Patients will ask for your help with “vaping cessation”…as reports of e-cigarette harms and deaths continue to stack up.
But there’s no good evidence on how to break the vaping habit.
Lean on usual smoking cessation strategies…especially to help “dual users” or to prevent e-cig users from turning to regular cigarettes.
Individualize your recommendations based on patient preference, vaping history, quit attempts, etc…and use these rules of thumb.
Advise setting a quit date…avoiding vaping triggers…and getting free support at GoSmokeFree.gc.ca/quit or BreakItOff.ca.
For adults who regularly use e-cigarettes, explain that adding meds may be worth a try…since most e-cigs contain nicotine.
Consider nicotine replacement therapy (NRT) first. Suggest a patch PLUS a short-acting product (gum, etc) for breakthrough cravings.
To suggest a patch dose, check the e-cigarette’s package or website to estimate nicotine content…and ask patients how much they vape.
For example, Juul 5% contains about 40 mg nicotine per “pod,” similar to smoking a PACK of cigarettes. For an adult vaping more than half a pod/day, think of a 21 mg/day patch as a reasonable starting point.
Or consider a 14 mg/day patch for patients using less nicotine. For instance, Vype 1.6% contains about 15 mg nicotine in half a pod.
But it’s not an exact science. Be ready to adjust doses as needed.
Consider Champix® (commercial name in Canada) (varenicline) next if NRT isn’t enough…or bupropion SR, particularly for e-cigarette users with depression. If needed, suggest combining Chantix® (Commercial name in USA) or bupropion SR with NRT.
Lean on behavioural strategies for teens. There’s little evidence smoking cessation meds help teens quit smoking…and none for vaping.
Use our new Vaping Cessation Guide to assess nicotine content in e-cigarettes, to manage triggers, and for other support options. Contact us for a copy!