Summary
Introduction:
This text provides a summary of a randomized clinical trial investigating the impact of nicotine salt pod system (NSPS) electronic cigarettes (e-cigarettes) on biomarkers of tobacco exposure and potential harm among african american and Latinx smokers. The study aims to understand the risk-benefit tradeoff of e-cigarettes and the potential benefits and adverse effects of NSPS e-cigarette use in adult combustible cigarette smokers.
Key Points:
* The study is a randomized clinical trial comparing 6 weeks of e-cigarette use versus cigarettes as usual among smokers in the San Diego, California, and Kansas City, Missouri areas.
* Participants included african american and Latinx adult combustible cigarette smokers who smoked at least 5 cigarettes/day on at least 25 of the past 30 days for at least 6 months and were interested in switching to e-cigarettes.
* The intervention group received a JUUL e-cigarette and pods in a choice of flavors (5% nicotine) along with brief education, training, and action planning to completely switch to e-cigarettes from combustible cigarettes.
* The primary outcome was a reduction in urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNaL) concentration at week 6. Secondary outcomes included change in urinary cotinine, expired carbon monoxide (CO), respiratory symptoms, lung function, blood pressure, past 7-day consumption of combustible cigarettes, and switching rates (e-cigarette group only) at weeks 2 and 6.
* The e-cigarette group had significantly greater reductions in NNaL, CO, respiratory symptoms, and number of cigarettes smoked in the past 7 days among those still smoking compared to the control group.
* Lung function and blood pressure remained unchanged, and cotinine levels were not significantly different at week 6 between the groups.
* approximately one-quarter of participants in the e-cigarette group were exclusively using e-cigarettes at week 6, while 58% were dual users and 14% had resumed exclusive use of combustible cigarettes.
Main Message:
The study suggests that e-cigarettes may be an inclusive harm reduction strategy for african american and Latinx smokers, as switching to e-cigarettes among adult smokers did not increase nicotine exposure and led to short-term reduction in the major pulmonary carcinogen, NNaL, compared with continued smoking. however, further research is needed to understand the long-term impact of e-cigarettes on the cardiopulmonary system and to guide regulatory and policy decisions.
Citation
Pulvers K, Nollen NL, Rice M, et al. Effect of Pod e-Cigarettes vs Cigarettes on Carcinogen Exposure among african american and Latinx Smokers: a Randomized Clinical Trial. JaMa network open. 2020;3(11):1. doi:10.1001/jamanetworkopen.2020.26324
