Using e-cigarettes to cut down on smoking may not increase nicotine addiction, study finds

Electronic cigarettes have attracted media and consumer attention due to their addictive nature, variety of flavors and increased use among adolescents, sparking regulatory oversight and policies. A Penn Condition School of Medicine study suggests that these devices can help people reduce their addiction to combustible cigarettes – which contain a range of harmful chemicals called toxins – without increasing their overall addiction to nicotine.

Smoking is a leading cause of death in the United States, and despite interest in cessation and the availability of FDA-approved cessation methods , smokers still find it difficult to quit. Some public health experts have offered e-cigarettes as a “lower risk” alternative to cigarettes for those not interested or able to quit smoking, citing reports such as that from the National Academies of Sciences, the engineering and medicine, which found that substituting e-cigarettes for combustible cigarettes reduced users’ exposure to carcinogens and other harmful toxic substances.

Jessica Yingst, an assistant professor of public health sciences and researcher at the Penn State Cancer Institute, and her colleagues at the Penn State Heart for Investigate on Tobacco and Well being are studying e-cigarettes and determining whether they can help nicotine users quit smoking. smoke or reduce their exposure to the harmful toxic substances found in cigarettes. Their latest study focused on a common question: could initiating e-cigarette use to reduce smoking could potentially increase nicotine addiction.

“ Research on this topic is conflicting because in previous studies, participants used their own devices with unknown nicotine delivery profiles,” Yingst said. “Our study used devices with known nicotine delivery profiles, which allowed us to effectively compare how different levels of nicotine in a device might affect a user’s nicotine dependence and ability. to reduce cigarette consumption.”

The researchers recruited 520 members interested in reducing their cigarette consumption but without project or interest in quitting smoking and asked them to reduce their cigarette consumption over the 6-month study period. Contributors were randomly given an e-cigarette delivering 50, 8 or mg/mL of nicotine, or a cigarette substitute that did not contain tobacco, for assist in their initiatives to reduce their cigarette consumption.

Participants self-reported their addiction to cigarettes and e-cigarettes at one, three and six months using validated dependency measures, including a questionnaire developed by Penn Point out that ranges from (not at all dependent) to 20 (very dependent). Urine samples were also collected throughout the study to measure cotinine, a biomarker of nicotine exposure.

At 6 months, all participants in the e-cigarette groups reported a significant decrease in cigarette smoking, with those in the 36 mg/mL group smoking the fewest cigarettes per day . Those in the e-cigarette groups reported significantly lower dependence on the Penn Point Cigarette Addiction Index than those in the cigarette substitute group.

Contributors also reported e-cigarette addiction using the Penn Condition E-Cigarette Dependence Index. E-cigarette addiction did not change significantly throughout the study, with the exception of participants in the mg group. /mL who found a significant increase in addiction over the course of the study, but still much lower compared to cigarette addiction. Urinary cotinine levels remained constant across all groups throughout the study, suggesting that there was no increase in overall nicotine exposure during the study. . The findings were published in the journal Nicotine and Tobacco Investigate.

“Our findings suggest that using e-cigarettes or a cigarette substitute to reduce cigarette smoking may lead to a reduction in self-reported cigarette smoking and dependence,” said Yingst, who directs the School of Medicine’s doctoral program in public health. “Importantly, high-strength e-cigarette use did not increase overall nicotine dependence and was associated with a greater reduction in smoking compared to the cigarette substitute.”

Although it has been speculated that e-cigarette use may increase overall nicotine addiction, the research team said their study found that the Initiation of e-cigarette use to reduce cigarette smoking resulted in reduced cigarette dependence and low e-cigarette dependence. In the future, they will assess the health effects of completely switching from cigarettes to e-cigarettes.

Xi Wang and Jonathan Foulds of Penn Point out University of Drugs Alexa Lopez of l University of Wisconsin-Milwaukee Alison Breland, Andrew Barnes, Megan Underwood and Melanie Crabtree of Virginia Commonwealth University Eric Soule of the College of Health and Human Performance at Eastern Carolina University and Joanna Cohen of the Johns Hopkins Bloomberg Faculty of Community Wellness also contributed to this research. Foulds has performed paid consulting for pharmaceutical companies involved in the manufacture of anti-smoking drugs (e.g., Pfizer, GlaxoSmithKline, Johnson and Johnson) and acted as an expert witness filed and compensated on behalf of plaintiffs suing cigarette manufacturers. Further author disclosures can be read in the published manuscript.

This research was supported by the Nationwide Institute on Drug Abuse of the Nationwide Institutes of Health and fitness and the Center for Tobacco Items from the United States Foods and Drug Administration (grant numbers P50DA036105 and U 50DA036105). Data collection was supported by the Penn State Clinical and Translational Science Institute (grant number UL1TR002014) and the C. Kenneth and Dianne Wright Middle for Medical and Translational Analysis from Virginia Commonwealth College (grant number UL1TR002649) through the Countrywide Center for Advancing Translational Sciences of the National Institutes of Health. The content is the sole responsibility of the authors and does not necessarily represent the official views of the sponsors.


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