The widespread belief among smokers that e-cigarettes are effective for smoking cessation may actually prolong nicotine dependence, experts warned. They cautioned that smokers who start using e-cigarettes to quit are likely to fall into "dual use," combining them with conventional cigarettes.
The findings were released at a forum hosted by the Korean Society for Research on Nicotine and Tobacco and the Korea Medical & Bio Reporters Association at Seoul National University Cancer Research Institute on the 27th. The survey covered 500 smokers aged 25 to 59 who had attempted to quit smoking in the past year or intended to quit in the future.
According to the survey, 43% of respondents believed e-cigarettes help with smoking cessation. Twenty percent reported having used e-cigarettes to quit smoking, and 23.5% said they intended to use them as a cessation method in the future.
The most common reason for choosing e-cigarettes was "to reduce withdrawal symptoms," followed by managing smoking cravings and the influence of users around them.
Experts, however, took a different view. Cho Hong-jun, professor emeritus at the University of Ulsan College of Medicine, said, "A significant number of people who used e-cigarettes as a cessation tool continued using them for more than six months," adding, "The rate of progression to complete cessation is lower than expected."
"When e-cigarettes are used alongside conventional cigarettes, many users return to combustible cigarette smoking over time," he stressed. "The perception that e-cigarettes are a definitive cessation tool is somewhat exaggerated."
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A significant portion of smokers perceive e-cigarettes as less harmful than conventional cigarettes. Among reasons for switching from conventional cigarettes to e-cigarettes, "less odor" was the most cited response, while "seems less harmful to health" also accounted for a high proportion.
Experts pointed out that odor and safety are separate issues. Lee Sung-kyu, head of the Korea Center for Tobacco Control Research and Education, said, "Research shows that using heated tobacco products indoors can result in nicotine concentrations far exceeding health standards." He added, "A weak or sweet flavor does not mean lower harm."
The forum also addressed misconceptions about nicotine replacement therapies. Nicotine patches, gum, and lozenges are classified as pharmaceutical smoking cessation aids, but some smokers mistakenly believe they carry the same risks as the nicotine in cigarettes.
According to the survey, nearly half of respondents who said they were aware of nicotine replacement therapies admitted they did not understand exactly how they work. A significant number also perceived no difference between the nicotine in cigarettes and that in nicotine replacement products.
Choi Soo-jeong, a professor of family medicine at Gachon University Gil Medical Center, said, "Viewing the two products as the same simply because both contain nicotine is a clear misconception." She explained, "Following the correct usage instructions for each form of nicotine replacement therapy — such as patches, gum, and lozenges — and using combination therapy when needed can significantly improve cessation success rates."
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