Not Everything Is as It Seems: The Flaws of a Study Condemning Vaping
A new study claims that vaping does not help people quit smoking. However, when we delve into the intricate layers of its methodology, we discover that its conclusions stem more from design and interpretation choices than from a comprehensive assessment of reality.
For two decades, millions worldwide have left cigarettes behind and turned to vaping as a less harmful alternative. By eliminating combustion, they have also reduced their exposure to toxins responsible for lung disease, cardiovascular conditions, and cancer. This is not an isolated narrative or an anecdotal claim—it is a well-documented phenomenon backed by rigorous clinical studies, systematic reviews, and meta-analyses.
Since 2020, we at The Vaping Today have brought this evidence to our readers, carefully analyzing data before publication with the rigor this debate demands. However, the battle over the smoking cessation narrative is still ongoing, and it is not always fought on scientific grounds.
Ideological positions often masquerade as academic certainties, headlines oversimplify complex realities, and public health gets caught between data and doctrine. In this context, the issue is not merely an academic discussion—it is the lives of millions of smokers who seek and deserve information based on facts, not prejudice.
A study published in JAMA Network Open, titled Daily or Nondaily Vaping and Smoking Cessation Among Smokers, challenges the idea that vaping facilitates smoking cessation. According to the authors, smokers who turn to e-cigarettes do not achieve higher quit rates than those who do not use them, and in some cases, their likelihood of success is even lower.
At first glance, the study delivers a definitive verdict against vaping. This finding may seem irrefutable proof of its ineffectiveness in the media ecosystem, where headlines often reduce science to absolute statements. But science is rarely that simple. This study highlights not an absolute truth about vaping but rather the limitations of its methodology.
Every study is built on choices: what to measure, what to compare, which variables to include, and which to exclude. These decisions shape the outcomes as much as the data itself. In this case, the way the analysis was designed overlooks key aspects of nicotine consumption and smoking cessation.
The issue is not whether e-cigarettes work but how their impact was evaluated. In science, answers depend on the questions being asked.
The problem is not just what is measured but how it is measured. Scientific results do not exist in a vacuum—they depend on the tools used, the variables selected, and, most importantly, the premises guiding the research.
As every study is a construct, absolute objectivity is an aspirational ideal rather than a guarantee. When the research questions are narrow, the findings reflect the study’s design more than the real-world phenomenon it attempts to understand.
This is precisely what happens with many vaping studies. Science is not immune to bias, significantly when influenced by political or ideological interests or a rigid view of what constitutes "success" in smoking cessation.
If the only valid criterion is complete nicotine abstinence, then any harm reduction strategy will be deemed a failure. If researchers fail to differentiate the initial dependency levels of smokers who opt for vaping, the results become skewed. If they do not account for vaping devices' evolution and varying efficacy, their conclusions will reflect a past that no longer exists.
How knowledge is constructed is just as important as the knowledge itself. What is not measured, ignored, or deliberately excluded from the analysis also tells a story. In the vaping debate, such omissions are no small matter—they can mean the difference between a public health policy based on evidence and one crafted to support a predetermined narrative, even if that does not reflect reality.
What Was Not Measured Matters as Much as What Was: The Gaps in the Study on Vaping and Smoking Cessation.
All research captures only a fragment of reality. Choosing what to measure also means deciding what to ignore. In the JAMA Network Open study, researchers analyzed data from the Population Assessment of Tobacco and Health (PATH), a representative U.S. cohort, and followed 6,013 smokers over four years. Their conclusions were stark:
Daily vaping was not associated with higher smoking cessation rates. In other words, vaping every day does not help people quit smoking.
Non-daily vaping was linked to lower smoking cessation rates (-5.3 pp, p = .01). Even occasional vaping made quitting smoking harder.
Complete nicotine abstinence (tobacco + e-cigarettes) was lower among daily vapers (-14.7 pp, p < .001) and non-daily vapers (-7.2 pp, p < .001). This means that people who vape, whether daily or occasionally, are less likely to quit nicotine entirely.
Based on these findings, the authors concluded that e-cigarettes not only fail to aid smoking cessation but may also prolong nicotine dependence. However, a key question immediately arises: What was not measured in this study that could have changed this conclusion?
The Missing Variable: Nicotine Dependency Levels
One of the study’s major flaws is the absence of an objective measure of nicotine addiction, such as the Fagerström Test for Nicotine Dependence (FTND). This metric is crucial because not all smokers are the same. If someone turns to vaping, it is likely because they struggle to quit nicotine using other methods. In other words, e-cigarette users may, on average, be more heavily addicted than those who do not use them.
If this factor is ignored, the comparison becomes unfair. It is like evaluating alcoholism treatments without distinguishing between occasional drinkers and those with severe dependence. Suppose the most addicted smokers are also the ones most likely to try vaping. In that case, their lower success rate in quitting is not proof that vaping does not work—it simply reflects the more significant challenge this group faces in quitting nicotine.
Device Type: Which Vaping Devices Were Used?
Another aspect the study ignores is the evolution of the vaping market. Since 2017, vaping devices have changed dramatically in terms of efficacy and nicotine delivery. Failing to differentiate between generations of e-cigarettes is like evaluating the effectiveness of mobile phones without distinguishing between a model from a decade ago and a modern smartphone.
Previous studies have shown that high-nicotine delivery vaping systems are significantly more effective for smoking cessation than older, low-power models. Suppose the study’s data includes smokers using outdated, less effective devices. In that case, the results do not reflect vaping’s efficacy in general but rather that of a specific product that technological advancements have since surpassed.
Reducing Cigarette Consumption: Success Framed as Failure
One of the study’s most severe methodological omissions is its failure to acknowledge harm reduction. Any smoker who continues using nicotine, even if they drastically cut down on cigarettes, is categorized as a failure.
If someone smoked 20 cigarettes a day but, thanks to vaping, reduced their intake to just two, their case is recorded as a failed quit attempt. However, from a public health perspective, this reduction represents significant progress.
This measurement approach distorts reality and penalizes harm reduction. If the only acceptable metric is total nicotine abstinence, then any strategy that reduces harm but does not eliminate nicotine use will be dismissed. This is a problem because every reduction in exposure to toxic substances is a step in the right direction.
The Great Misunderstanding: Nicotine Is Not Tobacco
One of the most glaring errors in the study is its claim that vaping "prolongs nicotine dependence," assuming that nicotine itself is the primary problem.
However, decades of research have made it clear that nicotine is not responsible for tobacco-related diseases—the real enemy is combustion. Equating nicotine with smoking is a conceptual mistake that skews the discussion.
The JAMA Network Open study is not irrelevant, but its conclusions must be read skeptically. It does not account for smokers’ addiction levels, ignores device evolution, and dismisses the benefits of smoking reduction. Instead of providing a complete picture, it constructs a narrative where total nicotine abstinence is the only acceptable outcome.
At the heart of the debate is not whether vaping helps people quit smoking but how we choose to measure success and whether we are measuring the right things. If public health policy is guided by ideology rather than evidence, the cost will be measured in lives.
Quach NE, Pierce JP, Chen J, et al. Daily or Nondaily Vaping and Smoking Cessation Among Smokers. JAMA Netw Open. 2025;8(3):e250089. doi:10.1001/jamanetworkopen.2025.0089