Changes in Nicotine Dependence among Smokers Using Electronic Cigarettes to Reduce Cigarette Smoking
Friday, March 17, 2023
Posted by: Natalia Gromov
Yingst
J, Wang X, Lopez AA, Breland A, Soule E, Barnes A, Cohen J, Underwood M,
Crabtree M, Foulds J.
Changes in Nicotine
Dependence among Smokers Using Electronic Cigarettes to Reduce Cigarette
Smoking in a Randomized Controlled Trial.
Nicotine Tob Res. 2023 Feb 9;25(3):372-378. doi: 10.1093/ntr/ntac153. PMID:
35752091; PMCID: PMC9910150.
Introduction. How
nicotine dependence will be affected when current smokers initiate electronic
cigarette (e-cigarette) use to reduce cigarette smoking is unknown. This study
evaluated cigarette, e-cigarette, and total nicotine dependence more than 6
months among smokers reducing cigarette consumption by replacing with
e-cigarettes.
Aims and methods. Adult
cigarette smokers were randomized to one of four conditions (36 mg/ml
e-cigarette, 8 mg/ml e-cigarette, 0 mg/ml e-cigarette, 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-cigarettes (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-cigarette conditions reported significantly lower PSCDI scores, compared
with baseline, and with the CS condition at all follow-up visits. Those in the
36 mg/ml e-cigarette condition reported greater PSECDI scores at 6 months,
compared with baseline and the 0 mg/ml and 8 mg/ml conditions. At all follow-up
visits, there were no differences in total nicotine exposure compared to
baseline, nor between any conditions.
Conclusions. E-cigarette
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-cigarette was
associated with a reduction in cigarette dependence and an increase in
e-cigarette dependence (in the condition with the highest nicotine
concentration only), with no long term increase in total nicotine dependence or
nicotine exposure.
|
|
Email to a Friend