Vaping products are becoming smarter – and potentially more addictive. Some new devices now offer cryptocurrency and other incentives linked to vaping behaviour, prompting researchers at MUSC Hollings Cancer Center to raise concerns about their potential public health impact. In a perspective published in the New England Journal of Medicine, researchers warn that combining addictive substances with financial rewards, gamification and artificial intelligence could encourage continued vaping and make quitting more difficult.

“What really stood out is that these products are rewarding people for engaging in an already rewarding behaviour,” said lead author Amanda Palmer, Ph.D., a Hollings researcher. “In substance use treatment, we do the opposite. We try to help people find rewarding activities that aren’t associated with using a substance.”

The researchers examined two recently introduced products: Puffpaw, a nicotine vaping device marketed as an aid for quitting e-cigarettes, and Gudtrip, a cannabis vaping device incorporating artificial intelligence and cryptocurrency. Both connect to smartphone apps and track users’ behaviour. Although such “smart vapes” are relatively new, researchers say their potential effects should be examined before they become more widespread.

Nicotine and cannabis activate the brain’s reward system, encouraging repeated use. Smart vaping devices add another layer by offering points or cryptocurrency for vaping and engagement. In some cases, rewards can be used to purchase refill cartridges. “There’s no incentive for not using the device,” Palmer said. Researchers note that this differs from evidence-based cessation programmes, where financial incentives can help people quit when they reward abstinence or healthier behaviours.

Researchers are particularly concerned about the potential appeal to adolescents and young adults. With mobile apps, artificial intelligence, cryptocurrency and game-like features, the products can resemble technology or gaming platforms more than conventional vaping devices. The researchers say these features may be especially attractive to younger users, while financial rewards could also appeal to people experiencing financial hardship.

The devices also raise regulatory questions. Nicotine vaping products must receive authorisation from the U.S. Food and Drug Administration before they can legally be marketed in the United States. The smart vaping devices discussed by the researchers have not received FDA authorisation, although unauthorised vaping products remain widely available. Cannabis products present additional challenges because regulation varies considerably from state to state.

Another concern is data collection. Because smart vaping devices connect with smartphone apps and can track detailed patterns of use, researchers say questions remain about how this information might eventually be used or shared. As vaping technologies become more sophisticated, they argue that regulations may need to keep pace with developments in artificial intelligence, digital rewards and behavioural tracking.

The researchers stress that they are not arguing against technological innovation or harm-reduction approaches. Rather, their concern centres on products that financially reward continued use of addictive substances. They are calling for closer regulatory review and greater awareness among clinicians and parents. “We’re trying to get ahead of what could become a much bigger issue,” Palmer said. “The vaping marketplace changes incredibly quickly, and it’s important that we think carefully about how these technologies are designed and marketed.”

More information: Amanda Palmer et al, Vaping for Crypto — Smart Devices, Risky Business, New England Journal of Medicine. DOI: 10.1056/NEJMp2606580

Journal information: New England Journal of Medicine Provided by Medical University of South Carolina