Patches, gums, electronic cigarettes, what are the best alternatives to quit smoking?

Are all alternatives to cigarettes safe for your health? What is their price? Which one to turn to? On the occasion of tobacco-free month, let’s take a look at the alternatives offered to help quit smoking.

Tobacco is a drug. And one “drug classified as strong as heroin [du point de vue de l’addiction]”, book Aline Finocchiaro, tobacco nurse at Besançon University Hospital in Doubs. Deciding to quit smoking requires willpower, perseverance and may require support from health professionals.

As a reminder, cigarettes contain more than 4,000 toxic substances. Smoking is the leading preventable cause of death. One in two smokers die from the consequences of tobacco consumption and there is no threshold below which smoking is not a risk.

According to figures from Public Health France published in May 2023, 15 million French people smoke. This represents about a quarter of the overall population. Among them, 12 million smoke daily, which represents 24.5% of the population aged 18 to 75.

To wean yourself off nicotine, the main agent of tobacco dependence, several substitutes exist and are even recommended. “As a health professional, I recommend nicotine replacement which will be a support for cessation assistance which will treat the physical need”, indicates the tobacco nurse.

The patch and oral substitutes

The patch is a transdermal patch that sticks directly to the skin. It slowly and continuously releases nicotine into the body. Dosages vary depending on individual consumption. It is possible to start with a high dose and gradually reduce the amount of nicotine. “There is no contraindication, other than allergy to the patches,” specifies Aline Finocchiaro. Its use is simple, once applied in the morning, no need to take care of it during the day. They are left in place between 16 and 24 hours depending on the case. Their price varies depending on the brand and dosage, but a box of seven patches costs between 20 and 25 euros.

They are 65% refundable by Social Security. They can be prescribed by a GP or a tobacco specialist. “Anyone addicted to nicotine is eligible,” specifies Aline Finocchiaro. As supplements, chewing gum or tablets and lozenges containing nicotine. “There are some of different sizes and tastes,” she emphasizes. These substitutes can help manage oral behavior related to smoking. They are also refundable by Social Security. A box of 30 gums or a box of 30 lozenges costs around 7 euros.

The electronic cigarette

By allowing gestures to be preserved, the electronic cigarette facilitates the transition to completely stopping smoking. Considered much less harmful, it does not produce toxic and carcinogenic substances present in cigarette smoke such as carbon monoxide and tar.

It takes a year of vaping to have the equivalent of a pack of cigarettes.

Aline Finocchiaro, tobacco nurse at Besançon University Hospital in Doubs

If the electronic cigarette does not have the harmful effects of the cigarette linked to combustion, you must however be careful with the liquids that you put in the electronic cigarette. “Studies have shown the instability of heated aromas”, specifies the nurse. Some aromas are therefore much more dangerous than others: “Popcorn, sometimes menthols, cinnamon and cherry”. They can increase inflammation at the respiratory level. To protect yourself from the effects of heating, you must also be careful when adjusting the electronic cigarette. Health professionals can help resolve it.

Prices vary. An electronic cigarette can cost from 20 euros up to 400 euros. It is not refundable by Social Security. The 2023 report on stopping tobacco consumption from the High Health Authority does not prohibit it, but does not authorize it either.

You also have to pay attention to the regulations. In France, liquids are subject to a European standard, but this is not the case for all liquids that can be purchased on the internet.

But for the tobacco specialist, “if the electronic cigarette is well oriented, it is a great tool to help quit smoking”. For her, this tool should only be transitory: “It’s in a shutdown project, we’re not going to vape for 20 years”.

The puff, a good idea?

Known to target young people, this disposable electronic cigarette costing around ten euros “holds up to 600 puffs, which corresponds to 40 cigarettes”, specifies Aline Finocchiaro. Unlike the electronic cigarette, the puff is already preset, “it therefore protects against the effects of heating”. But the tobacco specialist still advises against its use: “They mainly guarantee fruity aromas and on aromas, we do not know the impacts”.

Currently, puffs are in the sights of the authorities. The Minister of Health, Geneviève Darrieussecq, intends to ban them. But for now, the application decrees are still awaited. Flavored nicotine sachets called “pouches” will also soon be banned. Very popular with adolescents and young adults, these sachets are sometimes used as a means of quitting smoking and cause acute nicotine syndromes (vomiting, convulsions, hypotension).

Inhaleurs et sprays

For people who do not want to use electronic cigarettes, there are nicotine inhalers. They release nicotine in the form of vapor that the user inhales. It is also covered by Health Insurance on prescription. But how to choose between electronic cigarette and inhaler? “It all depends on the person’s life context. If it’s a young person who frequents festive environments, you should forget the inhaler.” decides the tobacco specialist. The prices of an inhaler vary depending on the number of cartridges. For a box of six cartridges, it costs between 15 and 30 euros.

The spray, for its part, relieves the desire to smoke within 30 seconds after use. It is sprayed directly into the mouth, on the inside of the cheek. It costs around twenty euros.