In order to reduce cigarettes, I combine them with ‘e-cigs’: is this a winning strategy?

A major scientific study that has just been published indicates that, unfortunately, ‘dual’ use does not bring real benefits (neither for health nor for being able to stop).

I’m about to turn 43, I’ve been smoking about a pack of cigarettes a day since I was a kid. Although I have tried several times, I have never been able to stop smoking and say goodbye once and for all to this habit. For the past three years, however, I have been using e-cigarettes for at least a while. I have a question for you: am I in danger of getting sick more or less than before?

Roberto Boffi, Head of the Unit of Pneumology and the Anti-Smoking Center at the National Cancer Institute of Milan, responds

This interesting question raises a subject which is still not very well dealt with: that of dual smokers. ‘Dual’ means the smoker who adds to his smoking routine the use of e-cigarettes, also known as e-cigs, as a short time. The reason that often drives the smoker to make this choice is, as in his case, the idea that with the support of such devices can reduce the number of cigarettes consumed and consequently limit the damage to his health. Unfortunately, a major study by Andrew C. Stokes and colleagues, just published in the journal Circulation, one of the most authoritative international scientific journals in the field of medical research on cardiovascular diseases, does not support this hypothesis at all.

The study: the dangers for dual smokers
Researchers at Boston University, through the blood and urine analysis of 7 thousand adults, divided according to their smoking habits (non-smokers, ecig users, traditional cigarette smokers and dual smokers), have in fact shown that classical and dual smokers have biomarker levels related to inflammatory and oxidative stress quite similar, while exclusive users of e-cigs show lower levels than in both categories. The authors of the US study conclude by emphasising the importance of completely replacing cigarette smoking with e-cigarettes, as dual use clearly does not bring real benefits. The reason why there does not seem to be a gain in health is not yet entirely clear, but one hypothesis is that the reduction in the daily number of cigarettes is associated with an increase in craving and this risks translating into the need for deeper and deeper mouthpieces, having to suck up the same amount of smoke inhaled before the reduction.

We would also like to point out that although the aerosol produced by e-cigarettes using liquids contains, in both qualitative and quantitative terms, substances that are certainly less harmful than those contained in tobacco, they cannot be considered harmless for various reasons, including the presence, in addition to numerous heavy metals (in particular nickel, chromium, silver and titanium, as already published by studies carried out at the National Cancer Institute) very often of nicotine that , among the different damages it causes, also involves the increase in blood pressure, heart rate and endotelial stiffness of the arteries. In addition to the suggestions given by colleagues, therefore, we feel that we advise smokers who really want to get less harmed (or try to quit permanently) using these devices, not only to replace all traditional cigarettes with these products but, considering the lack of studies on the use of e-cigs in the long term, to use electronic devices only for the period necessary to overcome the fearsome abstinence symptomatology related to the cessation of tobacco smoke.