Vaping May Not Help Cancer Patients Quit Smoking

A recent study published in Cancer, a journal of the American Cancer Society, found that among cancer patients who smoke, those who use e-cigarettes are more likely to show nicotine dependence and are less likely to quit traditional tobacco. The findings also raise questions about whether e-cigarettes are beneficial for helping cancer patients quit smoking.

Because of the risks of continued smoking, all cancer patients who smoke should quit. But for patients and healthcare providers, do e-cigarettes help or hinder smoking cessation? The rise in e-cigarette use is raising many questions, and even regulators are struggling with the complexity when weighing the pros and cons of e-cigarette use in the general population and among cancer patients.

To evaluate e-cigarette use and cessation among cancer patients, Jamie Ostroff and colleagues at Memorial Sloan Kettering Cancer Center in New York studied 1,074 cancer patients who smoked and were enrolled in the tobacco treatment program at a comprehensive cancer center during 2012-2013.

The researchers found that e-cigarette use increased threefold during 2012-2013 (10.6%-38.5%). At baseline, e-cigarette users were more nicotine-dependent than non-users, had made more quit attempts in the past, and were more likely to be diagnosed with thoracic or head and neck cancers. During follow-up, there was no significant difference in smoking status between e-cigarette users and non-users (OR=1.0; 95% CI, 0.5-1.7). However, after intention-to-treat analysis, e-cigarette users were nearly twice as likely to still be smoking as non-users (OR=2.0; 95% CI, 1.2-3.3).

In their conclusion, the researchers wrote, “The high rate of e-cigarette use in this study is consistent with the recent increase in e-cigarette use in the general population, and the findings raise questions about whether e-cigarettes are beneficial for helping cancer patients quit smoking. More research is still needed on the safety and effectiveness of e-cigarettes as a smoking cessation treatment for cancer patients.”

The researchers believe that oncologists should advise all smokers to quit traditional combustible tobacco, encourage patients to use FDA-recommended cessation treatments, recommend participation in smoking cessation counseling, and inform patients about the potential risks of long-term e-cigarette use and the lack of known benefits.