Effects of E-cigarettes on Combustible Cigarette Smoking Among Adults With Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial

Introduction:
This text summarizes a research study examining the feasibility, acceptability, and preliminary effectiveness of electronic cigarettes (EC) as a harm reduction tool for combusted cigarette (CC) smokers with opioid use disorder (OUD) on buprenorphine maintenance treatment. The study aims to address the limited representation of this population in EC research.

Key Points:

* Single-arm pilot study with 30 participants recruited from an outpatient clinic providing maintenance treatment for OUD.
* Participants received an EC device, freebase nicotine liquid (6 mg/mL), and a brief educational session on EC use.
* EC liquid amount was calculated based on self-reported daily smoking rate (150% of daily CPD).
* Primary outcome measures included feasibility, acceptability, and changes in CPD, CO levels, and nicotine dependence (FTND scores) from baseline to weeks 4 and 8.
* Secondary outcomes included the percentage of participants who partially or completely switched to EC at weeks 4 and 8.
* Sensitivity analyses were conducted to examine the effect of time and frequency of EC use on CPD, CO levels, and FTND scores.

Main Message:
The study found that implementing an EC protocol in outpatient maintenance treatment programs for people with OUD on buprenorphine is feasible and acceptable. Preliminary results suggest that ECs may facilitate reductions in cigarettes per day, CO levels, and nicotine dependence. Further research is needed to explore the effect of prolonged EC use on harm reduction and cessation milestones. The study highlights the potential of EC as a harm reduction strategy for adult CC smokers with OUD on buprenorphine who are unable to quit using evidence-based medications. However, it is essential to consider the potential limitations and regulatory implications of EC use in this population.

Irene Pericot-Valverde, Moonseong Heo, Shadi Nahvi, Justin Barron, Sarah Voss, Erik G Ortiz, Diann Gaalema, James F Thrasher, Abigail W Batchelder, Kaileigh A Byrne, Deborah Kunkel, Alain H Litwin, Effects of E-cigarettes on Combustible Cigarette Smoking Among Adults With Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial, Nicotine & Tobacco Research, Volume 27, Issue 5, May 2025, Pages 856–863, https://doi.org/10.1093/ntr/ntae260