Vapers or hookah users may be at greater risk for nose and sinus cancers, and upper respiratory ailments, than cigarette smokers

Photo by Antonio Perez/Chicago Tribune, via Alamy

Electronic cigarette vapers and hookah smokers are more than twice as likely to exhale particles through their nose compared with cigarette smokers, who favor exhaling the emissions from their mouth, says a study led by researchers at New York University.

The study discreetly followed 341 men and women from March 2018 to February 2019, and they found that vapers and hookah smokers exhaled through their nose (63% and 50% respectively). By contrast, only 22% of cigarette smokers did the same. The study is published in the journal Tobacco Use Insights.

“Our findings suggest that the unique way vapers and hookah smokers use their devices may expose the nose and sinuses to far more emissions than cigarettes, which may in turn increase their risk for upper respiratory diseases,” says the study's lead author, Emma Karey.

Experts have long known that smoking techniques for traditional tobacco products can influence which parts of the respiratory tract are at highest risk for disease. Past studies have shown, for example, that cigarette smokers, who tend to inhale more deeply, more frequently develop lung cancer. Cigar smokers, who tend to breathe more shallowly, are more likely to develop mouth and throat cancers. However, the new study is the first to examine exhalation patterns in e-cigarette and hookah pipe users outside of a controlled laboratory setting, says Karey.

“Because vaping and hookah devices are used differently than traditional cigarettes, we need to consider diseases of both the nose and lungs to evaluate their safety before judging whether one is more risky than another,” says study senior author Terry Gordon.

Gordon notes that in a related study, the research team identified increased damage in the nasal passages of vapers and hookah users but not in cigarette smokers, lending credence to the concern. He cautions, however, that the investigators still need to determine whether this nasal damage seen in vapers is truly a result of their unique breathing pattern and not due to an unrelated issue.

Baptist Health offers a free, one-hour, online class to help smokers quit; the next one is scheduled for Wednesday, Jan. 12

"Quitting tobacco is one the most common New Year’s resolutions made each year, but often proves to be one of the most difficult to keep," Baptist Health says in a news release about its free, online class in how to quit.

Quitting is tough for most people. The Centers for Disease Control and Prevention says more than half of adult smokers try to stop smoking but only one in 10 succeed. The pandemic is making it even tougher for many to quit, says Crystal Labbato, a certified tobacco-treatment specialist with Baptist Health.

“The pandemic has been so hard and isolating, and smoking is a common way to cope with stress,” Labbato says in the news release. “If you don't have alternative coping techniques, then you tend to fall back on the thing you know best. Unfortunately, smoking happens to be that for a lot of people.”

Labbato is the leader of "Plan to be Tobacco Free," the free one-hour class offered by Baptist Health and the Kentucky Cancer Program. The one-time online class, next scheduled Jan. 12, helps viewers learn about tobacco and nicotine addiction, over-the-counter replacement products and how to develop a personal plan to quit.

Labbato offers these tips for those in the class, and to anyone trying to quit:

If at first you don’t succeed, try, try again: In Labbato’s experience, it can take many attempts before someone is able to quit tobacco for good, because nicotine is so addictive and behavior is hard to change. She urges her patients not to get discouraged if their first try doesn’t work out.

“I always like to remind people that quitting smoking is probably the hardest thing they will ever do,” Labbato says. “It took you a while to learn how to smoke, it’s going to take you a while to learn how to live as a nonsmoker. The only thing that matters is that you keep showing up and you keep trying, because you will get there.”

Smokers who want to quit should review their past attempts, she says, to find a new strategy that will work. “I think you learn something new about yourself at each quit attempt, so with each try you bring along new skills that you've learned from the last try,” she says.

Don’t be afraid to ask for help: Quitting tobacco for good takes more than willpower, and health-care providers can be important partners to get you the resources you need.

“We've moved away from talking about smoking and continuing smoking as a moral failure,” Labbato says. “Nicotine addiction is a physiologic process is happening in your brain. our doctor can help you get real treatment, so always be honest about tobacco use.”

Labbato says medicine and counseling can double the chances of quitting. The Food and Drug Administration has approved seven medications to help smokers quit, which are reviewed in the "Plan to be Tobacco Free" class.

“The idea behind using medications is to calm down the mind and the withdrawal symptoms that cause anxiety . . . so you can work on the behavioral changes and new coping skills that you need to develop to walk away from cigarettes,” Labbato says.

A personalized plan can increase chances of success: In her one-on-one counseling sessions, Labbato works with patients to create a customized stop-smoking plan. To find new coping skills, for example, she asks them to think about where they find relaxation, which might be talking to a trusted friend.

Other recommendations can include increasing the amount of water you’re drinking, reducing alcohol and caffeine, or increasing physical activity.

“Personalizing it for the individual is important,” Labbato said. “What their sources of strength are, what are the sort of healthy coping patterns that they've used in the past, and we've also worked to explore new coping pattern, so that's an essential part of any quit plan.”

Register for "Plan to be Tobacco Free": The next free, one-hour, online class is scheduled for Wednesday, Jan. 12. More information and registration are at www.BaptistHealth.com/event/plan-to-be-tobacco-free-louisville.