A lifelong smoker switched to Juul to help him quit. His nicotine addiction worsened.
Cherry Hill Courier-Post
Joseph Malanka quit smoking “cold turkey” many times over the years. For the first few days, each time, the nicotine withdrawal was stressful, even enraging.
“Any little thing would set you off,” the Manalapan resident said. But he didn’t like nicotine replacements. The gum tasted terrible; the patches burned his skin.
Last February, tired of smoking after a 20-year stretch, he put down his preferred Parliaments and bought a Juul e-device and pods filled with mint-flavored vaping liquid. Instead of helping him quit, he said, the easy-to-use device ramped up his nicotine intake.
“I found myself, as it was going on, pulling on this thing greater than I would have on cigarettes,” the 65-year-old Brooklyn native said. “I knew this wasn’t the thing for me.”
Often touted as a healthier alternative to cigarettes and as a method to quit smoking, vaping is sending a growing number of users to New Jersey-funded quit centers.
About one-fifth of patients enrolled in the nicotine and tobacco recovery program at RWJBarnabas Health Institute for Prevention and Recovery use both cigarettes and e-devices, said Kristopher Novak, the program’s assistant director. Most are middle-aged people who have spent decades addicted to nicotine.
“They tried already to quit using a vape device and could not — and now, they’re stuck using both,” said Novak, whose quit program serves six counties. “I think it may actually worsen their nicotine addiction, because it’s now readily available at any time you want, and not just in places where you can smoke.”
It’s not yet known how vaping affects a person’s health over the long term, but lung specialists are troubled by what they’ve seen so far.
Vape users inhale aersolized oil, which can affect the way oxygen crosses the alveolar membrane, explained Dr. Emilio Mazza, a pulmonologist for Virtua Health in South Jersey who has treated young adults diagnosed with EVALI (e-cigarette or vaping, product use–associated lung injury).
Some EVALI patients develop lipoid pneumonia, caused when fat enters the lung. Others have an immune reaction called hypersensitivity pneumonitis. In the worst cases, patients suffer acute respiratory distress syndrome or ARDS, a potentially fatal condition.
“You feel like you’re drowning,” Mazza said. “You’re desperate. It’s a horrible feeling … when you’re in respiratory distress and you can’t breathe and you’re begging for somebody to put you on a ventilator.”
One of his patients quit vaping altogether after she left the hospital, but Mazza worries about those who think they’ll be fine.
“It’s not regulated. Who knows what’s in there? That’s the problem,” Mazza said. “I don’t think it’s an alternative (to cigarettes). It’s a bad alternative with risks. There’s no free lunch in any of this stuff.”
As vaping-associated hospitalizations and deaths began hitting the news last summer, Malanka heard a radio ad for free tobacco cessation help in his area. He signed up for RWJBarnabas program, which offers clients a combination of behavioral modification and medication.
It typically takes seven to 15 attempts before a person quits for good, Novak said. About 30 percent of the program’s vaping clients reported they were still abstaining from nicotine 30 days after completing the program.
“We really don’t look at someone who tried to quit as a failure,” Novak said. “We know it’s going to take multiple attempts.”
Malanka met with a counselor once a week over two months, and used nicotine replacement lozenges to ease withdrawal.
This time, it worked.
“I couldn’t do it on my own,” Malanka said. His addiction to nicotine was “ridiculous,” he said.
“If you do it long enough,” Malanka said, “it will have you by your heels and control you.”
If you go:
For telephone counseling or to find a New Jersey-funded quit center, call the NJ Quitline at 1-866-NJSTOPS or visit www.njquitline.com
Kim Mulford is a senior reporter for the Courier Post and The Daily Journal, with an interest in health and human services. She is a South Jersey native. If you have a news tip or story we should tell, contact her at firstname.lastname@example.org or (856) 486-2448.
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