How to quit vaping: Steps for success

In 2003, Hon Lik, a Chinese pharmacist, created the modern e-cigarette as a device to allow smoking without the combustion of tobacco, although the original smokeless device dates from 1930 (1, 2). His late father died of lung cancer after a lifetime of cigarette smoking. By 2008, e-cigarettes were introduced to the European and American markets, and their popularity grew exponentially.

Hon Lik’s invention has an irresistible appeal to a smoker’s mind - or any human mind for that matter - the promise of delivering just the same pleasure without the consequences. The view that vaping is not harmful is misguided and dangerous (3, 4); vaping is alluring and often harder to quit than cigarettes.

Inside a smoker’s mind

We all have an inner voice that tells us what we should and should not do. Some call it "the voice of reason". The argument that vaping is 'healthier' is used by the 'addiction voice' to appease the voice of reason somewhat and reduce its impact - diminishing guilt with arguments such as "It is a step in the right direction" or "It is a pathway to quitting". (Spoiler alert: these are excuses, the addiction part has no intention of quitting.)

With its cleaner user experience, fancy flavours, and devices, vaping's social and technological appeal further embeds it into users' lifestyles. Despite the debate surrounding its safety, many view vaping as a transitional step towards quitting, not recognising it as a persistent trap fueled by addiction. Vaping is now, in fact, harder to quit.

Social pressure, a powerful driver for change, weighs heavier on cigarette smoke than on vapes. Instead, vaping has its own culture and community. It's not just about inhaling nicotine; it's about the flavours, the tech behind the devices, and even the tricks you can do with the vapour. 

Plus, you can control your nicotine intake more precisely, which is a big deal for people trying to wean off nicotine gradually (how long is a piece of string?). 

It's a hobby as much as it is a habit. 

This community aspect provides a sense of belonging and support, especially when trying to quit smoking. (It is like the AA for cigarette smokers, except no one has actually stopped smoking. Instead, there is further and better nicotine addiction).

Of course, you are aware of the concerns surrounding vaping. However, it still feels like progress from cigarettes because "tar is the problem, not the nicotine", and I will eventually stop (another hint: the end is not in sight).

Transactional analysis and vaping's psychological appeal

Understanding the decision-making process behind vaping can be illuminated through Eric Berne’s transactional analysis (TA), a theory of psychology that explores personal interactions and decision-making through three ego states: the Parent, the Adult, and the Child.

These ego states are present in each and all of us. Our 'inner child' often drives our pursuit of immediate gratification, pleasure, and play - often tricking our Adult state's logical reasoning and fact-checking to get what it wants.

Smoking is a typical case of the inner child bypassing the adult’s better judgment. The inner child is leading behaviour that defies logic and good sense, leaving the Adult stunned at its powerlessness. The problem with nicotine is that the inner child is not working alone - it is getting a lot of help from powerful marketing tactics.

New tech, old tricks

The tobacco industry, by extension through vaping, has ingeniously exploited this dynamic. Consider the classic sales technique that activates the child's ego state:

A customer expresses hesitation about a purchase, mentioning financial constraints. The salesperson retorts with a seemingly sympathetic but ultimately manipulative statement: "This is a wonderful product, shame you can’t afford it." This tactic directly appeals to the inner child, provoking a need to assert independence and capability, leading the customer to purchase the product just to prove they can.

Vaping taps into a similar mechanism. It tells the inner child: "The tar from cigarettes causes cancer, we don’t want that. Nicotine causes atherosclerosis, cellular oxidative stress, endothelial dysfunction, and all those things that cause you to age faster and lead to organ failure, but no one mentions that anywhere so it must be okay. Besides, how could something tasting of tutti-frutti cause limb amputation? Surely not." 

The lack of explicit warnings against less-known but serious risks, like atherosclerosis, works as leverage to a rationalisation that appeals directly to the inner child's desire for immediate pleasure and play, effectively bypassing the adult's rational and health-conscious considerations.

