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Randomized Controlled Trial
. 2024 Aug 22;26(9):1150-1158.
doi: 10.1093/ntr/ntae047.

Using Pod Based e-Cigarettes and Nicotine Pouches to Reduce Harm for Adults With Low Socioeconomic Status Who Smoke: A Pilot Randomized Controlled Trial

Jaqueline C Avila  1 , Dale Dagar Maglalang  2   3 , Nicole L Nollen  4 , Sangah Clara Lee  3 , Riley Suh  3 , Mona Malone  3 , Urvi Binjrajka  3 , Jasjit S Ahluwalia  3   5
Affiliations
Randomized Controlled Trial

Using Pod Based e-Cigarettes and Nicotine Pouches to Reduce Harm for Adults With Low Socioeconomic Status Who Smoke: A Pilot Randomized Controlled Trial

Jaqueline C Avila et al. Nicotine Tob Res. .

Abstract

Introduction: Alternative Nicotine Delivery Systems (ANDS) such as e-cigarettes (EC) and oral nicotine pouches (ONP) may facilitate the substitution of smoking for those unwilling to quit. This pilot study assesses the harm-reduction potential of EC and ONP among smokers with low socioeconomic status (SES).

Aims and methods: Adults who smoked daily in the past 6 months, had a household income < 250% federal poverty level and had no intention of quitting smoking in the next 30 days were randomized 2:2:1 to 8 weeks of 5% nicotine EC; 4 mg ONP or assessment-only control (CC). The primary outcome was a within-group change in cigarettes per day (CPD) from Baseline to week 8.

Results: Forty-five individuals were randomized (EC: N = 18; ONP: N = 18; CC: N = 9). Analyses included 33 participants who completed the week 8 visit. The mean age was 50.1 years (SD: 10.7) and the average CPD at baseline was 13.9 (SD: 10.1). For those randomized to EC, the average CPD decreased from 14.7 (95% CI: 10.3 to 19.1) at the Baseline to 2.9 (95% CI: .1 to 5.8) at week 8 (p-value < .001). For those randomized to ONP, average CPD decreased from 15.0 (95% CI: 5.0 to 24.9) to 8.3 (95% CI: 1.3 to 15.2) by week 8 (p-value = .01). In the EC and ONP groups, respectively, 4 (28.6%) and 1 (8.3%) participant fully switched from smoking to the ANDS product by week 8.

Conclusions: Individuals with low SES who smoke had lower CPD after switching to EC or ONP. These findings show the potential of ANDS in helping smokers switch to less harmful devices.

Implications: This study provides novel evidence that e-cigarettes and nicotine pouches can be a harm-reduction tool for individuals with lower SES who smoke and are not willing to quit smoking, contributing to reducing tobacco-related disparities in this population.Clinical Trials Identifier: NCT05327439.

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Conflict of interest statement

JSA serves as a consultant and has equity in the start-up company Qnovia. This is a start-up company developing smoking cessation prescription medications through the FDA. They currently do not have a product that is available for sale. The other authors have no conflict of interest to disclose.

Figures

Figure 1.
Figure 1.
Participant recruitment flowchart. (a) Includes participants in multiple categories. Definitions: CO: carbon monoxide; EC: electronic cigarettes; FPL: federal poverty level; ONP: oral nicotine pouches.
See this image and copyright information in PMC

References

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