# Higher-Nicotine Vapes Seem Better at Helping Smokers Quit Cigarettes



## fbb1964 (24/4/21)

https://filtermag.org/higher-nicotine-vapes-better-quitting/

*Higher-Nicotine Vapes Seem Better at Helping Smokers Quit Cigarettes*

Alex Norcia

April 22, 2021


A new study published in _The Lancet_, one of the world’s oldest and most highly regarded peer-reviewed medical journals, suggests that smokers given higher-nicotine vaping products consume fewer dangerous carcinogens through continued smoking compared with their peers given lower-strength vapes.

The study—funded by the National Institutes of Health (NIH) and the Food and Drug Administration (FDA)—looked at how smokers’ use of electronic nicotine delivery systems (ENDS) could help them cut back on cigarettes.

The participants, aged from 21 to 65, had smoked more than nine cigarettes per day for at least the past year and were not currently using ENDS. They then received either a cartomizer-based, pen-style ENDS paired with 0, 8, or 36 mg/mL liquid nicotine, or—for the control group—a cigarette-shaped plastic tube that did not deliver _any_ nicotine or aerosol. Over the course of 24 weeks, all groups were instructed to reduce their cigarette consumption first by 50 percent, and then by 75 percent.

At 24 weeks, the participants had their levels of NNAL—a biomarker that shows exposure to carcinogens specific to tobacco—measured. Among the findings, participants given the placebo product without nicotine or aerosol saw an 8 percent NNAL decrease, while those given an e-cigarette with 0 mg/mL—delivering aerosol without nicotine—saw a 20 percent decrease. Those with 8 mg/mL saw nearly a 32 percent drop, whereas those with the 36 mg/mL nicotine ENDS showed a 46 percent reduction.

“It was really only the dose that we know delivers nicotine in a comparable level to cigarettes that really had a reliable reduction in cigarette smoking,” Jonathan Foulds, one of the co-authors and a Penn State professor who researches smoking cessation, told _Filter_.

The paper includes a caveat about other variables: User behavior, device design and battery power might all play a role. But it still disputes the notion that lowering the amount of nicotine in vaping products would have a desirable outcome—that is, allowing adult smokers to transition from lethal combustible cigarettes to safer alternatives. In fact, the conclusions point in the other direction. If only low-nicotine vapes are permitted to be on the market, and higher-nicotine—and more satisfying—cigarettes remain, switching won’t be easy.

“If you give an e-cigarette a lot of disadvantages, like lowering the nicotine level so it can’t compete with a cigarette, then it simply won’t compete.”

The results could have major implications for upcoming policy discussions, especially as the Biden administration considers lowering the nicotine levels in combustible cigarettes and several countries, meanwhile, pursue nicotine caps in e-cigarettes.

At the moment, Canada is entertaining instituting a nicotine cap similar to the European Union at 20 mg/mL. Tobacco harm reduction advocates have warned that such a policy is flawed, as it would make it harder for smokers to ditch cigarettes and substitute them with easy-to-use vapes. (The US has also flirted with a similar strategy.)

Many experts argue, in other words, that vapes are direct substitutes for cigarettes, and that a major factor in people’s likelihood of switching is how much a given vaping product mirrors the nicotine intake—and the familiar feeling—from a cigarette. Should an adult or even a teen choose to consume nicotine, they reason, the less dangerous option should be incentivized.

“This study is consistent with the idea that reducing the amount of nicotine in e-cigarettes may not have the desired effects, like that it’s less addictive,” Foulds told _Filter_. “It may have the opposite effect. The [lower-nicotine] e-cigarette is less addictive, but therefore less satisfying and less able to reduce the use of the more addictive product, the cigarette.”

“If you give an e-cigarette a lot of disadvantages, like lowering the nicotine level so it can’t compete with a cigarette,” he continued, “then it simply won’t compete.”

Foulds clarified that the participants did have other incentives and requirements. They didn’t have to pay for vaping products, for example, and they had to keep rigorous track of their consumption. But they did _not _want to quit smoking. They simply professed some interest in wanting to limit the number of cigarettes they smoked.

“They’re not that unlike the way many real consumers approach their attempts to use e-cigarettes,” Foulds said.

Reactions: Like 2 | Agree 1 | Winner 2 | Informative 6


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## Alex (24/4/21)

This was a very interesting study, and the results mirror my personal view on nicotine strengths in vape liquid. The importance of very high nicotine is vital, Especially when first trying to transition away from cigarettes. 

Thanks for sharing @fbb1964

Reactions: Like 1 | Agree 6 | Thanks 1


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## Raslin (24/4/21)

I agree with @Alex, after 3 years on 1.5 to 3mg in my sqounkers I am feeling the need to go back to 6 and even 9mg juices.

Reactions: Like 3 | Funny 1


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## Grand Guru (24/4/21)

I quit smoking with 18mg free base Nic and now I’m down to 1mg with some Nic free juice sessions in between... I’m getting a silver even with 1mg juice nowadays ​

Reactions: Like 2


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## Raslin (24/4/21)

I was there too, but fell off the wagon after the 5 year mark. So I have decided to start at the begining again. Back on the Reo from next week.

Reactions: Like 2


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## YeOldeOke (25/4/21)

Somewhere in my dim past, in the sixties I think, someone did a study on whether animals feel pain, believe it or not. After millions spent, it concluded that they do. Colour me dumbfounded. I could have saved them millions by kicking the dog. If it yelps, yup, it feels pain.

Reactions: Like 3


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## fbb1964 (25/4/21)

Alex said:


> This was a very interesting study, and the results mirror my personal view on nicotine strengths in vape liquid. The importance of very high nicotine is vital, Especially when first trying to transition away from cigarettes.
> 
> Thanks for sharing @fbb1964



I agree @Alex. Quite interesting. Strange how it varies from person by person. I started vaping nearly 4 years ago. Ex heavy smoker packet of marlboro reds 25 a day or two. Tried 18 mg juice couldn't do it coughed my lungs out. Tried 16mg juice same thing. Settled on 12 mg juice no problem. Ok no worries let's try 9mg and 6mg about a year ago. Nogo it didn't work just vaped heaps more with juice flowing like water. Back on 12 mg juice I'm in my happy place again.
Then today I actually checked and marlboro red cigarettes are 12 mg nicotine. Wtf! So the nicotine strength consumed while I was smoking was directly replaced by the nicotine strength in the juice I'm vaping now. Good on the many vapers cutting down their nicotine intake to such really low levels. Me? Quite OK to stay in my happy place with 12mg nicotine vaping now.

Reactions: Like 4


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## Silver (25/4/21)

Thanks @fbb1964
Also agree with @Alex

when transitioning to vaping from smoking, high Nic strength is vital

I did it with Twisp Clearo 1 about 7 yrs ago. With 18mg and even then I pulled on those first Gen MTL devices like a steam train to get in the desired Nic. I tried 24mg and that was good too

I also think MTL is easier for the transition (from a similarity of action to smoking point of view) and that also requires higher Nic juice owing to less volume of vapour.

It’s more important to get the transition right when you start vaping. Plenty time to reduce Nic strength later.

Reactions: Like 2 | Agree 4


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