Jessica Yingst1, Xi Wang1, Alexa A Lopez2, Alison Breland3, Eric Soule4, Andrew Barnes5, Joanna Cohen6, Megan Underwood3, Melanie Crabtree3, Jonathan Foulds1. 1. Department of Public Health Sciences, Penn State College of Medicine, Center for Research on Tobacco and Health, Hershey, PA, USA. 2. College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA. 3. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA. 4. Department of Health Education and Promotion, College of Health and Human Performance East Carolina University, Greenville, NC, USA. 5. Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA. 6. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
BACKGROUND: How nicotine dependence will be affected when current smokers initiate electronic cigarette (e-cig) use to reduce cigarette smoking is unknown. This study evaluated cigarette, e-cig, and total nicotine dependence over 6 months among smokers reducing cigarette consumption by replacing with e-cigs. METHODS: Adult cigarette smokers were randomized to one of four conditions [36mg/ml e-cig, 8mg/ml e-cig, 0mg/ml e-cig, or cigarette-substitute (CS) (provided at no cost)] and instructed to reduce their cigarette smoking by 75% at 1 month. Participants completed follow-up at 1, 3, and 6 months. The Penn State Nicotine Dependence Index (PSNDI) measured dependence on cigarettes (PSCDI) and e-cigs (PSECDI). Urine cotinine measured total nicotine exposure. Linear mixed effects models for each outcome were conducted and included interaction terms between visit and condition. RESULTS: Participants (n=520) were 58.8% female, 67.3% White, and 48.0 years old. At baseline, the median number of cigarettes smoked per day was 17.3 and the mean PSCDI score was 13.4, with no significant differences between conditions. Participants in the e-cig conditions reported significantly lower PSCDI scores, compared with baseline, and with the CS condition at all follow-up visits. Those in the 36mg/ml e-cig condition reported greater PSECDI scores at 6 months, compared with baseline and the 0mg/ml and 8mg/ml conditions. At all follow-up visits, there were no differences in total nicotine exposure compared to baseline, nor between any conditions. CONCLUSION: E-cig use was associated with reduced cigarette dependence, compared to the CS, without significant increases in total nicotine exposure. IMPLICATIONS: Initiation of electronic cigarette use while continuing to smoke could potentially increase nicotine dependence. In this randomized trial aimed at helping smokers to reduce their cigarette intake, we found that use of an e-cig was associated with a reduction in cigarette dependence and an increase in e-cig dependence (in the condition with the highest nicotine concentration only), with no long term increase in total nicotine dependence or nicotine exposure.
BACKGROUND: How nicotine dependence will be affected when current smokers initiate electronic cigarette (e-cig) use to reduce cigarette smoking is unknown. This study evaluated cigarette, e-cig, and total nicotine dependence over 6 months among smokers reducing cigarette consumption by replacing with e-cigs. METHODS: Adult cigarette smokers were randomized to one of four conditions [36mg/ml e-cig, 8mg/ml e-cig, 0mg/ml e-cig, or cigarette-substitute (CS) (provided at no cost)] and instructed to reduce their cigarette smoking by 75% at 1 month. Participants completed follow-up at 1, 3, and 6 months. The Penn State Nicotine Dependence Index (PSNDI) measured dependence on cigarettes (PSCDI) and e-cigs (PSECDI). Urine cotinine measured total nicotine exposure. Linear mixed effects models for each outcome were conducted and included interaction terms between visit and condition. RESULTS: Participants (n=520) were 58.8% female, 67.3% White, and 48.0 years old. At baseline, the median number of cigarettes smoked per day was 17.3 and the mean PSCDI score was 13.4, with no significant differences between conditions. Participants in the e-cig conditions reported significantly lower PSCDI scores, compared with baseline, and with the CS condition at all follow-up visits. Those in the 36mg/ml e-cig condition reported greater PSECDI scores at 6 months, compared with baseline and the 0mg/ml and 8mg/ml conditions. At all follow-up visits, there were no differences in total nicotine exposure compared to baseline, nor between any conditions. CONCLUSION: E-cig use was associated with reduced cigarette dependence, compared to the CS, without significant increases in total nicotine exposure. IMPLICATIONS: Initiation of electronic cigarette use while continuing to smoke could potentially increase nicotine dependence. In this randomized trial aimed at helping smokers to reduce their cigarette intake, we found that use of an e-cig was associated with a reduction in cigarette dependence and an increase in e-cig dependence (in the condition with the highest nicotine concentration only), with no long term increase in total nicotine dependence or nicotine exposure.
Authors: Savreen K Saran; Kalin Z Salinas; Jonathan Foulds; Övgϋ Kaynak; Brianna Hoglen; Kenneth R Houser; Nicolle M Krebs; Jessica M Yingst; Sophia I Allen; Candace R Bordner; Andrea L Hobkirk Journal: Int J Environ Res Public Health Date: 2022-08-20 Impact factor: 4.614