Quitting smoking or switching
[7.0] I am planning on quitting altogether. Why should I switch products?
If you are a smoker who wants to quit using nicotine entirely, and believe that you can quit soon, we encourage you to go ahead and quit. There are plenty of sites on the web that offer advice for quitting, or better yet, consult with your doctor.
Tobacco harm reduction is focused on people who choose to continue using nicotine, or who try quitting and find they cannot. Unfortunately, many people who try to quit, even those who are quite sure they are ready and able to do so, start smoking again. Even people who quit for a time often start again in a year or two. For these people, we try to offer an alternative other than a never-ending cycle of failed quit attempts.
[7.1] What if I end up using smokeless tobacco or electronic cigarettes but don't quit smoking?
In Sweden, most people who successfully switch over to smokeless tobacco (ST) take some time making the full transition. At first, it might seem that you have just added another habit in addition to smoking when you are really on the path to quitting smoking. These things take time.
If you find yourself using ST or e-cigarettes at times...right direction. Since we promote using alternative sources to reduce the amount of traditional smoking, we would not consider it progress if you only used them when you could not smoke anyway. On the other hand, it is not going to hurt you much to use them only at those times (there is no point in being miserable craving a cigarette if you are not going to quit entirely), and maybe then you'll start using them at times you would have smoked.
Though many people have successfully switched, we cannot guarantee you will either find either of these substitutes satisfying enough, or that you will necessarily quit smoking, but we think that in the interests of a healthier life, you should at the very least try them and see if they work for you.
[7.2] Is there evidence that switching to ST or e-cigarettes can really help me quit smoking? - Yes there is.
In addition to the experience in Sweden, there is U.S. data that shows many people have used ST to quit smoking, and probably did it without even knowing how much safer it was. If you talk to ST users, you will probably find that many switched from cigarettes. There has even been a clinical trial (Rodu, below) that successfully got smokers to switch. For more on this, see our (smokeless tobacco and quitting reading list.)
Switching from smoking to one of these alternatives will not work for everyone but for many people they have been just the answer they were looking for. (See Rodu & Phillips 2008 regarding using ST as a cessation method, or Heavner et al. reporting on a study of e-cigarette users, and Bill Godshall's report from Vapefest 2009 also on the experiences of former smokers now using e-cigarettes. And if you are interested in some stories about successful switching to snuff, see the ToqueSnuff blog. (Snus type smokeless tobacco is banned in Britain so snuff use is the more common form.)
We understand that it may seem daunting to enter a whole new product category. Modern smokeless tobacco comes in may forms and flavors. To help you decide on where you might like to start, at snusauthority.com they are methodically going through the popular products and letting you know how they taste and feel. For those curious about Swedish snus brands, Snustopia is a good place for information.
The good news is that if it doesn't work, you have not really lost anything. When you do try it, make sure to really give it your best shot. See below for a description of the kind of experience most people have who have successfully switched over to using smokeless tobacco.
[7.3] Can I use ST to help me quit using nicotine entirely?
Maybe. There is not much evidence about this because current politics favor pharmaceutical nicotine products and oppose any use of tobacco. If you want to taper off, little-by-little, you might find that it is easier with ST than with cigarettes. Or you might not. You might find that e-cigarettes or pharmaceutical products work better. There is no reason not to experiment to see what might work for you.
If you replace long-term smoking with long-term ST use, you might find it easier to quit in the future (though again, the evidence is not very clear on this). There is some evidence that a large fraction of ST users just quit after a few decades of use, which is less true of smokers. ST users may find it much easier to quit than smokers do (or maybe just the most dedicated nicotine users choose to smoke. We cannot be sure).
[7.4] I am sure I will quit smoking someday, so wouldn't it be better to just wait until then, rather than switching to another habit? - Perhaps not.
It depends a lot on when you quit, if you succeed, and what you mean by "better". Every day that you smoke is another day that your smoking might kill you. Even though the health risks from smoking accumulate over a lifetime, there will be that last straw. For every smoker that died from smoking, there was a time they could have quit and avoided the disease that killed them. If you are quitting smoking to protect your health, you should try to make sure you do it before then.
It is impossible to know this for sure, but if switching to ST reduces your risk by more than 99%, for the average smoker this would be about the same as quitting about three months later. (This will vary depending on age and some immeasurable variables, but it provides some idea; see Phillips 2009 for a discussion of this.). This means that if you are a 45-year-old man and expect to quit entirely a year from now, you would probably be better off switching to ST now (especially since you may find that you cannot quit right away). And the same argument probably holds as well for switching to e-cigarettes.
If you are worried about the financial expense or other impacts of using tobacco, or the possible small risk from nicotine, then quitting altogether might be your goal. Even then, if you could switch to ST or e-cigarettes now, and then quit entirely later, you would avoid the smoking-related health risks until the day came when you quit all nicotine.
[7.5] I am interested in switching. Can I do it all at once?
In Sweden, where most of our knowledge of switching to ST comes from, the typical switcher transitioned gradually over an 18 month period. Usually, they start with a bit of experimentation, then using ST while still smoking some, and then eventually not smoking or very little.
In other words, switching may take a little time and effort. Give yourself time to get used to it and gradually shift from one to the other. Of course, in terms of health, the sooner you can give up smoking entirely the better, but take consolation in the fact that even if you cannot do that, every little move in that direction works in your favour. Don't worry if it takes a little longer than you planned. Any major life change, and quitting smoking is a big one, takes time.
Even before you have entirely switched over you will experience less smoky smell in your hair and clothing, more fresh air in general, and clearer lungs. That increase in general well being should help keep you focussed on quitting smoking entirely.
[7.6] Isn't promoting smokeless tobacco just a tobacco industry strategy to keep the profits rolling in?
Does it really matter what their motive is? Every company produces products in order to profit. Pharmaceutical companies produce lifesaving drugs to make money. Should we not use those drugs because someone is profitting? Most of these drugs would not exist if someone wasn't trying to make a profit. The point is to take the action that improves your health.
Think of it this way. If you continue to smoke because you dislike the tobacco industry profiting from selling smokeless tobacco, you are still giving them your money AND you are damaging your health.
References
1. Tilashalski K, Rodu B, & Cole P. 2005. Seven year follow-up of smoking cessation with smokeless tobacco. Journal of Psychoactive Drugs 37: 105-108. Abstract.