Speaking to the adult within

To help the logical adult ego state take charge, it's important to dissect the myth that nicotine is not harmful*. 

Atherosclerosis and nicotine

Atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque comprises fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries, limiting the flow of oxygen-rich blood to your organs and other parts of your body. In its advanced state, it leads to infections, limb amputations, organ failure, and sepsis. 

Nicotine and cholesterol

Nicotine affects lipid metabolism, increasing levels of low-density lipoprotein (LDL) cholesterol, which is the "bad" cholesterol, and decreasing the levels of high-density lipoprotein (HDL) cholesterol, known as "good" cholesterol. Elevated LDL levels contribute to plaque development in the arteries, while lower levels of HDL reduce the body's ability to remove this plaque.

Oxidative stress and inflammation

Nicotine induces oxidative stress by generating free radicals (the stuff that makes you age). These reactive molecules can damage the endothelial cells lining the blood vessels, leading to inflammation. Chronic inflammation in the blood vessels is a key process in the development of atherosclerosis. The damaged endothelium becomes more permeable, allowing more LDL cholesterol to penetrate into the arterial wall and become oxidised, further accelerating the inflammatory response and plaque formation.

Endothelial dysfunction

The endothelium is critical in maintaining vascular health by regulating blood flow and preventing clotting. Nicotine impairs the function of endothelial cells, reducing the availability of nitric oxide, a molecule essential for vasodilation (the widening of blood vessels). This dysfunction contributes to the stiffening of arteries and promotes the progression of atherosclerosis.

Promotion of vascular smooth muscle cell proliferation

Nicotine stimulates the proliferation of vascular smooth muscle cells (VSMCs) in the arterial wall. These cells contribute to the structure of the plaque and its growth. As VSMCs accumulate in the area, they secrete extracellular matrix proteins, which can further narrow and stiffen the arteries, exacerbating the atherosclerotic process (4).

Respiratory effects - Inhaling any substances into the lungs can potentially cause irritation and damage. The long-term effects of vaping on lung health are not fully understood. Still, when inhaled, there are concerns about the impact of various flavouring agents, propylene glycol, and vegetable glycerin. 

Activating the adult ego-state is critical for progress. This can be done by exposing the inner child’s fallible logic with evidence and fact-checking. 

A psychotherapist or hypnotherapist can help the process by helping you identify ego-states, create a relationship with them, and dis-identify with them, allowing you to understand when they are influencing your decisions - so you know when "here is my inner child talking", or "my adult mind knows, but my inner parent thinks I shouldn’t", and so on.

In addition to ego-states, there is another important psychological aspect of vaping addiction: classical conditioning.

Pavlovian

Smoking is often seen as a coping strategy to address other psychological symptoms, mostly anxiety-related.

Anxiety is a generalised feeling of danger and impending doom, for which a puff of nicotine offers some relief. However, it is possible that smoking itself is causing the anxiety in the first place. Let’s look at the pioneer behaviourist Pavlov’s theory to see how that can work.

In the context of smoking, Pavlov’s classical conditioning can explain how certain environments, situations, or emotional states become cues or triggers for smoking behaviour. Here's how the process works with smoking:

• Unconditioned stimulus (US) and response (UR): Initially, the act of smoking is an unconditioned stimulus - that is, something done for the first time - that produces an unconditioned response - that is, something that has not yet been "learnt" - the response is the instant pleasurable buzz from the nicotine.
• Neutral stimuli: Neutral stimuli are everyday situations, locations, or emotions that, on their own, do not cause a person to crave a cigarette. Drinking coffee, finishing a meal, feeling stressed, or taking a break at work.
• Conditioning process: Over time, if smoking (US) consistently occurs in conjunction with these neutral stimuli, the brain begins to associate the neutral stimuli with the act of smoking.

This means that if a person regularly smokes while drinking coffee, the brain starts to connect the taste or act of drinking coffee with the effects of smoking. This helps explain why smokers often find themselves craving a cigarette in specific contexts or emotional states, even if they are not actively thinking about smoking. 

