A Randomized Clinical Trial Examining the Effects of Instructions for Electronic Cigarette Use on Smoking-Related Behaviors, and Biomarkers of Exposure
Mené aux Etats-Unis auprès de 264 fumeurs ne souhaitant pas arrêter de fumer immédiatement (âge médian : 47 ans ; 48% de femmes), cet essai randomisé évalue l'effet, sur leurs comportements tabagiques et du point de vue du taux de tabagisme et du niveau des biomarqueurs d'exposition au tabac, d'une information sur l'exposition aux produits toxiques et d'une incitation à recourir uniquement aux cigarettes électroniques
Electronic cigarettes (e-cigarettes) have the potential to significantly reduce exposure to harmful constituents associated with cigarette smoking when smokers completely substitute cigarettes with e-cigarettes. This study examined patterns of e-cigarette and cigarette use, and extent of toxicant exposure, if smokers were instructed and incentivized to completely switch to e-cigarettes compared to instructions to use the product ad libitum.U.S. adult daily smokers (n =264; 48.3% female; Mage = 47.0), uninterested in quitting smoking immediately, were recruited from Minneapolis, MN, Columbus, OH, and Buffalo, NY. Participants were randomized to eight weeks of instructions for: a) ad libitum use of e-cigarettes (AD-E); 2) complete substitution of cigarettes with e-cigarettes (CS-E); 3) complete substitution of cigarettes with nicotine gum or lozenge (CS-NRT); or 4) continue smoking of usual brand cigarettes (UB). Participants were incentivized for protocol compliance, including complete switching in the CS-E and CS-NRT groups. Outcome variables were cigarette smoking rate and tobacco-related biomarkers of exposure.Smokers in the CS-E and CS-NRT groups showed lower rates of smoking, and lower exposure to carbon monoxide, tobacco carcinogens and other toxicants than smokers in the AD-E groups. In general, no significant differences were observed between CS-E vs. CS-NRT or between AD-E vs. UB for most biomarkers. Significantly higher 7-day point prevalence smoke-free rates were observed for CS-E vs. CS-NRT.Smokers instructed and incentivized to completely switch to e-cigarettes resulted in lower smoking rates and greater reductions in exposures to harmful chemicals than smokers instructed to use the product ad libitum.