Study Finds What Vapers Knew: Accidental Quitting Is Real

Many people begin using e-cigarettes with no intention to quit smoking, but then do quit smoking. The phenomenon is so widely recognized in the vaping community that it has a name: accidental quitting. Lots of vapers refer to themselves as accidental quitters or accidental vapers.

People who smoke but don’t intend to quit begin vaping for various reasons. They may try vaping out of curiosity, or vape as a substitute in settings where smoking isn’t allowed, or they may buy an e-cigarette on a whim. What we know is that, for whatever reason they try vaping, many discover they prefer it to smoking, or at least that it’s a good enough replacement that they decide to do it full time.

Now for the first time, a peer-reviewed study has recognized the experience of the accidental quitter. “Association of e-Cigarette Use With Discontinuation of Cigarette Smoking Among Adult Smokers Who Were Initially Never Planning to Quit” is the tongue-twister title of an open-access paper published yesterday in the journal JAMA Network Open. The study was authored by a group of researchers led by Dr. Karin A. Kasza, a research scientist in the Department of Health Behavior at the Roswell Park Comprehensive Cancer Center in Buffalo, NY.

I'm actually an accidental vaper. I smoked 2 packs a day for 20 years. I never smoked in my house because I hated the smell sticking to everything. I started vaping to "smoke" when inside but I ended up vaping more than smoking. It wasn't long before I was vaping exclusively.

— Sorteal (@Sorteal) January 10, 2021

The authors found that when smokers vape daily their odds of quitting smoking rise dramatically—even though they didn’t intend to quit smoking before vaping. The researchers identified 1,600 people who, at the beginning of the study, smoked cigarettes, didn’t vape, and didn’t intend to quit smoking. Among that group, 28 percent of those who began vaping daily quit smoking. Among those who didn’t vape at all, just 5.8 percent quit smoking.

“Most other studies focus exclusively on people who are actively trying to quit smoking, but this study suggests that we may be missing effects of e-cigarettes by not considering this group of smokers with limited intention to stop smoking—a group that is often at the highest risk for poor health outcomes from cigarette smoking,” said Dr. Andrew Hyland, Chair of Health Behavior at Roswell Park and one of the study’s authors.

The study used four waves of data from the Population Assessment of Tobacco and Health (PATH) Study, collected between 2014 and 2019. PATH is a national longitudinal study of tobacco and nicotine product users, run jointly by the FDA Center for Tobacco Products (CTP) and the National Institute on Drug Abuse (NIDA). The Roswell Park study was funded by grants from the CTP and NIDA.

In addition to being far more likely to quit smoking completely, smokers who vaped daily were also more than four times as likely to switch from daily to less frequent smoking (45.5 percent) than those who didn’t vape (9.9 percent) or vaped less often (10.2 percent).

"We found evidence that the use of e-cigs could have a positive impact on this very hard-to-reach group of recalcitrant smokers. To truly understand the health impact of vaping on the U.S. population, we need to consider those with no intention to quit."

— Jukka Kelovuori (@jkelovuori) December 28, 2021

The authors believe “accidental quitters” (a term they don’t use) are a large enough group that their experience should matter to regulators like the FDA. “Our findings here suggest that such smokers should be specifically considered when evaluating the risk-benefit potential of e-cigarettes for smoking cessation in the population,” they note in the paper.

Clinical trials have shown that vaping outperforms nicotine replacement therapy for smokers intending to quit. But the smokers represented in the Roswell Park study are a much more difficult group, because they don’t intend to quit smoking.

“We found evidence that the use of e-cigarettes could have a positive impact on this very hard-to-reach group of recalcitrant smokers,” says Dr. Hyland. “To truly understand the health impact of vaping on the U.S. population, we need to consider those with no intention to quit.”

It should surprise no one that vaping, with its endless device and flavor options and its similarity to the act of smoking, offers the best chance to reach the most hardened smokers. Unfortunately, the trick must be performed while smokers are also bombarded with misinformation intended to sow doubt about vaping, and laws and regulations designed to restrict access and affordability. How many smokers would get interested if public health organizations recommended vaping and shared honest estimates of harm compared to smoking?