{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:53:41Z","timestamp":1791341621568,"version":"4.3.1"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Brown University Office of Vice President Research"},{"name":"Center of Biomedical Research Excellence","award":["P20GM130414"],"award-info":[{"award-number":["P20GM130414"]}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Alternative Nicotine Delivery Systems (ANDS) such as e-cigarettes (EC) and oral nicotine pouches (ONP) may facilitate the substitution of smoking for those unwilling to quit. This pilot study assesses the harm-reduction potential of EC and ONP among smokers with low socioeconomic status (SES).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>Adults who smoked daily in the past 6 months, had a household income\u2005&amp;lt;\u2005250% federal poverty level and had no intention of quitting smoking in the next 30 days were randomized 2:2:1 to 8 weeks of 5% nicotine EC; 4 mg ONP or assessment-only control (CC). The primary outcome was a within-group change in cigarettes per day (CPD) from Baseline to week 8.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-five individuals were randomized (EC: N\u2005=\u200518; ONP: N\u2005=\u200518; CC: N\u2005=\u20059). Analyses included 33 participants who completed the week 8 visit. The mean age was 50.1 years (SD: 10.7) and the average CPD at baseline was 13.9 (SD: 10.1). For those randomized to EC, the average CPD decreased from 14.7 (95% CI: 10.3 to 19.1) at the Baseline to 2.9 (95% CI: .1 to 5.8) at week 8 (p-value\u2005&amp;lt;\u2005.001). For those randomized to ONP, average CPD decreased from 15.0 (95% CI: 5.0 to 24.9) to 8.3 (95% CI: 1.3 to 15.2) by week 8 (p-value\u2005=\u2005.01). In the EC and ONP groups, respectively, 4 (28.6%) and 1 (8.3%) participant fully switched from smoking to the ANDS product by week 8.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Individuals with low SES who smoke had lower CPD after switching to EC or ONP. These findings show the potential of ANDS in helping smokers switch to less harmful devices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>This study provides novel evidence that e-cigarettes and nicotine pouches can be a harm-reduction tool for individuals with lower SES who smoke and are not willing to quit smoking, contributing to reducing tobacco-related disparities in this population.<\/jats:p>\n                  <jats:p>Clinical Trials Identifier: NCT05327439<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntae047","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T06:24:01Z","timestamp":1709619841000},"page":"1150-1158","source":"Crossref","is-referenced-by-count":21,"title":["Using Pod Based e-Cigarettes and Nicotine Pouches to Reduce Harm for Adults With Low Socioeconomic Status Who Smoke: A Pilot Randomized Controlled Trial"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2019-6453","authenticated-orcid":false,"given":"Jaqueline C","family":"Avila","sequence":"first","affiliation":[{"name":"Department of Gerontology, University of Massachusetts Boston , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8909-0193","authenticated-orcid":false,"given":"Dale Dagar","family":"Maglalang","sequence":"additional","affiliation":[{"name":"Silver School of Social Work, New York University , New York, NY ,","place":["USA"]},{"name":"Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole L","family":"Nollen","sequence":"additional","affiliation":[{"name":"Department of Population Health, School of Medicine, University of Kansas Medical Center , Kansas City, KS ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangah Clara","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riley","family":"Suh","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Malone","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3262-4562","authenticated-orcid":false,"given":"Urvi","family":"Binjrajka","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasjit S","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI ,","place":["USA"]},{"name":"Warren Alpert School of Medicine, Brown University , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"2025052602164033400_CIT0001","volume-title":"How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General","author":"Centers for Disease Control and Prevention (US), National Center for Chronic Disease Prevention and Health Promotion (US), Office on Smoking and Health (US)","year":"2010"},{"issue":"18","key":"2025052602164033400_CIT0002","doi-asserted-by":"crossref","first-page":"475","DOI":"10.15585\/mmwr.mm7218a1","article-title":"Tobacco product use among adults","volume":"72","author":"Cornelius","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"2025052602164033400_CIT0003","volume-title":"Smoking Cessation. 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