Do E-Cigarettes “Work” for Smokers as a Step on the Way to Cessation? an analysis of the Temporal and Spatial Correlates of Switching in a harm Reduction Trial among adult Smokers.

Introduction:
This text is a summary of a scientific study examining the relationship between acute cigarette reduction and the use of electronic cigarettes (ECs) as a reduction/cessation tool. The study uses data from a randomized controlled trial of 84 adult smokers who were asked to substitute an EC for at least half of the cigarettes they normally smoke. The study analyzes the trajectories of cigarette reduction post-introduction of an EC using ecological momentary assessment data.

Key Points:

* The study found that participants clustered into four distinct, linear trajectories based on daily cigarette use during the 3-week intervention.
* higher readiness to quit smoking, prior successful quit attempts, and lower baseline cigarette consumption were associated with assignment into "more successful" cigarette reduction classes.
* The study demonstrates that a fine-grained trajectory approach can be applied to examine switching patterns in the critical first weeks of an attempt.
* The study participants were diverse, with over 50% of the total sample size being Black and Latino populations.
* The study found that the device used in the RCT, which would be considered a "first generation" EC device, may not deliver as much nicotine or deliver the nicotine as efficiently as newer models.
* The study design included a smoking cessation counseling call and encouragement to use the EC to help achieve a 50% smoking reduction, which may impact the generalizability of the findings to the broader smoking population.
* The study used self-reported data, which may include self-report biases.

Main Message:
The study suggests that ECs may be a useful mechanism to promote cigarette reduction. The fine-grained trajectory approach used in this study can be applied to examine switching patterns in the critical first weeks of an attempt. however, the study also highlights the need for further research on larger samples to understand the reduction and switching patterns amongst smokers using ECs as a stepping-stone on the way to cessation.

Guttentag a. Do E-Cigarettes “Work” for Smokers as a Step on the Way to Cessation? an analysis of the Temporal and Spatial Correlates of Switching in a harm Reduction Trial among adult Smokers. Ph.D. New York University College of Global Public health; 2021.