Dual use of combustible and electronic cigarettes is worse for your health

More than 1 in 4 young Americans vape every day, according to the most recent FDA data.

While vaping on its own is less harmful than smoking cigarettes, researchers say that many people are falling into a concerning “dual use” pattern of smoking both cigarettes and e-cigarettes. 

Recent research has shown that people who use both cigarettes and vapes over long periods of time have a four-fold increase in their risk of lung cancer. 

“Very few people these days just smoke cigarettes,” said Megan Piper, a director of research at the University of Wisconsin-Madison Center for Tobacco Research and Intervention. Piper is currently conducting a study of dual users to figure out effective ways to help them quit cigarettes. She shared some of her findings about smoking and vaping  with WPR’s “Wisconsin Today.” 

Young people and vaping 

Most young people don’t identify as being smokers or vapers, Piper said. 

“If you ask most young adults, ‘Do you think you’ll be smoking in the future? Do you think you’ll be vaping in the future?’ Most of them … don’t identify as a smoker or a vapor, and so they don’t see themselves doing it in the future,” she said. “The problem is, when you’re dealing with a substance as addictive as nicotine, that dependence builds early and makes it that much harder to be smoke-free or vape-free as you move into later adulthood.”

But, Piper said, young people are using e-cigarettes less frequently than they used to. 

“Kids get that you can become addicted to e-cigarettes now, and they understand the dangers,” she said. “It doesn’t mean they think it’ll happen to them. But the notion that it’s a completely safe product has evolved.”

Why it can be so hard to quit 

Although there are a lot of services designed to help people quit smoking, there’s little data to support which ones are most effective, Piper said. 

And the programs that help people quit smoking may not be as effective with vaping. 

“Vaping is relatively new, and so the treatment research is trying to catch up,” she said.

Why dual use is so common

Many smokers use both traditional cigarettes and e-cigarettes.

“A lot of people who smoke thought when e-cigarettes came around, ‘This might be a healthier way to get my nicotine, and maybe it’ll help me quit.’ We have a lot of people in this country that are stuck in this dual use pattern, where sometimes they’re smoking (cigarettes) but they’re also vaping, maybe in places where they can’t smoke,” she said.

E-cigarettes can help some people quit smoking, Piper said, as long as people don’t continue smoking tobacco.

“There’s evidence that they can be as effective as things like the nicotine patch,” she said. “But you can’t get stuck in that dual pattern. You have to completely switch.” 

Searching for interventions that help dual users quit cigarettes 

Piper’s center is compiling data to show which interventions are the best at helping dual users quit cigarettes.

“What we want to do is take interventions that we know help people quit smoking and see if we can modify them so that they’ll be really effective for people who are dual users,” she said. “We’re looking to help people who smoke and vape focus on quitting smoking and seeing the best way that they can do that.”

“How much nicotine are you actually taking into your system if you’re smoking and vaping? Once we have that information, it’ll help us understand why a nicotine patch might work better for some. Or maybe (dual users) do much better with a pill like Chantix, otherwise known as varenicline.”

People can see if they’re eligible to sign up for the study at avenuesstudy.com. 

Getting help

Piper said there are a variety of programs and medications that might help people quit smoking and vaping.

She recommends on online intervention called This is Quitting. 

”It allows people to interact with other folks trying to quit vaping,” she said. 

Medications like varenicline have also been shown to help people quit vaping.

To explore various options, Piper recommends contacting the  Wisconsin Quit Line. The Quit Line has different options for connecting, so if people don’t want to talk to anybody, they don’t have to. They can instead text ‘ready’ to 34191.