Titled, “Effect of Pod e-Cigarettes vs Cigarettes on Carcinogen Exposure Among African American and Latinx Smokers,” the study consisted of a six-week-long randomized trial comparing e-cigarette use to traditional cigarette use, amongst African American and Latin smokers.
“The primary outcome was reduction in urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentration at week 6. Secondary outcomes were change in urinary cotinine, expired carbon monoxide (CO), respiratory symptoms, lung function, blood pressure.”
Co-program leader of KU Cancer Center’s Cancer Prevention and Control research program, Nikki Nollen, PhD, acted as site principal investigator.
“Fourth generation e-cigarettes contain high concentrations of nicotine and other appealing features that may support switching and reduce potential health risks among those who smoke combustible cigarettes,” Dr. Nollen said. “We wanted to examine the biomarkers of exposure in both groups and determine the risk-benefit tradeoff of e-cigarettes.”
The participants were adult smokers who consumed at least 5 cigarettes/d on at least 25 of the past 30 days for at least 6 months and were interested in switching to e-cigarettes. Data were analyzed and collected between September 18th, 2019, and September 4th, 2020.
According to the study Abstract, the study subjects were offered a 6 week supply of vaping products in their preferred flavours (at 5% nicotine) along with brief education, training, and action planning to completely switch to e-cigarettes from combustible cigarettes. While the control group were instructed to keep smoking as usual.
A reduction in the analysed biomarkers was measured
The compiled data indicated a reduction in the analysed biomarkers. “The primary outcome was reduction in urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentration at week 6. Secondary outcomes were change in urinary cotinine, expired carbon monoxide (CO), respiratory symptoms, lung function, blood pressure, past 7-day consumption of combustible cigarettes, and switching rates (e-cigarette group only) at weeks 2 and 6.”
Nollen pointed out that the level of reduction in certain biomarkers was surprising. “What was most surprising was the magnitude of change experienced by those in the e-cigarette group,” Dr. Nollen said. “They reduced their NNAL by 64%, carbon monoxide by 47% and respiratory symptoms by 37% compared to those in the control group who continued to smoke cigarettes as usual.”
Dual users experienced benefits aswell
Moreover, reported the study, the benefits were not only experienced by those who switched completely, but also by dual users, even though to a lesser degree than those who made a complete switch. “The e-cigarette trajectory subgroups differed significantly for NNAL and CO levels. Exclusive e-cigarette users had the most pronounced changes, followed by dual users, and then exclusive cigarette smokers. At week 6, exclusive e-cigarette users had significantly greater reductions in NNAL and CO levels than dual users and cigarette smokers. Dual users also had greater reduction of CO levels compared with exclusive cigarette smokers.”
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