Nicotine Replacement Therapy vs Vape: Which Is Better for Quitting Nicotine?

Medically reviewed by | By

Update Date 11/05/2020 . 4 mins read

Smoking is the leading preventable cause of death worldwide, claiming more than 8 million lives annually. Furthermore, an estimated 1.2 million annual deaths from tobacco involve those who are passive smokers, smoking also harm those around them. The peril of tobacco is a major public health concern in all countries. In Malaysia, the government has made tremendous strides in combating tobacco use – from making the mQuit service more widely available and accessible, to enforcing a 3-meter smoking ban from public eateries. With regards to quitting nicotine, a new device has sparked a trend and gained notoriety in both the international and local scene – vape. The proponents of vape argue that it has helped them to quit the nicotine but beyond anecdotal evidence, how much of this is actually true? How does it fare against the established use of Nicotine Replacement Therapy for nicotine cessation? 

How Do They Work? 


Interchangeably referred to as e-cigarettes, vape is a form of electronic nicotine delivery device or system (ENDS) which generate nicotine aerosol (vapor) without combustion of tobacco. A typical device comprises three fundamental parts: the battery, the heating element (atomiser), and a cartridge that contains solutions mainly composed of nicotine dissolved in propylene glycol, glycerin, or the mixture of the two. When a user takes a puff, the battery powers up the heating element, which will then heat the liquid to produce an aerosol mist or vapor.

Nicotine Replacement Therapy (NRT)

NRT helps smokers to quit by taking care of their withdrawal syndrome. It does this by supplying low doses of nicotine to the body to overcome the physiological cravings. By effectively managing the cravings, NRT reduces the motivation to smoke, and therefore increases the likelihood of remaining abstinent. NRT is available in many forms and doses, with each having their own unique advantage. These include nicotine skin patches, gums, lozenges, sublingual (under the tongue) tablets, inhalers and sprays. 

Clean Nicotine Delivery?

It is true that both NRT and vapes contain nicotine. But the fact is that vapes can contain undetermined level of nicotine as they can be mixed and augmented by users. Furthermore, they can contain more than only nicotine; a 2013 study in the Journal of Tobacco Control found that there are other harmful chemicals found in these devices, albeit at levels of 9 to 450 times lower than in regular cigarette smoke. Another study done by the U.S. Food and Drug Administration (FDA) found that vapes studied do contain detectable levels of known carcinogens and toxic chemicals that could affect the health of users. The mixture of flavorings and propylene glycol (PG) in vapes leads to the formation of so-called acetals that have been shown to activate irritation receptors, predisposing users to the same potential dangers as using traditional cigarettes. Even the vapour released isn’t necessarily clean – a review of 11,830 kids with asthma in the 2016 Florida Youth Tobacco survey found that secondhand aerosol exposure increased the odds of an asthma attack by 27%. The same cannot be said for NRT solutions, which do not deliver any other harmful substances or cause damage to by-standers.

Creating the Next Generation of Nicotine Addicts

In Malaysia, vaping is a growing trend and vape stores have been growing like mushrooms after rain. The most important reason for this is the lack of regulation on the sales and purchase of vape products. The underlying reason is that not everyone sees vape as conspicuously harmful or dangerous. In fact, many people just see it as a device that delivers a low dose of nicotine with a little flavour on the side. The problem with this mild and harmless perception of vape is that it is very appealing to youngsters, especially those who have never smoked. In 2015, the U.S. surgeon general reported that the use of Vape among high school students in America had increased by 900 percent, and 40 percent of young vape users had never smoked regular tobacco. These facts should make anyone pushing vapes to wean of nicotine very weary. Similar statistics where NRT is the initial cause of nicotine addiction are not to be found.

Safety and Regulations

One important thing to note in this matter is the difference in regulations between the two. Whereas NRT is regulated by the Ministry of Health, vapes are not. This means that the Ministry of Health does not test the safety of vapes and you are taking a personal risk by ingesting the vapours into your system.

In a nutshell, vape does certainly not seem to be the solution for the world’s cigarette problem. The nicotine delivery is not as pure as advertised, and they offer a hip solution to youngsters in an age where governments are finally standing up to cigarettes. On top of that, vapes are not even regulated by the Ministry of Health. Therefore, do speak with your healthcare professionals to understand further on what is the best option for you to quit smoking safely and successfully.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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Hello Health Group does not provide medical advice, diagnosis or treatment.

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