Effect of Pod e-Cigarettes vs Cigarettes on Carcinogen Exposure Among African American and Latinx Smokers

Pulvers, Kim; Nollen, Nicole L.; Rice, Myra; Schmid, Christopher H.; Qu, Kexin; Benowitz, Neal L.; Ahluwalia, Jasjit S.

doi:10.1001/jamanetworkopen.2020.26324

Cited by 68 publications

(98 citation statements)

References 36 publications

(62 reference statements)

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“…Supporting the idea that nicotine dose is an important determinant of success in smoking cessation, quitting rates in the population as a whole are higher when later‐generation e‐cigarettes with higher power such as tank‐style devices are used compared with first‐generation devices 90 and when e‐cigarettes are used more frequently 90,91 . The only trial to date using modern pod devices was a harm reduction study using 59 mg/mL nicotine pods 92 . This study found a reduction in a primary pulmonary carcinogen exposure overall, a reduction of tobacco cigarette consumption in those who used both e‐cigarettes and continued to smoke, with approximately one‐fourth of the participants switching exclusively to e‐cigarettes 92 .…”

Section: Potential To Aid Smoking Cessation/support Harm Reductionmentioning

confidence: 99%

“…The only trial to date using modern pod devices was a harm reduction study using 59 mg/mL nicotine pods 92 . This study found a reduction in a primary pulmonary carcinogen exposure overall, a reduction of tobacco cigarette consumption in those who used both e‐cigarettes and continued to smoke, with approximately one‐fourth of the participants switching exclusively to e‐cigarettes 92 . Another recent study reported higher quit rates with a combination of nicotine patches and nicotine‐containing e‐cigarettes compared with the patches and nicotine‐free e‐cigarettes, 81 which supports the importance of adequate nicotine substitution as well as the potential of e‐cigarettes to be used as an aid in addition to the currently licensed pharmacotherapies.…”

Section: Potential To Aid Smoking Cessation/support Harm Reductionmentioning

confidence: 99%

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Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame

Benowitz

Helen

Liakoni

2021

The Journal of Clinical Pharma

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Electronic nicotine delivery systems (ENDS) such as e‐cigarettes and heated tobacco products are novel battery‐operated devices that deliver nicotine without combustion of tobacco. Because cigarette smoking is sustained by nicotine addiction and the toxic combustion products are mainly responsible for the harmful effects of smoking, ENDS could be used to promote smoking cessation while exposing users to lower levels of toxicants compared with conventional cigarettes. The currently available evidence from clinical and observational studies indicates a potential role of e‐cigarettes as smoking cessation aids, although many continue to use e‐cigarettes long after quitting smoking. Nicotine and toxicant delivery vary considerably by device and depend on the characteristics of the e‐liquid formulation. Because smokers tend to titrate their nicotine intake to maintain their desired pharmacologic effects, device and liquid characteristics need to be considered when using ENDS as an aid to quit smoking. Factors potentially limiting their use are the currently still unknown long‐term safety of these products and concerns regarding widespread use among youth. Implications of clinical pharmacology data on ENDS for the cigarette endgame and regulation by the U.S. Food and Drug administration are discussed.

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Section: Potential To Aid Smoking Cessation/support Harm Reductionmentioning

confidence: 99%

Section: Potential To Aid Smoking Cessation/support Harm Reductionmentioning

confidence: 99%

Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame

Benowitz

Helen

Liakoni

2021

The Journal of Clinical Pharma

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“…This is a secondary analysis from the first reported randomized clinical trial of NSPS ECs testing effects on toxicant exposure among AA and Lx adults who smoke [ 19 ]. As described in detail elsewhere [ 19 ], this multi-site study was conducted from July 2018 to May 2019.…”

