of bystanders.
Two myths that can be addressed together are the idea that e-cigarettes encourage young people to smoke because of things like ‘fruity flavours’ - and that the tobacco industry is using e-cigarettes as a method to keep people smoking. Whilst young people are experimenting with e-cigarettes, this does not turn into regular use in most cases - data collected by Action on Smoking and Health (ASH) showed a rise in the percentage of people who have tried e-cigarettes, but occurrence of regular use remained at 1%. This, coupled with the fact that 2016 saw the lowest prevalence of smokers in the UK since 2010 - just 15.8% - strongly suggests that tobacco use is in decline, not being exacerbated by e-cigarettes.
Lastly, sceptics have suggested that e-cigarettes don’t actually help you quit smoking - all the evidence shows this to be incorrect. Some studies have shown that using an e-cigarette can be almost twice as effective as other forms of nicotine replacement therapy - one study showed a 9.9% abstinence rate at one year using NRT, whereas the e-cigarette group saw 18% abstinence rate at the one year mark (6), when both products were accompanied with behavioural support.
THE RISKS OF SMOKING CIGARETTES
Smoking cigarettes poses a significant risk to your health, contributing to a range of serious conditions such as heart disease, stroke, and various types of cancer. Respiratory issues like chronic obstructive pulmonary disease (COPD) are also common among smokers. According to the Centers for Disease Control and Prevention (CDC), smoking cigarettes is the leading cause of preventable death in the United States, accounting for more than 480,000 deaths each year.
Quitting smoking can dramatically reduce these risks and improve overall health and well-being. The benefits of quitting smoking are immediate and long-term, from improved lung function and circulation to a reduced risk of heart disease and cancer. This makes quitting smoking one of the most impactful decisions you can make for your health.
IS VAPING A MEANS FOR QUITTING SMOKING?
Making the switch from smoking to vaping cuts out all the harmful chemicals found in tobacco, and allows you to get your nicotine in a way that feels similar to smoking. There is high certainty evidence from scientific studies demonstrating that e-cigarettes are more effective than traditional nicotine replacement therapies for smoking cessation. Public Health England maintains that e-cigarettes are 95% less harmful than smoking (7), so using e-cigarettes to stop smoking is an effective way of delivering the nicotine to your body and keeping your hands busy while you do!
THE BENEFITS OF VAPING FOR QUITTING SMOKING
Vaping, or using electronic cigarettes, has emerged as an effective method for quitting smoking. Studies have shown that vaping can help people quit smoking by mimicking the sensation of smoking, without exposing them to the harmful chemicals found in tobacco smoke. Vaping products, such as e-cigarettes, provide a controlled amount of nicotine, which can help manage withdrawal symptoms and cravings more effectively than traditional nicotine replacement therapies like nicotine patches and gum.
Additionally, vaping products can be more cost-effective and convenient to use. They offer a variety of flavours and nicotine strengths, allowing users to tailor their experience to their needs. However, it’s important to note that while vaping is much less harmful than smoking, it is not without risks, and more research is needed to fully understand its long-term effects.
CHOOSING THE RIGHT VAPE FOR QUITTING
Choosing the right vape for quitting smoking can be a daunting task, given the plethora of options available. When selecting a vape, consider factors such as the type of device, nicotine strength, and flavour. It’s advisable to start with a device that is user-friendly and offers a high nicotine strength to help manage withdrawal symptoms effectively.
Flavour is another crucial factor; choosing an appealing flavour can help distract from cravings and make the transition smoother. Ensure that the vape is sourced from a reputable supplier and meets safety standards. Consulting with a healthcare professional or a vaping expert can also provide valuable guidance in making an informed decision.
OVERCOMING THE CHALLENGES OF QUITTING
Quitting smoking is undoubtedly challenging, but it’s far from impossible. One of the biggest hurdles is managing withdrawal symptoms like cravings and irritability. Having a well-thought-out quit plan can make a significant difference. This plan might include using nicotine replacement therapy, such as nicotine patches or gum, or opting for vaping products to manage cravings.
Support systems are equally important. Friends, family, or support groups can provide the motivation and accountability needed to stay on track. Identifying and avoiding triggers can also help reduce cravings and prevent relapse. Celebrating small milestones, like reaching a week without smoking, can keep you motivated and encouraged throughout the quitting process.
By addressing both the physical and psychological aspects of smoking addiction, and leveraging the right tools and support, you can overcome the challenges of quitting smoking and enjoy a healthier, smoke-free life.
WHAT'S BEST: VAPING VS NICOTINE PATCHES VS NICOTINE GUM?
In all seriousness, the action of smoking is a big part of the addiction, if only psychologically. Vaping is brilliant because it delivers nicotine in an action that smokers are used to, without the negative effects from smoking cigarettes. Forms of nicotine replacement therapy are normally prescribed for a course, and while the general consensus is that using these products long term is safer than long term tobacco use, there is some indication in animal studies that long term use can increase cancer risk.
