Jeannie Cox currently enjoys a flavor called Coffee & Cream when she vapes. She’s also fond of White Lotus, which tastes “kind of fruity.”
She buys those nicotine-containing liquids, along with her other e-cigarette supplies, at Mountain Oak Vapors in Chattanooga, Tennessee, where she lives. A retired secretary in her 70s, she’s often the oldest customer in the shop.
Not that she cares. What matters is that after ignoring decades of doctors’ warnings and smoking two packs a day, she hasn’t lit up a conventional cigarette in four years and four months.
“Not one cigarette,” she said. “Vaping took its place.”
Like Cox, some smokers have been able to stop smoking by switching to e-cigarettes. A recent study by the Centers for Disease Control and Prevention found that more smokers now attempt to quit by using e-cigarettes than by other more established methods.
Her success is what researchers disdainfully call “anecdotal evidence,” however. At the moment, therefore, neither the CDC, the Food and Drug Administration nor the U.S. Preventive Services Task Force has approved or recommended e-cigarettes for smoking cessation.
But while the proportion of Americans who smoke continues to decrease — down to 15.1 percent in 2015 — the decline has stalled among older adults.
People older than 65 have always been less likely to smoke, in part because premature death means fewer smokers survive to older ages. In 1965, 18.3 percent of older adults were smokers. It took 20-plus years for that to fall below 15 percent. But over the last six years, that percentage has plateaued, bouncing between 8 and 9 percent. That still leaves millions of older smokers.
Might switching to vaping improve their health, even if they never become nicotine-free?
“Vaping is clearly less harmful than regular cigarettes,” said Dr. Steven Schroeder, who directs the Smoking Cessation Leadership Center at the University of California, San Francisco.
Nicotine is the addictive ingredient that keeps smokers lighting up. But the thousands of other chemicals in combustible cigarettes do most of the damage.
“If you could get nicotine in a safer form, like an FDA-approved medication, even for the rest of your life, you’d be in far better shape,” said David Abrams, a clinical psychologist at New York University.
This argument, known as harm reduction, recognizes that the best course is to quit both cigarettes and e-cigarettes — but given the difficulty of quitting altogether, vaping could provide a reasonable alternative.
“Any smoker, especially an older smoker, who isn’t thinking about switching is doing himself a major disservice,” Abrams said.
Cox loved smoking ever since she was a teenager sneaking Marlboros, and wasn’t trying to quit. But she’d planned a fall visit to her nonsmoking children in Alaska in 2013, and standing outside their home to smoke sounded unappealingly chilly. Cox did some online research, tried several flavors at Mountain Oak and bought a starter kit.
“I’m not quitting smoking, I’m just trying this newfangled thing,” she told herself. “Three days later, I realized I hadn’t smoked a cigarette in three days. I thought, ‘This is working out kind of nice. Quitting is not supposed to be this easy.'”