A Descriptive Analysis of Transitions from Smoking to Electronic Nicotine Delivery System (ENDS) Use: A Daily Diary Investigation

Conner, Tamlin S.; Zeng, Jiaxu; Blank, Mei‐Ling; He, Vicky; Hoek, Janet

doi:10.3390/ijerph18126301

Cited by 9 publications

(10 citation statements)

References 46 publications

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“…Unlike previous research, we found no consistent evidence that vaping may increase the likelihood of later smoking behaviours [14] or act as a cessation pathway from smoking to vaping [2,13]. Instead, in support of Conner et al [18], there are frequent transitions between smoking and vaping and vice versa. This is further supported visually in the Sankey plots exploring behaviours over time.…”

Section: Discussioncontrasting

confidence: 99%

“…One possible reason for the conflicting evidence in adults is the high individual variability in smoking and e-cigarette use [18]. Using a daily-diary survey approach to assess smoking and e-cigarette use during an individual's attempt to quit smoking, Conner et al [18] reported that individuals frequently moved between dual usage of both e-cigarettes and cigarettes and exclusive e-cigarette or cigarette use.…”

Section: Is Vaping Increasing or Decreasing Smoking Behaviours?mentioning

confidence: 99%

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Effects of vaping on uptake and cessation of smoking: Longitudinal analysis in Aotearoa New Zealand adults

Mason

Riordan

Winter

et al. 2023

Drug and Alcohol Review

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IntroductionGlobally, the use of vapes, or e‐cigarettes, is increasing. While vaping is less harmful than smoking and may help smokers to quit, there is also the possibility that vaping may lead to smoking. The current study aimed to determine the prevalence of vaping and smoking in Aotearoa New Zealand and explore longitudinal pathways between smoking status and vape use.MethodData related to smoking and vaping status was analysed from Times 10, 11 and 12 across 2018–2020 of the New Zealand Attitudes and Values study, a large, representative, multi‐wave study of adults living in New Zealand. Weighted descriptive analyses were used to determine prevalence rates of vaping and smoking and a generalised linear modelling approach was used to examine the likelihood of changing to, or taking up, the other behaviour in the transition between time points.ResultsBroadly, the prevalence of smoking was found to be decreasing over time while the prevalence of vaping was increasing. Despite these general trends, no differences were observed in the likelihood of transitioning from smoking to vaping or from vaping to smoking, indicating that either pathway was equally as likely.Discussion and ConclusionsThe current findings demonstrate that vaping appeared to be just as likely to have a gateway effect to smoking as it was to have a cessation effect. This highlights the need for greater consideration regarding vaping‐related policies and restrictions.

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Section: Discussioncontrasting

confidence: 99%

Section: Is Vaping Increasing or Decreasing Smoking Behaviours?mentioning

confidence: 99%

Effects of vaping on uptake and cessation of smoking: Longitudinal analysis in Aotearoa New Zealand adults

Mason

Riordan

Winter

et al. 2023

Drug and Alcohol Review

Self Cite

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“…The same factors might have contributed to the comparable effectiveness between ECs and HTPs and to the progressive transition from dual use to solo use by the end of the intervention phase. Dual use is known for being a common transitory state, with transitions to solo use taking variable time to occur [ 38 , 39 ]. In our switching trial, IQOS users reported increased dual use in the first 2 weeks compared to JustFog users, but this quickly stabilized by week 4.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Effectiveness, Tolerability, and Acceptability of Heated Tobacco Products and Refillable Electronic Cigarettes for Cigarette Substitution (CEASEFIRE): Randomized Controlled Trial

