The Impact of Three Alternate Nicotine-Delivery Products on Combusted Cigarette Use: A Randomized Controlled Trial

Introduction:
This text is a summary of a research study examining the impact of three alternate nicotine-delivery products on combusted cigarette use. The study aims to determine the effectiveness of e-cigarettes and very low nicotine cigarettes (VLNCs) in reducing the number of usual brand cigarettes smoked per day, both with and without the use of a nicotine patch. The results of this study have important implications for regulatory policies regarding these products.

Key Points:

* The study is a randomized controlled trial with a mixed design, involving 160 adult daily smokers not motivated to quit.
* Participants were randomized to one of three study products: VLNCs, e-cigarettes, or no product, and used these products for four weeks.
* During two switch weeks, participants were instructed to not smoke their usual cigarettes and instead use their assigned study product and a nicotine patch or placebo patch.
* The study found that both VLNCs and e-cigarettes reduced the number of usual brand cigarettes smoked per day, regardless of patch condition.
* Behavioral factors, such as the conditioned reinforcement of smoking-related cues, play an important role in sustaining smoking behavior.
* The study suggests that both e-cigarettes delivering nicotine and VLNCs equally reduce usual brand cigarettes smoked among adults who smoke daily and do not want to quit.
* The study highlights the potential of behavioral substitutes for cigarettes, whether or not they deliver nicotine, in reducing smoking rates.

Main Message:
The study demonstrates the potential of e-cigarettes and VLNCs as behavioral substitutes for combusted cigarettes, with both products reducing the number of usual brand cigarettes smoked per day among daily smokers not motivated to quit. The results suggest that regulatory policies should consider the potential benefits of these products in reducing smoking rates, while also addressing potential risks associated with their use. Additionally, the study highlights the importance of addressing behavioral factors, such as conditioned reinforcement of smoking-related cues, in smoking cessation treatment.

Megan E Piper, Tanya R Schlam, Eric C Donny, Kate Kobinsky, Julia Matthews, Thomas M Piasecki, Douglas E Jorenby, The Impact of Three Alternate Nicotine-Delivery Products on Combusted Cigarette Use: A Randomized Controlled Trial, Nicotine & Tobacco Research, Volume 27, Issue 2, February 2025, Pages 317–325, https://doi.org/10.1093/ntr/ntae014