Today, I review, link to, and excerpt from The Addiction Medicine Podcast‘s #30 Blazing Hot Takes: The Latest in Vaping With Drs. Ling and Vijayaraghavan.*

*Kryzhanovskaya E, Ling P, Vijayaraghavan M, Huxley-Reicher Z, Sonoda K, Chan, CA. “Blazing Hot Takes: The Latest in Vaping”. The Curbsiders Addiction Medicine Podcast. https://thecurbsiders.com/addiction  8/22/24.

All that follows is from the above resource.

Transcript available via YouTube

Join us to hear the latest pearls and best practices on talking to patients about vaping, if e-cigarettes can be used to stop smoking cigarettes, and every other question you hadn’t thought to ask about vaping with Drs. Pam Ling (UCSF) and Maya Vijayaraghavan (UCSF).

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Production Partner: ACAAM

Show Segments

• 00:11 Intro, disclaimer
• 02:22 Guest bios
• 04:28 Guest one-liners
• 10:28 Case from Kashlak
• 11:55 Vape info and definitions
• 14:32 How to discuss vaping with patients
• 17:53 FDA authority over vapes
• 20:37 Development of nicotine (via vaping) use disorder
• 23:29 Questions to ask about use disorder
• 30:53 E-cigarettes for tobacco cessation
• 35:39 Exploring ways to quit smoking (+/- vapes)
• 39:53 Screening for vaping use disorder; research measures
• 43:10 Resources for e-cigarette cessation
• 45:33 Medication approaches
• 48:25 Behavioral supports for e-cigarette cessation
• 1:00:31 Take Home Points
• 1:05:08 Outro

Vaping Pearls

1. Vape/e-cigarette products are highly varied in nicotine concentration and amount per pod/cartridge
2. Discuss the granular details of a patient’s vape/e-cigarette usage with them – what product, when and how are they using etc.
3. Be sure to assess for nicotine use disorder when discussing vape/e-cigarette use.
   1. Clinical Interventions to Treat Tobacco Use and Dependence Among Adults from The CDC.
   2. “Medications for Smoking Cessation: Guidelines from the American Thoracic Society” from The American Family Physician
   3. #11 Smoking Cessation: It’s Not a Drag from The Addiction Medicine Podcast
4. E-cigarettes are not approved as smoking cessation aids by the US Food and Drug Administration (FDA) although the latest Cochrane review suggests it can be an effective smoking cessation aid (Lindson, 2024).
5. While there are no FDA approved cessation treatments for nicotine dependence/use disorder in patients using vapes/e-cigarettes, it is reasonable to consider nicotine replacement therapy (NRT) and/or varenicline at similar doses to what is recommended for smoking cessation.
6. Counseling/behavioral health support should be provided either in person, via quitline services, or with digital aids when using pharmacotherapy.
   1. #10 The ABCs of CBT: Psychosocial Interventions 101 from The Addiction Medicine Podcast
   2. Behavioral Health and Tobacco Cessation from The American Family Physician
   3. Tobacco, Nicotine, and E-Cigarettes Research Report: What are treatments for tobacco dependence? from The National Institute On Drug Ab use

Blazing Hot Takes: The Latest in Vaping – Notes

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