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Introduction

Smoking is a leading cause that brings consequential health and social issues
Relatively higher prevalence among substance use disorder (SUD) patients compared to the general population
Smoking cessation tool: Nicotine Replacement Therapy (NRT) and Electronic Cigarettes (EC)
Limited studies have specifically investigated the disparities in smoking patterns among the SUD population and the potential effects of tobacco treatment programs

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Research Question and Hypothesis

How has cigarette dependence changed after NRT and EC interventions were assigned to SUD patients?”

Patients randomized to EC will lead a lower cigarette dependence at the end of intervention while the EC dependence will increase

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Methods

Background:

Datacore from Bellevue Hospital and NYU Grossman School of Medicine
Six-week, two-armed, randomized controlled trial
NRT = 23, EC =17

Measures:

Primary outcome: Fagerstrom Test of Nicotine Dependence (FTND), secondary outcomes: Minnesota Withdrawal Symptoms Scales (MNW), electronic cigarette dependence index, and reduction level no. of cigarettes per day (CPD)
Covariates: Gender, Ethnicity, Education level, and Marital status

Statistical Analyses:

Stata Standard Edition 17.0
Univariate analyses / Fisher’s Exact Test / Student’s T-Tests
Binomial regression to estimate the risk ratio at each level of reduction of CPD for EC against NRT

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Results

	FTND at baseline (Mean, SD)	FTND at the end of treatment (Mean, SD)	P-value
E-cig	5.12 (1.45)	1.71 (2.14)	0.000
NRT	5.22 (1.57)	1.91 (1.86)	0.000

	MNW at baseline (Mean, SD)	MNW at the end of treatment (Mean, SD)	P-value
E-cig	25.54 (8.95)	16.88 (8.50)	0.004
NRT	20.43 (8.23)	16.70 (8.26)	0.051

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Results

No difference at the level of 25% and 50% or higher.

EC has a higher reduction in CPD of at least 75% (p-value = 0.035) and 100% (p-value = 0.01).

55.6% in the EC arm achieved complete abstinence from CC smoking whereas only 17.4% in the NRT arm

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Conclusions

EC has a greater effect in reducing the cigarettes smoking and withdrawal symptoms scale compared to NRT
Limitations

Selection bias: data only collected at one single center
Information bias: Telehealth interviews may introduce recall bias/open-ended questions
Limited sample size

As it is a pilot study there should be further studies with increased sample sizes are necessary to determine the long-term effectiveness of EC.

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References

1. General S. The health consequences of smoking—50 years of progress: a report of the surgeon general. Citeseer; 2014:

2. Drope J, Liber AC, Cahn Z, et al. Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States. CA: a cancer journal for clinicians. 2018;68(2):106-115.

3. Health UDo, Services H. The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease …; 2014.

4. McBride PE. The health consequences of smoking: cardiovascular diseases. Medical Clinics of North America. 1992;76(2):333-353.

5. Shah RS, Cole JW. Smoking and stroke: the more you smoke the more you stroke. Expert review of cardiovascular therapy. 2010;8(7):917-932.

6. Wolf PA, D'Agostino RB, Kannel WB, Bonita R, Belanger AJ. Cigarette smoking as a risk factor for stroke: the Framingham Study. Jama. 1988;259(7):1025-1029.

7. Hecht SS. Cigarette smoking: cancer risks, carcinogens, and mechanisms. Langenbeck's Archives of Surgery. 2006;391(6):603-613.

8. Guydish J, Passalacqua E, Tajima B, Chan M, Chun J, Bostrom A. Smoking prevalence in addiction treatment: a review. Nicotine & Tobacco Research. 2011;13(6):401-411.

9. Abuse S. Key substance use and mental health indicators in the United States: results from the 2019 National Survey on Drug Use and Health. 2020;

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