Quitting electronic cigarettes: information on the Internet is not easy to read for everyone

The information available on the Internet concerning weaning off electronic cigarettes is quite rare and may be difficult to read for the least educated, according to a US study.

For the general public, finding medical information today most often involves searching on the Internet. However, this information must be accessible and easily understandable by non-doctors, and as much as possible by people with little education. A team of American researchers has thus looked at the readability of online information on quitting e-cigarettes[1].

Strengthening the accessibility of content on quitting vaping

From a list of keywords around quitting vaping, the authors of the study analyzed 464 web pages intended for the general public. These pages were, on the one hand, coded according to the Flesch-Kincaid Grade Level, which makes it possible to estimate the level of readability of written content based on the length of sentences and words used. The readability of this content was, on the other hand, analyzed according to the target audiences, depending on whether they were parents or teenagers, and users or non-users. The relevance of the information provided was not studied.

The results of this research indicate that the average of the observed pages would be 7^th level of study (equivalent to grade 5^th in the French school system) and that only 23% of these pages would be located at 6^th level of education (6th grade in France), considered the national average in the United States. The authors conclude that most web pages devoted to quitting e-cigarettes would be insufficiently readable for the vast majority of American Internet users. They therefore recommend favoring short sentences and the use of words with few syllables, while avoiding medical jargon. No significant difference was also noted according to the type of sites visited (favorable or unfavorable to vaping). The distinction according to the target audiences (parents/adolescents and users/non-users) did not appear to be significant either.

In France, advice similar to that for quitting smoking

While the debate continues over the possible effectiveness of e-cigarettes in smoking cessation, more and more vapers are looking to quit vaping, after a more or less long period of consumption. Some manage to do so without any problem, others experience more difficulties, particularly when their use of e-cigarettes has become almost permanent. An updated study by the Truth Initiative indicates that in the United States, 54% of regular vapers aged 15 to 24 want to quit vaping[2]. Truth Initiative has also set up a program to help young vapers wean themselves off e-cigarettes.[3].

In the absence of validated scientific recommendations concerning the cessation of vaping, the information available on French-language sites is inspired by the therapies proposed for smoking cessation, or even those used for cessation of cannabis in the 2000s.[4]. The information provided encourages, for example, drawing up a list of reasons for quitting, reducing the nicotine content of e-liquids, setting a date for quitting vaping, hiding vaping equipment from view and avoiding smokers and vapers for a while. In the absence of a scientifically validated protocol on quitting vaping, the Tabac Info Service website refers to tobaccologist consultations or your doctor.[5].

The French-language commercial sites visited recommend a gradual cessation of vaping, spread over several months, and the purchase of lower-dose or nicotine-free e-liquids – which seems mainly intended to prevent customer loss.

Dual use of tobacco and vaping, to be avoided

The use – and by extension the withdrawal – of the electronic cigarette should therefore only be considered when the smoked cigarette has already been completely abandoned. However, it appears that in France, more than one in two vapers is in fact a “vapofumeur”, who combines and alternates smoked and electronic cigarettes[6] ; this dual practice is at least as harmful as the use of smoked tobacco alone and it is strongly advised not to continue it[7]. It is also strongly advised that non-smokers do not start vaping, even in the absence of nicotine in the e-liquids.

Keywords: electronic cigarette, vaping, withdrawal, readability, United States

©Tobacco Free Generation

M.F.

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[1] Wood L, Agbonlahor O, Tomlinson M, Kerstiens S, Vincent K, McLeish A, Walker K, Hart J, Readability of online e-cigarette cessation information, Tob. Induc. Say. 2022;20(June):53[2] More than half of young people consider quitting vaping in 2022, new survey finds, Truth Initiative, published January 5, 2022, accessed June 10, 2022.[3] This is leaving, Truth Initiative.[4] Cannabis Quit Help Guide, INPES, 2004.[5] "We do not have a scientifically validated protocol for quitting e-cigarettes. You can get help with this process from a tobacco specialist, who will guide you face to face." https://www.tabac-info-service.fr/questions-reponses/04_questions-mises-en-ligne/vapoteuse45[6] Andler R, Richard JB, Guignard R, Quatremère G, Verrier F, Gane J, Nguyen-Thanh V. Decline in the prevalence of daily smoking among adults: results of the 2018 Public Health France Barometer. Bull Epidemiol Weekly. 2019;(15):271-7.[7] The combined use of electronic cigarettes and smoked tobacco would expose people to as many cardiovascular risks as cigarettes alone., Generation Without Tobacco, published on May 11, 2022, consulted on June 10, 2022.National Committee Against Smoking |