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We hypothesized that providing nicotine from ENDS in addition to nicotine skin patches would promote smoking reduction relative to non-nicotine control ENDS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>To assess the effects on smoking behavior of using nicotine vs. placebo ENDS in smokers using nicotine vs. placebo patches.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Ninety-four daily smokers were enrolled in a study that randomly assigned them to receive ENDS with nicotine vs. without nicotine and skin patches with vs. without nicotine. Smoking reduction and cessation were assessed over an 8-week period by self-report and by expired air carbon monoxide (CO) measurements. The primary outcome was defined as reduction in expired air CO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The use of nicotine in ENDS led to significant reductions in smoking (ENDS nicotine vs. placebo difference in CO change = \u22129.2 ppm; 90% CI (\u22121.5 ppm, \u221216.9 ppm)) and was highly correlated with reductions in self-reported cigarettes per day (<jats:italic>r<\/jats:italic>=0.6). The effect of nicotine in nicotine patches was not statistically significant (patch nicotine vs. placebo difference in CO change = \u22120.1 ppm; 90% CI (\u22127.8 ppm, 7.6 ppm)).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The presence of nicotine in ENDS was associated with a large reduction in smoking. Additional studies will be needed to determine whether there may be additive effects of nicotine ENDS and nicotine patches on smoking abstinence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00213-023-06401-y","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T04:01:53Z","timestamp":1689566513000},"page":"1901-1909","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Smoking reduction using electronic nicotine delivery systems in combination with nicotine skin patches"],"prefix":"10.1007","volume":"240","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4861-7750","authenticated-orcid":false,"given":"Jed E.","family":"Rose","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Frisbee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Salley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Claerhout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"issue":"1","key":"6401_CR1","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s12954-021-00475-7","volume":"18","author":"K Adriaens","year":"2021","unstructured":"Adriaens K, Belmans E, Van Gucht D, Baeyens F (2021) Electronic cigarettes in standard smoking cessation treatment by tobacco counselors in Flanders: e-cigarette users show similar if not higher quit rates as those using commonly recommended smoking cessation aids. 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