Smokers attempting to quit the habit by vaping or using e-cigarettes do not always find the process plain sailing, according to new University of Otago research published in the international journal, Tobacco Control.

The study, which involved in-depth interviews with 20 vapers who also smoked traditional cigarettes regulary, explored why some smokers did not make a full transition to vaping.

Lead author, Dr. Lindsay Robertson, a Research Fellow in the University of Otago's Department of Preventive and Social Medicine, says the main reason this group of vapers did not stop smoking completely was a strong attachment to, and a sense of nostalgia for, what they described as "real" cigarettes.

"Many started their quit attempt expecting that vaping would offer them exactly the same experience as smoking. However, they often became disappointed when their experiences didn't replicate smoking, and continued smoking as well as vaping."

One way of addressing this problem could involve managing smokers' expectations more carefully. This includes ensuring smokers who want to switch to vaping receive good advice from well-trained retailers with specialist vaping knowledge, the researchers suggest.

"Participants see specialist vape-shop staff as expert advisers; retailers of electronic nicotine delivery systems could help remind people of the importance of giving up entirely," says Professor Janet Hoek, who leads the Health Research Council-funded research project.

"This advice could be very important because some participants thought having cut down the number of cigarettes they smoked was a successful outcome, and so stopped trying to stop smoking completely."

Professor Hoek highlights a UK study published in the British Medical Journal last week that showed smoking only one cigarette per day carries a much greater risk of developing heart disease and stroke than previously expected: around half of the risk for people who smoke 20 per day.

Other reasons study participants used both e-cigarettes and traditional cigarettes were to side-step legislation that has made tobacco less affordable and less convenient to use in public spaces, and to avoid feelings of stigma.

Dr. Robertson says whether participants vaped or smoked a cigarette often depended on the people around them, and some participants reported experiencing stigma towards vaping.

Government legislation could help people make a full transition away from smoking to exclusive use of e-cigarettes and vape devices, say the researchers.

"We need to get the balance of regulation right, to ensure smokers who choose to quit by vaping receive the best support and advice possible, are not encouraged back towards smoking and, of course, to prevent harm to young people," Professor Hoek says.

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