E-cigarettes as a Harm Reduction Strategy

October 29, 2024 updated by: Prisma Health-Upstate

E-cigarettes for Harm Reduction in Adults With Opioid Use Disorder

E-cigarettes have emerged as an effective strategy for replacing cigarettes among smokers from the general population, but there is a dearth of studies investigating their utility in replacing cigarettes among smokers with opioid use disorder (OUD). This study aims to evaluate the feasibility and acceptability of implementing a cigarette harm reduction intervention involving e-cigarettes in office-based buprenorphine clinics.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Between 84-94% of individuals with opioid use disorder (OUD) smoke cigarettes, a rate six times higher than the general US adult population. Despite the majority of smokers with OUD expressing motivation to quit, cessation rates remain extremely low, even with evidence-based medications. E-cigarettes have emerged as a harm reduction strategy for smokers unable or unwilling to quit. Research on the effectiveness of e-cigarettes for smoking reduction among individuals with OUD on buprenorphine/methadone maintenance treatment is scarce but promising. This study is an open-label single-arm clinical trial testing the use of e-cigarettes as a harm reduction strategy among smokers with OUD on buprenorphine in a real-world setting.

Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • South Carolina
      • Greenville, South Carolina, United States, 29609
        • Prisma Health

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Adult (age ≥21)
  • Report smoking ≥ 5 cigarettes per day for ≥ one year
  • Interested in switching to e-cigarettes (self-reported)
  • OUD diagnosis (DSM-V)(chart review)
  • Currently receiving buprenorphine or other medications for opioid use disorder (MOUD) (chart review)
  • Plan to remain on buprenorphine for at least 3 months (duration of the study) (self-reported)
  • Have a smartphone with internet access

Exclusion Criteria:

  • Use of other tobacco or nicotine products other than cigarettes (≥9 days in the past 30)
  • Used nicotine replacement, bupropion or other pharmacotherapies as cessation aids in the past month (bupropion will be allowed for treatment of depression) (self-reported) (3)
  • Having a severe medical condition, including decompensated cirrhosis, severe cardiovascular
  • disease (myocardial infarction, percutaneous transluminal coronary angioplasty, unstable angina, coronary artery bypass graft, and/or serious arrhythmia in the
  • prior 6 months) (chart review)
  • Having severe asthma or chronic obstructive pulmonary disease requiring supplemental oxygen or hospitalization in the past 6 months (chart review)
  • Being hospitalized for human immunodeficiency virus/acquired immunodeficiency syndromes-related illness in the past 6 months (chart
  • review)
  • Having a history of seizure disorder (chart review)
  • Pregnancy (chart review) or breast-feeding (self-reported) for female participants
  • Having current DSM-V criteria for mania, psychosis, or major depressive disorder (chart review)
  • Current suicidal ideation or past year suicide attempt (PHQ-9; see protections against risk)
  • Being hospitalized for psychiatric reasons in the past year (chart review)
  • Being unable to independently read and/or comprehend the consent form or other study materials (unable to read study materials aloud)
  • Being unable to read/speak English (inability to read and complete study materials)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: E-cigarette
Participants will be supplied with an e-cigarette along with a 4-week supply of e-liquid. Participants will receive training on how to use the device and practice puffing with the e-cigarette during the research visit. They will be instructed to self-regulate administration according to their craving and withdrawal symptoms and to refrain from using other nicotine and tobacco products.
Participants will be supplied with an e-cigarette along with a 4-week supply of e-liquid. Participants will receive training on how to use the device and practice puffing with the e-cigarette during the research visit. They will be instructed to self-regulate administration according to their craving and withdrawal symptoms and to refrain from using other nicotine and tobacco products.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of people who are eligible
Time Frame: Baseline
Percentage of people who are screened for the study who are eligible and consent to participate in the study
Baseline
Percentage of consented participants
Time Frame: Through study completion, 1 month follow-up
Percentage of consented participants will complete the study
Through study completion, 1 month follow-up
Percentage of participants who report using the e-cigarette at least once a day
Time Frame: Week 1 to week 4
Percentage of participants who report using the e-cigarette at least once a day in weeks 1-4
Week 1 to week 4
Percentage of participants with at least one puff of study e-cigarette
Time Frame: Week 1 to week 4
Percentage of participants with at least one puff of e-cigarette a day in weeks 1-4
Week 1 to week 4
Percentage of daily diary completed
Time Frame: Week 1 to week 4
Percentage of daily diary entries completed
Week 1 to week 4

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cigarette dependence measured via the Fagerstrom test for nicotine dependence
Time Frame: Baseline to week 4
Change in cigarette dependence- baseline vs. week 4
Baseline to week 4
Cigarette demand measured via the cigarette purchase task
Time Frame: Baseline to Week 4
Change in cigarette demand- baseline vs. week 4
Baseline to Week 4
Combustible cigarette smoking
Time Frame: Baseline vs week 4
Change in average number of cigarettes consumed- baseline vs week 4
Baseline vs week 4
Switching to e-cigarettes
Time Frame: week 4
Percent of participants who switch to e-cigarettes by the end of week 4
week 4
Smoking reduction
Time Frame: From baseline to Week 4
Percent of participants who change their smoking by at least 50%
From baseline to Week 4

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 20, 2023

Primary Completion (Actual)

March 18, 2024

Study Completion (Actual)

March 18, 2024

Study Registration Dates

First Submitted

January 19, 2024

First Submitted That Met QC Criteria

February 21, 2024

First Posted (Actual)

February 26, 2024

Study Record Updates

Last Update Posted (Actual)

October 31, 2024

Last Update Submitted That Met QC Criteria

October 29, 2024

Last Verified

October 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • 1901611-9

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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