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

Avila, Jaqueline C, Maglalang, Dale Dagar, Nollen, Nicole L, Lee, Sangah Clara, Suh, Riley, Malone, Mona, Binjrajka, Urvi, Ahluwalia, Jasjit S·2024·Nicotine and Tobacco Research
DOI 10.1093/ntr/ntae047
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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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Cited by

Sorted by citations

Authors
Avila, J. C., Maglalang, D. D., Nollen, N. L., Lee, S. C., Suh, R., Malone, M., Binjrajka, U., & Ahluwalia, J. S.
Venue
Nicotine and Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2024-03-06
Volume
26
Issue
9
Pages
1150-1158
ISSN
1469-994X
DOI
10.1093/ntr/ntae047
Cited by
21
References
5
Language
en
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Funders
  • Brown University Office of Vice President Research
  • Center of Biomedical Research Excellence (P20GM130414)
  • NIH

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