Tobacco-cessation
help lines — traditionally aimed at cigarette smokers — are receiving a surge
in calls from people who vape and want to quit
Hotlines to quit
smoking, or “quitlines,” were designed to help people kick cigarette habits,
but calls and texts from people who use e-cigarettes are climbing as more
people fall ill with the mysterious and devastating respiratory illness linked to vaping.
These are just a few of
the messages that teen vapers texted in September to the new “My Life,
My Quit” program, which offers phone, text and chat lines to young
people trying to quit smoking in 13 states:
“I stopped for a few days and then I
ended up buying new pods. The withdrawals got to me.”
“My friends are the ones who got me into
vaping. And they think I shouldn’t stop, but I want to because I don’t want to
hurt my family if I get sick.”
“I feel like I get winded easily and I
just know it’s not good for me. I want to quit so bad but it’s really hard when
all your friends are vaping around you.”
Health officials are
investigating 1,080
cases in 48 states and the U.S. Virgin Islands, including at least 18 deaths. In
California, more than 110 residents have
fallen ill, and two have died, according to the California
Department of Public Health.
The department in
September called on everyone to refrain from vaping,
“no matter the substance or source,” while the investigations continue. The
Centers for Disease Control and Prevention also advised people to
“consider refraining” from using e-cigarette products,
especially those that contain THC, the main psychoactive ingredient in
marijuana, which has been linked to most of the illnesses.
The rise in calls to
help lines means the message is penetrating, said Stanton Glantz, director of
the University of California-San Francisco Center for Tobacco Control Research
and Education.
“The more we learn
about e-cigarettes, the more dangerous they look,” Glantz said. “Callers are
right to be worried, frankly.”
Optum, which operates
tobacco quitlines for 23 states and the District of Columbia and for more than
1,000 employers, logged a 50% increase in callers asking for help to quit
vaping since the CDC released its first
report on the illnesses in early September, said Seth Serxner,
the company’s chief health officer.
The majority of state
quitlines are run by Optum or National Jewish Health, a respiratory research
hospital in Denver, whose My Life, My Quit program is aimed at youths. National
Jewish Health runs help lines for 16 states — not all of which offer My Life, My
Quit — enrolling about 100,000 people each year into tobacco cessation
programs.
The quitlines are publicly funded,
and the counseling is free.
Almost 20% of all
callers to Optum’s help lines said they used vapes, up from 3% during the same
period in 2015, Serxner said.
“People are going,
‘Whoa, I didn’t know this was that bad for me,’” he said.
In July, National
Jewish Health enrolled 88 people into its cessation program who said they vaped
exclusively. In August and September combined, the organization enrolled 457
people who vaped exclusively, more than five times the July figure, said Thomas
Ylioja, clinical director for health initiatives at the organization.
Calling 1-800-QUIT-NOW
routes callers to counselors in their state, where they can get counseling to
help them set quit dates and identify triggers that could lead to a relapse. If
clients give permission, counselors follow up with them in the days and weeks
after their initial call, when quitting can be most difficult.
Depending on where
callers live and what kind of insurance they have, they may qualify for free
nicotine replacement therapy, like patches, gum, lozenges or prescription
medication. Vapes and e-cigarettes are not a federally approved treatment for
smoking cessation, so help lines have not recommended them to clients to help
them quit.
Not all state quitlines
are seeing an uptick in calls. Calls from vapers were flat for West Virginia’s
help line from July through September compared with the same period in 2018,
said Lindsy Hatfield, program director for First Choice Services, which
operates the state’s quitline.
But starting in August,
Hatfield noticed that some callers didn’t realize that their Juul e-cigarettes,
the nation’s
most popular brand, could addict them to nicotine, even though it is
listed as an ingredient on the package.
“Some people we found
did not know that Juul was an e-cigarette, vape or nicotine device,” Hatfield
said. “They felt that Juul did not have nicotine in it, and so it couldn’t be
the same thing” as an e-cigarette.
The University of
California-San Diego runs California’s tobacco quitline (which offers help in
English and Spanish) and serves about 30,000 callers a year. It also runs a
national help line for people who speak Mandarin, Cantonese and Vietnamese.
Since 2017, the
quitline has received a steady increase in calls from people who vape. Most
said they were using e-cigarettes to quit or cut down on cigarettes because
they thought of vapes as a “better alternative,” said Niki Hoang, a San
Diego-based counselor and former smoker who has been with the help line for
seven years.
Hoang and her
colleagues noticed a change this summer: Callers who used vapes to quit
cigarettes are now trying to quit vaping, she said.
And smokers who have
never tried vaping are vowing to stay away, saying that they don’t want to “be
the guinea pig,” according to Hoang.
The summer’s influx of
calls prompted the help line to train the California staff — about 60
counselors — on the history of the devices and how to counsel people who want
to quit.
The calls for help are
a far cry from 2007, about the time vapes hit the
U.S. market and were described
as safer than cigarettes.
Millions have started
using them since then, including teens and young adults. Recent federal data
funded by the National Institute on Drug Abuse show that 25% of this year’s
high school seniors and 20% of 10th graders reported
vaping nicotine in the past month. That’s more than double the
use reported in 2017.
Little research exists
on the best strategies to stop vaping, so quitline counselors generally employ
techniques they’d use for cigarette addiction.
But there is at least
one key difference between smoking and vaping that might make the latter more
difficult to quit, said Ylioja of National Jewish Health. Vapers have an easier
time evading restrictions on smoking in indoor spaces or public places because
the smell dissipates faster, he said.
That makes it difficult
for vapers to make a plan to avoid situations or people sparking future
cravings.
“They have a harder
time identifying what triggers might be,” Ylioja said. “They were using these
products in so many different social situations.”
This story was produced
by Kaiser Health
News (KHN), which publishes California Healthline, an editorially
independent service of the California Health Care Foundation.
KHN is not affiliated with Kaiser Permanente.
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