Vaping has become more mainstream as a recommended quit tool in the United Kingdom but the team highlight: “Although many smokers manage to quit, evidence (primarily predating the widespread use of e‐cigarettes) suggests that many successful quitters relapse over time.”
They wanted to see how vaping had impacted on this situation and if it supported those who would have otherwise gone from an occasional fag to full-time smoking again, “this is so that we can develop evidence based advice, guidance or interventions to support those who have quit smoking to stay abstinent in the longer term.”
The subject is dogged by problems with definitions informing viewpoints with loaded political and moral overtones. Defining what constitutes a lapse and relapse can lead to individuals being categorised as “addicts” in need of “treatment”. They argue for a fairer approach because “qualitative studies have suggested that, for some, smoking lapse, and relapse, situated in people's lives, is complex, related to unfolding processes of identity development, and involving the loss and regaining of pleasure.”
In what is quite unusual for vape studies (although should be commonplace) the team spoke to actual vapers – using our anecdotes that are all too often dismissed by tobacco controllers.
Forty subjects were encouraged, “to ‘tell the story’ of their history of tobacco use, previous quit attempts, quitting using an e‐cigarette, patterns and experiences of e‐cigarette use over time, and, for this article, the focus was on detailing any lapses or the circumstances surrounding relapse where this had occurred.”
They found: “In previous literature, a brief lapse has been strongly associated with smoking relapse. In our data too, individuals frequently described how previous instances of lapse prior to vaping inevitably led to relapse. However, in the context of quitting smoking by vaping, brief lapses could be purposive or permissive, without resulting in subsequent relapse.”
“In countries with policies enabling vaping, vaping is a viable, and indeed for many, preferable, alternative to smoking, allowing any sense of ‘failure’ at lapsing to be minimised. By interrupting the almost automatic processes between lapse and relapse through offering an alternative; our exploratory study suggests that relapse need not be inevitable following a brief tobacco lapse amongst those who vape.”
The team concludes: “We tentatively suggest that our findings uniquely demonstrate how the role of smoking lapse may be theoretically redefined, in the context of vaping, questioning the utility of previous theories of the role of smoking lapse in the relapse process. For ex‐smokers, vaping appears to offer a powerful substitution option for smoking and an alternative to relapse, even following situations of brief lapse.”