Caponnetto¹,

Campagna²,

Maglia³

et al. 2023

JMIR Public Health Surveill

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Background People who smoke and who face challenges trying to quit or wish to continue to smoke may benefit by switching from traditional cigarettes to noncombustible nicotine delivery alternatives, such as heated tobacco products (HTPs) and electronic cigarettes (ECs). HTPs and ECs are being increasingly used to quit smoking, but there are limited data about their effectiveness. Objective We conducted the first randomized controlled trial comparing quit rates between HTPs and ECs among people who smoke and do not intend to quit. Methods We conducted a 12-week randomized noninferiority switching trial to compare effectiveness, tolerability, and product satisfaction between HTPs (IQOS 2.4 Plus) and refillable ECs (JustFog Q16) among people who do not intend to quit. The cessation intervention included motivational counseling. The primary endpoint of the study was the carbon monoxide–confirmed continuous abstinence rate from week 4 to week 12 (CAR weeks 4-12). The secondary endpoints included the continuous self-reported ≥50% reduction in cigarette consumption rate (continuous reduction rate) from week 4 to week 12 (CRR weeks 4-12) and 7-day point prevalence of smoking abstinence. Results A total of 211 participants completed the study. High quit rates (CAR weeks 4-12) of 39.1% (43/110) and 30.8% (33/107) were observed for IQOS-HTP and JustFog-EC, respectively. The between-group difference for the CAR weeks 4-12 was not significant (P=.20). The CRR weeks 4-12 values for IQOS-HTP and JustFog-EC were 46.4% (51/110) and 39.3% (42/107), respectively, and the between-group difference was not significant (P=.24). At week 12, the 7-day point prevalence of smoking abstinence values for IQOS-HTP and JustFog-EC were 54.5% (60/110) and 41.1% (44/107), respectively. The most frequent adverse events were cough and reduced physical fitness. Both study products elicited a moderately pleasant user experience, and the between-group difference was not significant. A clinically relevant improvement in exercise tolerance was observed after switching to the combustion-free products under investigation. Risk perception for conventional cigarettes was consistently higher than that for the combustion-free study products under investigation. Conclusions Switching to HTPs elicited a marked reduction in cigarette consumption among people who smoke and do not intend to quit, which was comparable to refillable ECs. User experience and risk perception were similar between the HTPs and ECs under investigation. HTPs may be a useful addition to the arsenal of reduced-risk alternatives for tobacco cigarettes and may contribute to smoking cessation. However, longer follow-up studies are required to confirm significant and prolonged abstinence from smoking and to determine whether our results can be generalized outside smoking cessation services offering high levels of support. Trial Registration ClinicalTrials.gov NCT03569748; https://clinicaltrials.gov/ct2/show/NCT03569748

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“…The Center for Tobacco Products requires information to assess the potential impact of a new product on current tobacco user behaviors, including who uses the product, how the product is used, and the effects of its use on the use of other tobacco products. Various study designs can be employed to provide this information, including randomized clinical trials, longitudinal cohort studies, and actual use studies (AUS) [3,[9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Designing Studies to Inform Tobacco Harm Reduction: Learnings From an Oral Nicotine Pouch Actual Use Pilot Study

Campbell¹,

Feehan²,

Kanitscheider³

et al. 2022

JMIR Form Res

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Background Introduction of new tobacco products in the United States, including those that may be lower on the risk continuum than traditional combustible cigarettes, requires premarket authorization by the US Food and Drug Administration and information on the potential impact of the products on consumer behaviors. Efficient recruitment and data capture processes are needed to collect relevant information in a near-to-real-world environment. Objective The aim of this pilot study was to develop and test a protocol for an actual use study of a new tobacco product. The product included in this study was a commercially available oral nicotine pouch. Through the process of study design and execution, learnings were garnered to inform the design, execution, analysis, and report writing of future full-scale actual use studies with tobacco products. Methods A small sample (n=100) of healthy adult daily smokers of 7 or more cigarettes per day were recruited to participate in an 8-week prospective observational study conducted at 4 geographically dispersed sites in the United States. A smartphone-based customized electronic diary (eDiary) was employed to capture daily tobacco product use, including 1 week of baseline smoking and 6 weeks during which participants were provided with oral nicotine pouches for use as desired. Results Online screening procedures with follow-up telephone interviews and on-site enrollment were successfully implemented. Of 100 participants, 97 completed the study, with more than half (59/99, 60%) identifying as dual- or poly-users of cigarettes and other types of tobacco products at baseline. There was more than 90% (91-93/99, 92%-94%) compliance with daily eDiary reporting, and the majority (92/99, 93%) of participants expressed satisfaction with the study processes. Product use data from the eDiary indicated that after an initial period of trial use, pouches per day increased among those continuing to use the products, while per day average cigarette consumption decreased for 82% (79/97) of all study participants. At the end of the week 6, 16% (15/97) of participants had reduced their cigarette consumption by more than half. Conclusions The design of this study, including recruiting, enrollment, eDiary use, and oversight, was successfully implemented through the application of a detailed protocol, a user-friendly eDiary, electronically administered questionnaires, and remote monitoring procedures. High-resolution information was obtained on prospective changes in tobacco product use patterns in the context of availability of a new tobacco product. Future, larger actual use studies will provide important evidence supporting the role that alternatives to combustible cigarettes may play in smoking reduction and/or cessation and lowering the population health burden of tobacco and nicotine-containing products.

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A Descriptive Analysis of Transitions from Smoking to Electronic Nicotine Delivery System (ENDS) Use: A Daily Diary Investigation

Cited by 9 publications

References 46 publications

Effects of vaping on uptake and cessation of smoking: Longitudinal analysis in Aotearoa New Zealand adults

Effects of vaping on uptake and cessation of smoking: Longitudinal analysis in Aotearoa New Zealand adults

Comparing the Effectiveness, Tolerability, and Acceptability of Heated Tobacco Products and Refillable Electronic Cigarettes for Cigarette Substitution (CEASEFIRE): Randomized Controlled Trial

Designing Studies to Inform Tobacco Harm Reduction: Learnings From an Oral Nicotine Pouch Actual Use Pilot Study

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