A Pilot Study to Test the Feasibility of a Randomized Controlled Trial of E-cigarettes as Harm Reduction Tools Among People Who Smoke and Previously Failed to Quit With Pharmacotherapy

Introduction:
This text presents the results of a pilot study examining the feasibility of a larger randomized controlled trial comparing e-cigarettes to traditional pharmacotherapy as harm reduction tools among people who smoke and previously failed to quit with pharmacotherapy. The study aims to determine the effect sizes of this intervention and its acceptability to participants.

Key Points:

* Participants were randomly assigned to either an e-cigarette group or a nicotine replacement therapy (NRT) group.
* Both groups received a 5-week supply of their respective products and were instructed to stop smoking completely and use the provided product exclusively.
* At least 90% of participants completed each weekly assessment and 77% of participants completed at least 80% of daily diaries.
* Mean cigarettes smoked per day reduced in both groups, with a numerically higher reduction in the e-cigarette group (87% vs. 70%).
* Rates of biochemically confirmed 7-day point-prevalence abstinence at the end of treatment were numerically, but not statistically, higher in the e-cigarette group than the NRT group (35% vs. 10%).
* Product adherence was high in both groups, with 85% of e-cigarette users and 80% of NRT patch users reporting using their product at least once per week for all 4 weeks after the target quit date.
* Secondary outcomes, such as dependence on cigarettes and respiratory health symptoms, improved similarly in both groups.

Main Message:
The study suggests that providing e-cigarettes as a harm reduction tool for people who smoke and have previously failed to quit with pharmacotherapy is a feasible intervention. While the results do not show statistical significance, they indicate a numerical difference between groups favoring the e-cigarette group. Further research is needed to confirm these findings and investigate the potential benefits of e-cigarettes as a harm reduction tool for this population.

Tracy T Smith, Anna Ferreira, Amy E Wahlquist, K Michael Cummings, Alana M Rojewski, Erin A McClure, Benjamin A Toll, Matthew J Carpenter, A Pilot Study to Test the Feasibility of a Randomized Controlled Trial of E-cigarettes as Harm Reduction Tools Among People Who Smoke and Previously Failed to Quit With Pharmacotherapy, Nicotine & Tobacco Research, Volume 27, Issue 3, March 2025, Pages 553–557, https://doi.org/10.1093/ntr/ntae212