Smoking reduction using electronic nicotine delivery systems in combination with nicotine skin patches

Rationale Electronic nicotine delivery systems (ENDS) are used by smokers seeking to reduce combustible cigarette (CC) use, but the role of nicotine replacement vs. behavioral and sensory factors is still poorly understood. We hypothesized that providing nicotine from ENDS in addition to nicotine sk...

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Bibliographic Details
Published in:Psychopharmacology 2023-09, Vol.240 (9), p.1901-1909
Main Authors: Rose, Jed E., Frisbee, Suzanne, Campbell, David, Salley, Alfred, Claerhout, Susan, Davis, James M.
Format: Article
Language:English
Subjects:
Biomedical and Life Sciences
Biomedicine
Carbon monoxide
Cigarettes
Electronic cigarettes
Methods
Neurosciences
Nicotine
Original Investigation
Pharmacology/Toxicology
Placebos
Psychiatry
Skin
Smoking
Smoking cessation programs
Statistical analysis
Transdermal medication
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Summary:Rationale Electronic nicotine delivery systems (ENDS) are used by smokers seeking to reduce combustible cigarette (CC) use, but the role of nicotine replacement vs. behavioral and sensory factors is still poorly understood. We hypothesized that providing nicotine from ENDS in addition to nicotine skin patches would promote smoking reduction relative to non-nicotine control ENDS. Objectives To assess the effects on smoking behavior of using nicotine vs. placebo ENDS in smokers using nicotine vs. placebo patches. Methods Ninety-four daily smokers were enrolled in a study that randomly assigned them to receive ENDS with nicotine vs. without nicotine and skin patches with vs. without nicotine. Smoking reduction and cessation were assessed over an 8-week period by self-report and by expired air carbon monoxide (CO) measurements. The primary outcome was defined as reduction in expired air CO. Results The use of nicotine in ENDS led to significant reductions in smoking (ENDS nicotine vs. placebo difference in CO change = −9.2 ppm; 90% CI (−1.5 ppm, −16.9 ppm)) and was highly correlated with reductions in self-reported cigarettes per day ( r =0.6). The effect of nicotine in nicotine patches was not statistically significant (patch nicotine vs. placebo difference in CO change = −0.1 ppm; 90% CI (−7.8 ppm, 7.6 ppm)). Conclusions The presence of nicotine in ENDS was associated with a large reduction in smoking. Additional studies will be needed to determine whether there may be additive effects of nicotine ENDS and nicotine patches on smoking abstinence.
ISSN:0033-3158
1432-2072
DOI:10.1007/s00213-023-06401-y