Reductions in biomarkers of exposure, impacts on smoking urge and assessment of product use and tolerability in adult smokers following partial or complete substitution of cigarettes with electronic cigarettes

Introduction:
This text presents the results of a clinical study examining the effects of partial or complete substitution of combustible cigarettes with electronic cigarettes on biomarkers of exposure, smoking urge, and product use and tolerability in adult smokers. The study aims to provide information on the relative internal exposures resulting from exclusive or dual use of electronic cigarettes.

Key points:

* The study included 105 adult smokers randomized into six groups that partially or completely substituted their usual brand combustible cigarette with commercial electronic cigarettes or discontinued all nicotine and tobacco products.
* Subjects switching to electronic cigarettes had significantly lower levels of urinary biomarkers of exposure (BoEs) after five days. Dual users who substituted half of their self-reported daily cigarette consumption with electronic cigarettes experienced reductions in BoEs, but had increases in nicotine equivalents.
* All groups experienced significant decreases in exhaled CO, while exhaled NO increased in the cessation and electronic cigarette use groups and minimally changed in dual users.
* By Day 5, all groups had greater reductions in smoking urge compared to cessation, with reductions being larger in the dual use group.
* No serious adverse events were observed.

Main message:
The study suggests that exposures to harmful smoke toxicants are lower in smokers who completely or partially replace their cigarettes with electronic cigarettes over five days. The results support the potential of electronic cigarettes as a harm reduction strategy for tobacco control. However, further research is needed to assess the long-term health impacts of electronic cigarette use.

D’Ruiz, Carl D., Donald W. Graff, and Edward Robinson. “Reductions in Biomarkers of Exposure, Impacts on Smoking Urge and Assessment of Product Use and Tolerability in Adult Smokers Following Partial or Complete Substitution of Cigarettes with Electronic Cigarettes.” BMC Public Health 16, no. 1 (December 2016): 543. https://doi.org/10.1186/s12889-016-3236-1.