Effect of Electronic Nicotine Delivery Systems on Cigarette Abstinence in Smokers With No Plans to Quit: Exploratory Analysis of a Randomized Placebo-Controlled Trial.

Introduction:
This text is a summary of a clinical trial examining the effects of electronic nicotine delivery systems (ENDS) on cigarette abstinence in smokers with no plans to quit. The trial compares the use of ENDS with different amounts of nicotine to a placebo and a cigarette substitute. The study aims to determine if the use of ENDS for smoking reduction leads to increased cessation in this population.

Key Points:

* The trial was a four-arm, parallel-group, placebo-controlled randomized trial, with three ENDS conditions administered double-blind.
* Participants were current adult smokers interested in reducing their cigarette consumption but not planning to quit.
* Participants were randomized to one of four 24-week conditions, receiving either an eGo-style ENDS paired with 0, 8, or 36 mg/ml nicotine liquid, or a cigarette-shaped tube as a cigarette substitute.
* The primary outcome was the carcinogen biomarker, NNAL, and the results on that outcome have been reported previously.
* The trial also collected data on cigarette abstinence-related outcomes, including intent-to-treat, self-reported 7-day point prevalence cigarette abstinence, biochemically confirmed by exhaled CO<10ppm for each visit up to 24 weeks after randomization.
* The trial found that participants randomized to 36 mg/ml were significantly more likely than those randomized to 0 mg/ml or the cigarette substitute to report at least 28 days abstinence at week 24.
* The trial also found that participants randomized to 36 mg/ml were significantly more likely than those randomized to each of the other groups to report at least one or more days of cigarette abstinence and more total days of cigarette abstinence throughout the trial.

Main Message:
The study found that ENDS with nicotine delivery approaching that of a cigarette are more effective in helping ambivalent smokers to quit cigarette smoking. This is important for regulatory matters as it suggests that ENDS with higher nicotine delivery may be more effective in promoting smoking cessation. However, it is also important to consider the potential risks and harms associated with ENDS use. Further research is needed to determine the overall health impacts of ENDS use and to inform appropriate regulation.

Foulds J, Cobb CO, Yen MS, et al. Effect of Electronic Nicotine Delivery Systems on Cigarette Abstinence in Smokers With No Plans to Quit: Exploratory Analysis of a Randomized Placebo-Controlled Trial. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2022;24(7):955-961. doi:10.1093/ntr/ntab247