Section: Methodsmentioning

confidence: 99%

“It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

et al. 2021

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Background Electronic cigarettes are a harm reduction strategy for individuals who smoke cigarettes who cannot or do not want to quit using FDA-approved cessation methods. Identifying perceived facilitators and barriers to switching among people who smoke cigarettes is critical to optimizing health impact. This is particularly important for the most dominant e-cigarette device, nicotine salt pod electronic cigarettes. We investigate the experience using pod electronic cigarettes among African American and Latinx individuals who smoke, the two largest racial/ethnic minority groups who experience significant health disparities. Methods From July 2018 to May 2019, adults who smoked cigarettes, age 21 + (N = 114; M age = 44.6, 59.6% male, 52.6% African American from Kansas City, 47.4% Latinx from San Diego) received JUUL-brand electronic cigarettes (referred to hereafter as JUUL) for 6 weeks and answered interview questions at week six. We inquired what they liked and disliked about using JUUL, what helped with switching and made switching difficult, future intentions for continued JUUL use, and how JUUL compared to past smoking reduction methods. Responses were coded into themes by independent raters. Theme frequencies were analyzed separately by race/ethnicity and week 6 use trajectory (exclusive JUUL use, dual JUUL and cigarette use, exclusive cigarette use). Results Clean/smell was the aspect of using JUUL most commonly liked (23%), followed by convenience (19%). Coughing/harshness was a more common barrier to switching for African American (44%) than Latinx (9%), and for continuing cigarette use (56%) than for those who exclusively switched or dually used JUUL and combustible cigarettes (15–21%). Most (78% African American; 90% Latinx) reported that the benefits of using JUUL outweighed barriers, and this varied by JUUL use trajectory: 94% exclusive switch, 86% dual use, and 42% continued cigarette use. The majority said they would continue using JUUL to replace cigarettes (83% African American; 94% Latinx) and that JUUL worked better than other methods to reduce cigarettes (72%). Conclusion African American and Latinx individuals who smoked experience using pod electronic cigarettes was generally positive. Understanding facilitators and impediments to switching to electronic cigarettes among racial/ethnic minority people who smoke can inform harm reduction interventions and reduce tobacco-related health disparities. Trial Registration ClinicalTrials.gov Identifier: NCT03511001 posted April 27, 2018.

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“…After being introduced to the U.S. market in 2007, e-cigarettes quickly gained popularity. While the long-term health effects of e-cigarettes await more research, existing evidence suggests that e-cigarettes may exude fewer toxins compared to combustible cigarettes [ 1 , 2 , 3 , 4 , 5 ]. As a result, there has been more discussion in recent years about encouraging a complete switch to e-cigarettes among smokers who otherwise are unable or unwilling to quit smoking [ 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Will E-Cigarette Modified Risk Messages with a Nicotine Warning Polarize Smokers’ Beliefs about the Efficacy of Switching Completely to E-Cigarettes in Reducing Smoking-Related Risks?

Yang

Barbati

Choi

2021

IJERPH

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In the U.S., e-cigarette companies can apply for permission to use reduced or modified risk messages (MRMs) in their marketing materials. Because e-cigarette marketing materials should have a nicotine addictiveness warning, MRMs and a nicotine warning could appear together—resulting in a conflicting message. When reading a conflicting message, individuals assimilate evidence supporting their pre-existing beliefs and eventually develop stronger beliefs, diverging more from those with different pre-existing beliefs (i.e., polarization). This study examined if exposure to e-cigarette MRMs with a nicotine warning polarizes smokers’ initially opposing beliefs about the efficacy of switching completely to e-cigarettes in reducing smoking-related risks, and if this polarization depends on individuals’ need for closure. An online experiment randomized 761 U.S. adult smokers to either three MRMs with a nicotine warning or three control messages. People reported their perceived efficacy of switching completely to e-cigarettes at pre- and posttest and need for closure at pretest. Linear regression showed no polarization effects. Nonetheless, need for closure and pretest efficacy beliefs influenced message response: MRMs with a nicotine warning only enhanced efficacy beliefs of smokers with low pretest efficacy beliefs and low need for closure. Evaluation of e-cigarette mixed communication should consider individuals’ motivational and cognitive differences.

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Effect of Pod e-Cigarettes vs Cigarettes on Carcinogen Exposure Among African American and Latinx Smokers

Cited by 68 publications

References 36 publications

Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame

Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame

“It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

Will E-Cigarette Modified Risk Messages with a Nicotine Warning Polarize Smokers’ Beliefs about the Efficacy of Switching Completely to E-Cigarettes in Reducing Smoking-Related Risks?

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