{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:03:14Z","timestamp":1782846194067,"version":"3.54.5"},"reference-count":74,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Adults who smoke cigarettes may reduce their exposure to cigarette smoke by switching completely or partially to an electronic nicotine delivery system (ENDS).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study investigated the use of a novel ENDS over 8 weeks, under near real-world conditions, among adults who smoke cigarettes daily and are living in the United States. The objectives were to assess the proportion of participants who switched completely to the novel ENDS and changes in cigarette consumption.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This actual use study assessed the use of the novel ENDS among exclusive cigarette smokers (n=353) and dual users of cigarettes and ENDS (n=367). Participants were required to be aged 21 to 64 years old, had smoked 100+ cigarettes in their lifetime, smoked cigarettes daily at the time of enrollment, and reported positive intention to try, use, and buy the study product (SP). Participants were recruited from consumer databases. During the baseline period, participants self-reported their daily use of cigarettes and ENDS using an electronic diary. During the observational period, self-reporting also included daily use of SP. The SP was available in 2 variants (tobacco and menthol) at one nicotine concentration (3.5%; 39 mg\/mL nicotine). Participants obtained 10 cartridges at the beginning of the observational period and could select either SP variant or both and were allowed to obtain additional SP. SP use patterns and sensory experiences were assessed at the end of the observational period, and cigarette consumption was compared to baseline. SP variant use and its impact on complete switching and cigarette consumption were also assessed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The average age of enrolled exclusive cigarette smokers and dual users was 47 (SD 10.4) years and 44.3 (SD 9.6) years, respectively, and there were more female than male participants (227\/353, 64.3% and 186\/367, 50.7%). Participants smoked on average 13.3 (SD 7.3) and 12.1 (SD 7.2) cigarettes per day, and mostly menthol cigarettes (197\/353, 55.8% and 201\/367, 54.8%). Most participants had no plan to quit cigarette smoking in the next 6 months (261\/353, 73.9% and 328\/367, 89.4%). At the end of the observational period, 86.2% (304\/353) of exclusive cigarette smokers and 92.1% (338\/367) of dual users used the SP; 4% (14\/353) of exclusive cigarette smokers and 4.1% (15\/367) of dual users switched completely to the SP. Furthermore, 25.8% (91\/353) of exclusive cigarette smokers and 28.1% (103\/367) of dual users substantially reduced their cigarette consumption (50% or more) compared to baseline. Finally, around half of the participants (exclusive cigarette smokers: 166\/304, 54.6%; dual users: 167\/338, 49.4%) used only the menthol SP variant, which was also more positively evaluated in taste, smell, and aftertaste than the tobacco SP variant.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study indicates that adults who smoke cigarettes can switch completely to the novel ENDS or substantially reduce their cigarette consumption. These results complement the scientific evidence suggesting that ENDS are an acceptable alternative to cigarettes for adults who smoke in the United States.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/76019","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T14:50:07Z","timestamp":1752504607000},"page":"e76019-e76019","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Use Patterns of a Closed Electronic Nicotine Delivery System Among Adults in the United States Who Smoke Cigarettes Daily: 8-Week Actual Use Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8359-8498","authenticated-orcid":false,"given":"Steve","family":"Roulet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6281-8615","authenticated-orcid":false,"given":"Claudia","family":"Kanitscheider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5503-078X","authenticated-orcid":false,"given":"Pierpaolo","family":"Magnani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1865-7353","authenticated-orcid":false,"given":"Gerd","family":"Kallischnigg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"issue":"18","key":"R1","doi-asserted-by":"publisher","first-page":"475","DOI":"10.15585\/mmwr.mm7218a1","article-title":"Tobacco product use among adults - United States, 2021","volume":"72","author":"Cornelius","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"7137","key":"R2","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1136\/bmj.316.7137.1043","article-title":"Smoking and risk of myocardial infarction in women and men: longitudinal population study","volume":"316","author":"Prescott","journal-title":"BMJ"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-11-36","article-title":"Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema","volume":"11","author":"Forey","journal-title":"BMC Pulm Med"},{"issue":"13","key":"R4","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1177\/2047487320918728","article-title":"Impact of smoking on cardiovascular outcomes in patients with stable coronary artery disease","volume":"28","author":"Bouabdallaoui","journal-title":"Eur J Prev Cardiol"},{"issue":"10","key":"R5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.31480","article-title":"Association between smoking, smoking cessation, and mortality by race, ethnicity, and sex among US adults","volume":"5","author":"Thomson","journal-title":"JAMA Netw Open"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2020.106099","article-title":"Tobacco harm reduction: past history, current controversies and a proposed approach for the future","volume":"140","author":"Hatsukami","journal-title":"Prev Med"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1136\/tobaccocontrol-2017-053759","article-title":"Potential deaths averted in USA by replacing cigarettes with e-cigarettes","volume":"27","author":"Levy","journal-title":"Tob Control"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2016.09.011","article-title":"Reasons for current e -cigarette use among U.S. adults","volume":"93","author":"Patel","journal-title":"Prev Med"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1093\/ntr\/nty270","article-title":"Cold Turkey and hot vapes? 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