Smokers who switch to e-cigarettes can adopt

According to a new study from the University of Washington, adult smokers who switch to using e-cigarettes may be more likely to improve their health and well-being.

The study tracked changes in smokers’ health and social functioning at two stages of adulthood, at age 30 and again at age 39. About a third of smokers have switched to vaping occasionally or all the time by age 39. This group reported better physical health, exercised more and had more active social engagement, according to the study.

“Despite the obvious risks to non-smokers, e-cigarettes have the potential to play a health-promoting role in the lives of smokers,” said study co-author Marina Epstein, a researcher at the social development research group at the UW School of Social Work.

The study, recently published in drug and alcohol addiction, was inspired by a larger longitudinal study, the Seattle Social Development Project, which began in 1985 to follow some 800 fifth-grade children in Seattle elementary schools. The sample for the present study focused on 156 of the participants who reported smoking at age 30 and smoking or vaping at age 39.

E-cigarettes first appeared in the United States in the mid-2000s, around the time the study sample participants turned 30. In 2018, 10% of adult smokers nationwide also used e-cigarettes. Vaping is especially popular among teens and young adults. the Centers for Disease Control and Prevention identifies e-cigarettes as the most popular tobacco product among young people in the United States, estimating that nearly 21% of young people use e-cigarettes. Previous research, from the UW and others, has found that vaping among teens and young adults can lead to later cigarette smoking. “In this way, e-cigarettes have been a disaster for public health,” said the study’s lead author, Rick Kosterman, a researcher with the Social Development Research Group.

At the same time, although vaping carries certain risks – the aerosol contains nicotine, small amounts of heavy metals and other ultra-fine, carcinogenic particles that can enter the lungs – the CDC considers them to be safer than traditional or combustible cigarettes.

Given the common perception of e-cigarettes as a “healthier” alternative, the researchers wanted to examine the behavior of smokers who switch to e-cigarettes occasionally or all the time as they approach their 40s. The research team collected a series of accepted measures of healthy aging and well-being, such as overall physical and mental health, adoption of healthy behaviors and social activities, and levels of education and income. They then asked the participants, aged 30 and 39, about this information and how often they engaged in certain activities.

Of the 156 participants in the study, 64% smoked only combustible cigarettes at age 39; 28% smoked and vaped; and only 8% vaped. Survey results showed that more frequent vaping – compared to smoking – was associated with better physical health, more exercise, more active social engagement and higher socioeconomic status.

“Although the study could not show a causal relationship, we believe that because e-cigarettes have less stigma, less odor, and are less physically harmful, they may increase opportunities for health promotion among smokers. E-cigarette users may be more likely to be in environments that promote physical activity and have more opportunities to interact with non-smokers,” Kosterman said.

No association was found between switching to vaping and better mental health, less frequent use of other substances such as alcohol, or whether one’s partner or closest peers smoked (although the broader social environment of vapers may be healthier).

Overall, the researchers point out that e-cigarettes still have significant public health harms, but this study shows that smokers who turn to vaping, whether occasionally or instead of cigarettes, may have more opportunities for healthier lifestyle choices. That doesn’t mean vaping is healthy, they say, but that for people who already smoke — and are unable to quit — it can be paired with other healthy routines.

The study was funded by the National Cancer Institute, the National Institute on Aging and the National Institute on Drug Abuse.

Co-authors were Jennifer Bailey and J. David Hawkins of the Social Development Research Group.

For more information, contact Kosterman at [email protected] or Epstein at [email protected]

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