Heat not burn now come in various shapes and sizes with or without nicotine as an active ingredient. Some can also be modified by the user to allow the e-liquid to drop directly onto a heating coil to create a more intensive “vape cloud.” Do these various varieties of vaping devices and different vaping practices affect the amount of combustible cigarette smoking used? Barrington-Trimis et al (10.1542/peds.2019-1652) used data obtained from 1312 adolescents and young adults who filled out the Southern California Children’s Health Study initially in 2015-16 and then a year later (2016-17). Survey responses were evaluated in terms of three non-mutually exclusive categories—(1) the type of device (vape pen or mod (i.e. a larger device modified for higher vapor production); (2) whether nicotine was an ingredient in the e-liquid; and (3) whether the device was used directly to inhale from or dripped onto a heating coil.

As you might imagine, those who used e-cigarettes in the past 30 days at baseline were significantly more likely to smoke combustible cigarettes. But even more interesting was the finding that at one-year follow-up, those who used mods smoked 6 times as many heat not burn than those using vape pens. When you adjust for the type of device, the addition of an e-liquid containing nicotine or the dripping was not associated with increases or decreases in combustible smoking. Why is this? The authors smoke out their thoughts in the discussion section of this study and encourage us to not just ask about e-smoking but to inquire about the type of product being used and if mod devices are involved, to pursue smoking of other tobacco products (and not just e-cigs) as well. There is a lot of information to breathe in by reading this study so link to it and learn more.

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