Breaking free from conditioned associations

Breaking the smoking habit involves breaking the conditioned associations between smoking and various aspects of daily life.

Conditioned stimulus (CS) and conditioned response (CR): Eventually, the previously neutral stimuli (i.e. coffee) become conditioned to trigger the conditioned response (CR) on their own. In this case, the sight, smell, or thought of coffee might alone trigger a craving for a cigarette. With the help of hypnotherapy, this can be changed to trigger a feeling of relaxation, even in the absence of actual smoking.

Albert Ellis can help you quit

Albert Ellis's Rational Emotive Behaviour Therapy (1981) book explains how it is not so much what happens to us but what we tell ourselves about what happens. 

Quitting smoking can trigger an inner child's response to feeling deprived. Instead, viewing it as an adult-mind decision to protect health and gain independence can shift the mindset from self-pity to empowerment and self-control.

It's important to empower the rational mind. Simple CBT strategies, like keeping a thought journal, can help assess our beliefs. Psychotherapy or hypnotherapy can help differentiate between the inner child's simplistic logic and the adult's reasoned logic.

Overcoming the inner child's belief that vaping is harmless is crucial for quitting successfully. The pleasure-seeking inner child will resist quitting and say it's the only source of joy. As an aware adult, you must challenge this argument and find new hobbies and passions to replace vaping.

Quitting vaping can reveal underlying struggles that were masked by it. Facing these issues can lead to personal growth and help address hidden fears. If quitting causes anger, it may be revealing a propensity for anger that nicotine has been soothing.

Freedom!

Recognising the true, harmful impact of vaping is the first step toward cessation. It's a realisation that vaping not only harms your health and drains your resources but also hinders personal growth by obscuring underlying challenges. Acknowledging these harms is essential to foster the motivation to quit and open up to seeking support.

This article is designed to equip you with knowledge and inspire you to pursue the support necessary for overcoming addiction. The journey to quitting is challenging but immensely rewarding, promising a healthier and more fulfilling future.

Support is available in many forms, offering guidance to unravel the web of classical conditioning, address anxiety, confront internal conflicts, and adopt healthier coping mechanisms. Hypnotherapy and/or psychotherapy are valuable resources, with their combination proving particularly effective.

Additionally, hypnotherapy can address the aspect of classical conditioning related to smoking, helping to establish new, healthier responses in place of the old reward-based smoking cues.

Feeling powerless in the face of addiction is a common experience. Yet, it's crucial to remember that this feeling is a product of conditioning and manipulative marketing, not a reflection of your true capabilities. You have overcome challenges before; you can also navigate this with the right strategies, awareness, and support.

I wish you health and prosperity, clarity, and purpose in all your endeavours.

*Note: The NHS website is mistakenly asserting nicotine is harmless despite medical evidence, which can be seen and verified (4). I understand the NHS's agenda to discourage smoking, but it does not justify publishing untrue information. There is an ongoing debate over this, read more on Jonas (2022) below.

References

Boseley, S. (2017) 'Hon Lik invented the e-cigarette to quit smoking – but now he’s a dual user,' The Guardian, Nov 29. https://www.theguardian.com/society/2015/jun/09/hon-lik-e-cigarette-inventor-quit-smoking-dual-user.

Jonas, A. (2022) 'Impact of vaping on respiratory health,' The BMJ, p. e065997. https://doi.org/10.1136/bmj-2021-065997.

Centers for Disease Control and Prevention (US) (2016) E-Cigarette use among youth and young adults. https://www.ncbi.nlm.nih.gov/books/NBK538680/.

Lee J, Cooke JP. The role of Nicotine in the pathogenesis of atherosclerosis. Atherosclerosis. 2011 Apr;215(2):281-3. doi: 10.1016/j.atherosclerosis.2011.01.003. Epub 2011 Feb 1. PMID: 21345436; PMCID: PMC3755365.