Electronic Nicotine Delivery Systems May Help Some People Quit Smoking Cigarettes
E-cigarettes containing cigarette-like nicotine may help some people quit smoking, according to a new study by researchers at Penn State College of Medicine and Virginia Commonwealth University. Switching to electronic cigarettes, the researchers said that tobacco users could reduce their exposure to certain carcinogens or carcinogens.
For six months, the research team followed 520 smokers who sought to reduce their cigarette consumption by at least 50% but had no intention of quitting. They observed whether the use of various electronic nicotine delivery systems (ENDS) – used by approximately 10 million American adults – resulted in reduced cigarette consumption. Participants were randomly given an ENDS containing 0 mg / mL (placebo), 8 mg / mL, or 36 mg / mL of nicotine, or a cigarette substitute without nicotine, electronics or aerosol.
Throughout the study, researchers encouraged participants to reduce their cigarette consumption. After six months, a significantly higher number of participants who received the 36 mg / mL nicotine ENDS, whose nicotine administration was similar to that of a cigarette, reported remaining abstinent from cigarettes compared to those who received nicotine. other study groups.
Overall, dropout rates were low as none of the participants entering the trial intended to quit, or received counseling to quit during those six months. However, over time, we noticed that the number of those receiving high nicotine NDTs who abstained from smoking gradually increased. This trend was not observed in those receiving either the ENDS placebo or the non-ENDS cigarette substitute. This is the first randomized clinical trial of electronic cigarettes to find that a nicotine e-cig produced a significant increase in smoking cessation at six months follow-up, compared to a placebo e-cig as well as a non-ENDS cigarette substitute. . “
Jonathan Foulds, senior author and professor of public health sciences, Penn State College of Medicine
Previous trials have looked at the effects of ENDS on smoking cessation, but the researchers noted that many of these studies used devices and fluids with unknown or unconfirmed nicotine delivery patterns.
“One of the strengths of our study was that the delivery of nicotine from the specific ENDS device in combination with the different fluids used in this study was confirmed prior to the trial,” said Thomas Eissenberg, co-author and professor at the Virginia Commonwealth University. “It is evident from our findings that ENDs with ineffective or less potent delivery of nicotine are unlikely to help participants quit smoking.”
The researchers encouraged the participants to reduce their cigarette consumption by 50% and then by 75% over a six-month period. They measured cigarette consumption and various biomarkers, such as exhaled carbon monoxide levels, during eight follow-up visits. They determined the proportion of participants in each group who reported that they had not smoked cigarettes in the previous week. After six months, significantly more participants in the 36 mg / mL nicotine group (approximately 11%) reported abstaining from smoking than in the 0 mg / mL (1%) and cigarette substitute (3%) groups. ). About 5% of participants in the 8 mg / mL group reported abstaining from smoking after six months.
“We were surprised to see that the 8 mg / mL group did not have a significantly higher dropout rate than the placebo group,” said Jessica Yingst, a researcher at the Penn State Cancer Institute and an assistant professor of science. public health at Penn State College of Medicine. . “These results indicate that if an ENDS does not provide as much nicotine as a cigarette, then smokers using these devices are less likely to abstain from using cigarettes.”
According to the researchers, the main finding of their study is that when people seeking to reduce their tobacco use try the ENDS, few of them quit in the short term. However, smokers who continued to use an ENDS with cigarette-like nicotine delivery (the 36 mg / mL group) were more likely to quit in the short term and switch to ENDS completely, compared to to those who have used a placebo ENDS. Cigarette-like nicotine-releasing devices may be more effective in helping ambivalent smokers to quit. The results were published in the journal Nicotine and Tobacco Research.
“In addition to having a higher dropout rate at the end of the trial, the 36 mg / mL group also reported more days without smoking cigarettes throughout the trial than the other three groups. “noted Caroline Cobb, co-author and associate professor at Commonwealth University of Virginia.
The study team said more research is needed to confirm and deepen their results, but they were encouraged that participants using ENDS products while smoking cigarettes did not have a higher frequency of d ‘serious adverse events. They noted that medical monitors did not attribute any serious adverse events observed during the study to the use of ENDS devices.
“The results of our study reflect many patterns of ENDS use that have been found in other studies and in society at large,” said Foulds, a researcher at the Penn State Cancer Institute. “Many people use NDT and continue to smoke cigarettes for a while before quitting. NDT is not a quick fix, but our results support the idea that NDT with a release cigarette-like nicotine may be essential to a person’s ability to abstain from cigarettes. “
Susan Veldheer, Shari Hrabovsky, Sophia Allen, Xi Wang, Chris Sciamanna, Erin Hammett, Breianna Hummer, Courtney Lester and John Richie of Penn State College of Medicine; Miao-Shan Yen, Phoebe Brosnan, Nadia Chowdhury, Jacob Graham, Le Kang and Shumei Sun of Virginia Commonwealth University; Alexa Lopez of the University of Wisconsin-Milwaukee; and Christopher Bullen from the University of Auckland also contributed to this research. Jonathan Foulds has performed paid consultations for pharmaceutical companies involved in the manufacture of anti-smoking drugs (eg Pfizer, GlaxoSmithKline, Johnson & Johnson); and acted as a testified and paid expert witness on behalf of plaintiffs suing cigarette manufacturers. Other author disclosures can be read in the published manuscript.
This research was funded by the National Institute on Drug Abuse of the National Institutes of Health (grants P50DA036105 and U54DA036105) and the Center for Tobacco Products of the United States Food and Drug Administration. Data collection was supported by the National Center for Advancing Translational Sciences through grants (UL1TR002649 at Virginia Commonwealth University and UL1TR002014 at Penn State University through Penn State Clinical and Translational Science Institute). The content is the sole responsibility of the authors and does not necessarily represent the official opinions of the National Institutes of Health or the Food and Drug Administration.
Pennsylvania State College of Medicine
Foulds, J., et al. (2021) Effect of electronic nicotine delivery systems on cigarette abstinence in non-intentional smokers: exploratory analysis of a randomized, placebo-controlled trial. Nicotine and tobacco research. doi.org/10.1093/ntr/ntab247.