[Healthy Aging] Should You Quit New Types of Electronic Cigarettes Too?

Professor Shin Dong-wook, Department of Family Medicine, Samsung Seoul Hospital.

Many people's New Year's resolution is to quit smoking. However, these days, perhaps because paper calendars are no longer used, it seems that fewer people make resolutions to quit smoking even when the New Year arrives. Another reason might be the increase in people using new types of electronic cigarettes instead of traditional combustible cigarettes. As smoking is legally restricted in workplaces and indoor spaces and aversion to cigarette odor has increased, many have switched to using new types of tobacco products instead of conventional cigarettes. Some around us have completely switched to new tobacco products and no longer smoke traditional cigarettes, while others use traditional cigarettes or new tobacco products depending on the situation.

Everyone knows that traditional cigarettes are harmful. They are linked not only to serious and fatal diseases such as cancer, myocardial infarction, and stroke but also to conditions like dementia and erectile dysfunction. The difficulty in quitting smoking is due to nicotine, one of the main components of cigarettes, which causes addiction. When smoking, nicotine strongly stimulates the brain for a short period, but after about two hours, the blood nicotine concentration drops to nearly zero, creating a strong craving to replenish it, leading to repeated smoking. Most smokers in Korea are men who learned to smoke during their school years or military service, influenced by peer groups and organizational culture, and despite aging and deteriorating health, many cannot quit due to addiction.

However, since the 2000s, new types of tobacco products other than traditional cigarettes have been developed and released. Among them, the first developed was the liquid-type electronic cigarette, an electronic device that delivers nicotine liquid in vapor form through a portable vaporizer. Some products are made more attractive by adding flavors, making them popular among women and adolescents. Pure nicotine liquid itself does not contain tobacco and is not carcinogenic, but it has harmful effects on cardiovascular diseases due to vasoconstriction. Also, since various companies manufacture these products with diverse additives and minimal regulation, some toxic substances may be mixed during production. Therefore, while not as harmful as traditional cigarettes, they still negatively affect health.

The more commonly used products nowadays are usually classified as heated tobacco products. Instead of burning tobacco leaves like traditional cigarettes, these products heat tobacco to produce a nicotine-containing gas that users inhale. They retain some of the characteristic tobacco flavor and produce less odor, making them preferred by office workers. Heated tobacco products are also perceived as less harmful than traditional cigarettes. In fact, the amount of toxic substances inhaled is about 60% of that from traditional cigarettes, but they still contain significant toxic substances and are harmful to health. A domestic study also showed that people who switched to electronic cigarettes still have a higher risk of cardiovascular disease compared to those who quit smoking completely. Additionally, the mistaken belief that these products are less harmful reduces the motivation to quit smoking, leading some to become dual users who smoke both traditional and heated tobacco products depending on the situation.

It goes without saying that quitting smoking is the best option. This applies equally to new electronic tobacco products. So how should one quit? Addiction is difficult to overcome by willpower alone, and the success rate of quitting on one’s own is only about 3%. Currently, the best-known method is using a medication called varenicline. It acts on nicotine receptors in the brain to reduce addiction, and many people succeed in quitting smoking by taking the medication for about three months. You can receive a prescription by visiting a general clinic that operates a smoking cessation clinic nationwide and consulting with them. If varenicline does not suit you, other options such as bupropion or nicotine replacement therapies can also be effective.

If quitting smoking is truly difficult, you can participate in a government-run smoking cessation camp. There are 17 smoking cessation support centers nationwide that offer a 4-night, 5-day program including medication treatment, individual counseling, group counseling, and even CT scans for lung cancer screening. The participation fee is very affordable at 100,000 KRW, and the intensive treatment results in a very high success rate. For detailed schedules, please refer to the Smoking Cessation Dodream website of the Korea Health Promotion Institute.

Dongwook Shin, Professor, Department of Family Medicine, Samsung Medical Center