Other factors that demonstrate the validity of vaping against forms of NRT include the nicotine delivery itself. Whilst vaping still doesn’t deliver the same nicotine hit as a cigarette, new generation devices have improved the level of nicotine absorption.
ARE NICOTINE PATCHES BETTER THAN VAPING? VAPING VS NICOTINE PATCHES
Nicotine patches are easy and convenient, only need to be applied in the morning and taken off after the indicated time period. It slowly builds the blood nicotine level and maintains it, which means there is a delay between the initial application and satisfaction, between 30 minutes to an hour. Vaping gets to a significant blood nicotine level much faster than the patch, so the faster action should result in less time craving or suffering withdrawal symptoms. With an e-cigarette you can adjust your dose accordingly by taking more (or less) puffs; patches deliver a consistent amount over time, so the dosing can’t be adjusted.
IS NICOTINE GUM BETTER THAN VAPING? VAPING VS NICOTINE GUM
Using gum has a similar problem to patches - the nicotine takes approximately half an hour to reach significant levels, meaning it does little to address a craving swiftly. It also has very specific instructions for use so the user must keep these in mind when chewing away, and eating or drinking shortly before (or during) use reduces nicotine absorption, so these instructions should be followed to extract maximum value from nicotine gum.
Vaping gets more nicotine into the blood (8) quicker than nicotine gum, so addresses cravings faster. Also, vaping can be done at your leisure, with some variation between devices and liquid strengths, where the gum should be used once every 2 hours (at least when you first start use), reducing the flexibility and ease of use. Here in the UK there are only 2 different nicotine strengths available in the gum, which again means less flexibility - vaping gives the option of different strength e-liquid, and the option to make your liquid, which can be tailored to your own needs.
The gum is also designed to be used as a quitting aid over a given period of time. While this pressure may be beneficial for some, vaping does not have the same limitations, and can be adjusted in different ways if necessary. Lower the nicotine content in your liquid, use the device less, take bigger but fewer drags, or even change device - the options for vaping are more numerous than those for gum, and as a ‘one-size-fits-all’ approach rarely works due to individual differences and preferences, this gives vaping the edge.
Nicotine lozenges are similar to the nicotine gum and people can experience a stomach upset if they are swallowed, so make sure to avoid swallowing any nicotine replacement products that go in your mouth!
As we have established, there is evidence to support the supposition that new generation e-cigarettes are more effective as a long term tool for quitting than the forms of nicotine replacement therapy available, when accompanied by behavioural support. The same study also demonstrated reduced coughing and phlegm production for the e-cigarette group versus the NRT group.
Another study looked at the short term efficacy of e-cigarettes, e-cigarettes with NRT, and NRT alone - all alongside behavioural support (9). The two groups that used an e-cigarette saw similar short term success: the e-cig only group had a 62.2% success rate at 4-6 weeks, the e-cig with NRT saw a 61.5% success rate, as opposed to the NRT only group, which saw a success rate of 34.8%.
Every new study appears to be providing more evidence to support the validity of e-cigarettes and vaping as a smoking cessation method. The efficacy is also consistently outperforming that of current nicotine replacement therapy products, in both short term and long term studies. If you are a smoker looking to quit nicotine, e-cigarettes may provide you with the best chances of success.
WHY VAPING IS BETTER THAN THE PATCH OR GUM - CONCLUSION
So why is vaping better than patches or gum? Patches and gum are slower to act, give the user less freedom, don’t replace the action of smoking, and the current evidence shows them to be less effective at helping people quit smoking.
While there are individual cases where nicotine replacement therapy in the form of patches gum, or other products may be preferred due to medical reasons, vaping is proving to be more successful than these other products for getting people away from smoking. Now that really is worth sharing!
REFERENCES
(1) Nicorette Gum Pharmaceutical Details
(2) How effective is nicotine replacement therapy in helping people to stop smoking?
(3) Nicotine Gum: Friend or Foe?
(4) Cleveland Clinic: Nicotine Patches
(5) UK Health Security Agency: Clearing up some myths around e-cigarettes
(6) A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy
(7) E-Cigarettes around 95% less harmful than tobacco estimates landmark review
(8) Nicotine absorption during electronic cigarette use among regular users
(9) Effects of e-cigarettes versus nicotine replacement therapy on short-term smoking abstinence when delivered at a community pharmacy
ABOUT THE AUTHOR
Written by Dan Overgage
Dan Overgage is a former smoker of 10 years until he became a client of SMOKO E-Cigarettes. Dan started working with SMOKO 5 years ago after successfully quitting using our e-cigarettes and works across our Customer Service and heads up our content creation and research with a strong focus on all things quitting smoking. During his tenure with SMOKO, Dan has written countless blogs and consults with countless clients every day to help them to stay smoke-free.
