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| Format: | Artículo Open Access |
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Wiley
2026
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| Online Access: | https://onlinelibrary.wiley.com/doi/10.1111/add.70421 |
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| _version_ | 1867007258062225408 |
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| author | Yoo Jin Cho Alice Hinton Jean Nshimiyimana Toral Mehta Lurdes Queimado Irina Stepanov Samantha Case Laura A. Beebe Theodore L. Wagener |
| author_facet | Yoo Jin Cho Alice Hinton Jean Nshimiyimana Toral Mehta Lurdes Queimado Irina Stepanov Samantha Case Laura A. Beebe Theodore L. Wagener Yoo Jin Cho Alice Hinton Jean Nshimiyimana Toral Mehta Lurdes Queimado Irina Stepanov Samantha Case Laura A. Beebe Theodore L. Wagener |
| collection | Wiley Open Access |
| contents | The effect of higher versus lower wattage e‐cigarettes on smoking: A randomized controlled trial Yoo Jin Cho Alice Hinton Jean Nshimiyimana Toral Mehta Lurdes Queimado Irina Stepanov Samantha Case Laura A. Beebe Theodore L. Wagener Addiction Abstract Aims To assess whether higher wattage e‐cigarettes (HWe), with improved nicotine delivery, enhance complete substitution compared with lower wattage e‐cigarettes (LWe) and whether complete switching lowers exposure to a cigarette‐derived lung carcinogen, using urinary 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol (NNAL) as a biomarker. Design A 3‐arm randomized controlled trial with a 12‐week treatment period and follow‐ups at 26 and 52 weeks. Participants were enrolled from June 2017 to December 2022, with all visits completed by March 2023. Setting Academic medical centers in the United States. Participants 372 adults who smoked and were not interested in quitting [mean age = 40 years; standard deviation (SD) = 11.0; 63% female; mean cigarettes per day = 17; SD = 8.9] were randomized and comprised the analytic sample. Intervention A 12‐week supply of HWe, LWe or usual brand cigarettes (UBC). Measurements The primary outcome was between‐group differences in complete substitution rates at week 12, defined as self‐reported smoking of 1 or fewer cigarettes in the past 7 days [confirmed by exhaled carbon monoxide (eCO) < 4 ppm], with missing data imputed as smoking, and self‐reported use of e‐cigarettes during the 7‐day period. Additional outcomes included urinary NNAL through week 12. Findings At 12 weeks, complete substitution rates were 6.0% (8 of 134) with HWe and 9.0% (12 of 133) with LWe, with no statistically significant between‐group difference. Complete substitution rates were 3.7% (HWe) vs. 9.0% (LWe) at 26 weeks, and 4.5% vs. 5.3% at 52 weeks, with no statistically significant between‐group differences. Among those who completely switched, mean NNAL levels decreased over 12 weeks with both LWe [mean decrease: 2.4 pmol/mg creatinine; 95% confidence interval (CI) = 1.2–3.7; P = 0.002] and HWe (mean decrease: 2.3 pmol/mg creatinine; 95% CI = 1.1–3.6; P = 0.002). Conclusions Provision of higher and lower wattage e‐cigarettes to adults who smoked and were not interested in quitting resulted in comparable substitution rates. Complete switching from cigarettes to higher and lower wattage e‐cigarettes reduced urinary 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol. Trial Registration: NCT03113136 ( ClinicalTrials.gov ). 10.1111/add.70421 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| doi_str_mv | 10.1111/add.70421 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_add_70421 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | The effect of higher versus lower wattage e‐cigarettes on smoking: A randomized controlled trial Yoo Jin Cho Alice Hinton Jean Nshimiyimana Toral Mehta Lurdes Queimado Irina Stepanov Samantha Case Laura A. Beebe Theodore L. Wagener Addiction The effect of higher versus lower wattage e‐cigarettes on smoking: A randomized controlled trial Yoo Jin Cho Alice Hinton Jean Nshimiyimana Toral Mehta Lurdes Queimado Irina Stepanov Samantha Case Laura A. Beebe Theodore L. Wagener Addiction Abstract Aims To assess whether higher wattage e‐cigarettes (HWe), with improved nicotine delivery, enhance complete substitution compared with lower wattage e‐cigarettes (LWe) and whether complete switching lowers exposure to a cigarette‐derived lung carcinogen, using urinary 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol (NNAL) as a biomarker. Design A 3‐arm randomized controlled trial with a 12‐week treatment period and follow‐ups at 26 and 52 weeks. Participants were enrolled from June 2017 to December 2022, with all visits completed by March 2023. Setting Academic medical centers in the United States. Participants 372 adults who smoked and were not interested in quitting [mean age = 40 years; standard deviation (SD) = 11.0; 63% female; mean cigarettes per day = 17; SD = 8.9] were randomized and comprised the analytic sample. Intervention A 12‐week supply of HWe, LWe or usual brand cigarettes (UBC). Measurements The primary outcome was between‐group differences in complete substitution rates at week 12, defined as self‐reported smoking of 1 or fewer cigarettes in the past 7 days [confirmed by exhaled carbon monoxide (eCO) < 4 ppm], with missing data imputed as smoking, and self‐reported use of e‐cigarettes during the 7‐day period. Additional outcomes included urinary NNAL through week 12. Findings At 12 weeks, complete substitution rates were 6.0% (8 of 134) with HWe and 9.0% (12 of 133) with LWe, with no statistically significant between‐group difference. Complete substitution rates were 3.7% (HWe) vs. 9.0% (LWe) at 26 weeks, and 4.5% vs. 5.3% at 52 weeks, with no statistically significant between‐group differences. Among those who completely switched, mean NNAL levels decreased over 12 weeks with both LWe [mean decrease: 2.4 pmol/mg creatinine; 95% confidence interval (CI) = 1.2–3.7; P = 0.002] and HWe (mean decrease: 2.3 pmol/mg creatinine; 95% CI = 1.1–3.6; P = 0.002). Conclusions Provision of higher and lower wattage e‐cigarettes to adults who smoked and were not interested in quitting resulted in comparable substitution rates. Complete switching from cigarettes to higher and lower wattage e‐cigarettes reduced urinary 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol. Trial Registration: NCT03113136 ( ClinicalTrials.gov ). 10.1111/add.70421 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| title | The effect of higher versus lower wattage e‐cigarettes on smoking: A randomized controlled trial |
| topic | Addiction |
| url | https://onlinelibrary.wiley.com/doi/10.1111/add.70421 |