{"id":34226,"date":"2026-07-31T15:21:04","date_gmt":"2026-07-31T19:21:04","guid":{"rendered":"https:\/\/therapytoronto.ca\/news\/?p=34226"},"modified":"2026-07-30T13:27:59","modified_gmt":"2026-07-30T17:27:59","slug":"experts-say-its-time-to-include-nicotine-e-cigarettes-in-smoking-cessation-conversations","status":"publish","type":"post","link":"https:\/\/therapytoronto.ca\/news\/2026\/07\/experts-say-its-time-to-include-nicotine-e-cigarettes-in-smoking-cessation-conversations\/","title":{"rendered":"Experts say it\u2019s time to include nicotine e-cigarettes in smoking cessation conversations"},"content":{"rendered":"

Cigarette smoking kills nearly half a million Americans each year, yet most people who smoke are unable to quit despite multiple attempts. Helping more people to quit smoking remains one of the greatest opportunities to reduce tobacco-related disease and death.<\/p>\n

An interdisciplinary group of tobacco treatment experts is urging clinicians to broaden the treatment options they discuss with patients who want to stop smoking cigarettes.<\/p>\n

In new recommendations published in JAMA<\/a><\/em>, the researchers outline how clinicians can incorporate nicotine e-cigarettes as part of patient-centered conversations about smoking cessation. The goal is not to encourage nicotine use but to help more people to stop smoking combustible cigarettes \u2013 the leading cause of preventable death in the U.S.<\/p>\n

Developed by the Harm Reduction Work Group of the Society for Research on Nicotine and Tobacco\u2019s Treatment Research Network<\/a>, the recommendations provide clinicians with practical guidance for discussing smoking cessation. Rather than taking a one-size-fits-all approach, the authors encourage clinicians to present patients with a \u201cmenu of options\u201d for quitting and work with them to weigh the risks and benefits.<\/p>\n

The paper also includes a conversation guide that walks clinicians through key questions to consider, strategies for addressing common misconceptions and evidence-based recommendations for counseling patients who choose to use nicotine e-cigarettes.<\/p>\n

\u201cWe\u2019ve had clinicians asking us for years how they should talk to their patients about e-cigarettes, and we really didn\u2019t have anywhere to point them,\u201d said Alana Rojewski, Ph.D.<\/a>, associate director of the Tobacco Treatment Program at MUSC Hollings Cancer Center<\/a>. \u201cThere was plenty of research literature but nothing that offered practical guidance on how to have these conversations in clinical practice.\u201d<\/p>\n

A patient-centered approach to quitting smoking<\/h2>\n

\u201cThe main takeaway is for clinicians to include e-cigarettes in their toolkit of smoking cessation options,\u201d said Tracy Smith, Ph.D.<\/a>, an addiction scientist and co-leader of the\u00a0Cancer Prevention and Control Research Program<\/a>\u00a0at Hollings.<\/p>\n

The authors emphasize that the best approach to quitting smoking will vary from person to person and should be tailored to each patient\u2019s goals, preferences and medical needs.<\/p>\n

\u201cThere isn\u2019t a one-size-fits-all approach to quitting,\u201d Smith added. \u201cOur job is to provide patients with accurate information and a menu of evidence-based options that give them the best chance of success.\u201d<\/p>\n

A major point of emphasis is on shared decision-making between clinicians and patients. If a patient has no preference about treatment options, smoking cessation medications already approved by the U.S. Food and Drug Administration (FDA) remain an appropriate place to start. However, if a patient prefers to try nicotine e-cigarettes, clinicians should support that decision rather than requiring them to try and fail other therapies first.<\/p>\n

That recommendation reflects a stark reality: Continuing to smoke cigarettes carries significant health risks, and delaying treatment can have serious consequences.<\/p>\n

\u201cTime is of the essence when we\u2019re trying to get people off cigarettes,\u201d Smith said. \u201cThe priority is helping people quit combustible cigarettes as quickly and effectively as possible.\u201d<\/p>\n

That message is particularly important for people whose health is already affected by smoking, including cancer survivors and people living with cardiovascular disease or other chronic illnesses.<\/p>\n

Importantly, the recommendations are intended only for adults who currently smoke cigarettes. The authors explicitly state that nicotine e-cigarettes should not be used by youth or people who have never used tobacco products.<\/p>\n

Correcting common misconceptions<\/h2>\n

Another major goal of the paper is correcting misconceptions about nicotine e-cigarettes among both patients and providers. The researchers note that public perceptions of nicotine e-cigarettes have become increasingly negative despite growing evidence supporting their use as smoking cessation tools.<\/p>\n

One of the most common misconceptions is that nicotine itself is responsible for smoking-related diseases, such as cancer and heart disease. In reality, most smoking-related illnesses are caused by the toxic chemicals produced when tobacco is burned, not nicotine itself.<\/p>\n

Because e-cigarettes do not involve combustion, they expose users to substantially fewer harmful chemicals. The paper cites high-certainty evidence from Cochrane systematic reviews<\/a>showing that nicotine e-cigarettes can be more effective than nicotine replacement therapies, such as patches and gum, at helping people to stop smoking. Other reviews have similarly found that their effectiveness is comparable to FDA-approved smoking cessation medications.<\/p>\n

But that does not mean nicotine e-cigarettes are risk-free.<\/p>\n

\u201cThe evidence for helping people quit smoking is pretty good, but they\u2019re not a magic bullet,\u201d Smith said. \u201cThere are lots of people who try e-cigarettes for whom they don\u2019t work or who end up using both products for a prolonged period of time. Like every smoking cessation treatment, there are risks and benefits that patients and clinicians should discuss together.\u201d<\/p>\n

Researchers also acknowledge that safety data on nicotine e-cigarettes are still limited. While e-cigarettes have been available for years, scientists will need decades of additional research to understand their long-term health effects fully.<\/p>\n

\u201cThe lack of long-term safety data is a potential risk,\u201d Rojewski said. \u201cBut helping people transition away from combustible cigarettes is what\u2019s most important. The sooner we can help someone quit, the better. Every conversation about smoking cessation is an opportunity to improve someone\u2019s health and reduce their risk of developing smoking-related disease.\u201d<\/p>\n

Practical guidance for clinicians<\/h2>\n

Beyond recommending that clinicians discuss nicotine e-cigarettes with patients who smoke, the paper offers practical recommendations for doing so. Those recommendations encourage clinicians to:<\/p>\n