Predictors of smoking reduction among African American and Latinx smokers in a randomized controlled trial of JUUL e-cigarettes. (November 2021)

• Record Type: Journal Article
• Authors: Rubenstein, Dana; Sokolovsky, Alexander W.; Aston, Elizabeth R.; Nollen, Nicole L.; Schmid, Christopher H.; Rice, Myra; Pulvers, Kim; Ahluwalia, Jasjit S.
• Is Part Of: Addictive behaviors. Volume 122(2021)
• Publication Date: 2021-11
• Subjects: E-cigarettes -- Smoking -- Reduction -- Cessation -- Racial/ethnic minorities -- Health disparities; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2021.107037
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: Minority smokers decreased cigarette consumption in a trial of e-cigarettes. Smoking reduction was associated with a higher number of JUUL pods used. Lower baseline cigarette dependence predicted greater smoking reduction. Lower baseline cotinine predicted greater smoking reduction. Abstract: Introduction: E-cigarette (e-cig) use is widespread and may play an important role in facilitating smoking reduction. Racial/ethnic minorities are less likely than Whites to use e-cigs and suffer disproportionate tobacco-related disease, making them a priority for harm reduction. This paper explores factors associated with smoking reduction among African American (AA) and Latinx smokers enrolled in a trial assessing toxicant exposure in those assigned to e-cigs or smoking as usual. Methods: Participants were randomized to receive 6 weeks of JUUL e-cigs or continue smoking cigarettes as usual ( N = 187). This analysis focuses on 109 participants randomized to e-cigs. We modeled cigarettes smoked in the past week at baseline and week 6 as a function of a priori selected predictors (number of JUUL pods used throughout the study, baseline cigarette dependence, and baseline cotinine) using a Poisson model fit with generalized estimating equations. Results: Over the six-week study, cigarette smoking decreased from an average of 82.4 to 15.5 cigarettes per week. Greater numbers of JUUL pods used predicted a greater smoking reduction by week 6 (IRR = 0.94 [0.91, 0.96], p < 0.001). Higher baseline cigarette dependence (IRR = 1.03 [1.01, 1.05], p = 0.004), and baseline cotinine (IRR = 1.18 [1.03, 1.37], p = 0.020) predicted a lesser smoking reduction. Conclusions: AA and Latinx smokers reduced their cigarette consumption while using JUUL e-cigs. Higher e-cig use during an intervention to switch to e-cigs to reduce harm may facilitate a transition to smoking fewer cigarettes, offering an opportunity to narrow smoking-related health disparities.