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The SRNT 2013 abstracts have been released at
http://www.srnt.org/conferences/SRNT_2013_Abstracts_H.pdf
At least nine abstracts (below) are about e-cigarettes, with most finding health benefits, and none finding health hazards.
E-CIGARETTES TOPIC:
POS2-133
CONSUMER PERCEPTIONS OF ELECTRONIC NICOTINE DELIVERY
devices AS SMOKING CESSATION AIDS
Blair N. Coleman, M.P.H.*, Eva Sharma, M.P.H., Magdalena Ignaczak, B.S., and
Pamela I. Clark, Ph.D., University of Maryland-College Park
Background: Electronic nicotine delivery devices (ENDS; or e-cigarettes)
have surged in popularity in recent years, however further research is needed
to determine consumer perceptions of their acceptability as smoking cessation
aids. The aim of this pilot study was to explore smokers perceptions of the
effectiveness of using ENDS during a 2-week cessation attempt. Methods: After
a laboratory-based study that had the advantage of familiarizing participants with
use of the ENDS, smokers motivated to quit were provided with an e-cigarette and
a 2-week supply of cartridges in the style (menthol or non-menthol) of their choice.
They received two in-person behavioral counseling sessions and two telephone
counseling sessions. At the end of the two-week quit attempt, in-depth qualitative
interviews were conducted to assess the subjects perceptions of the effectiveness
of using ENDS as a cessation tool. Sessions were audio-recorded and the data
transcribed and analyzed using a thematic approach. Results: Themes that
emerged included lower perceptions of nicotine content compared to own brand
cigarettes, a higher sense of control with regards to nicotine self-administration
compared to other cessation mechanisms (e.g., nicotine gum, patch), and an
ease of transition to the e-cigarette to assist with a quit attempt. Additionally,
similarities between own brand of cigarettes and e-cigarettes generally included
similar smoking patterns (in terms of duration and time of day), but participants
found greater resistance to draw with the e-cigarette compared to conventional
cigarettes, and reported that they often failed to provide the level of satisfaction
produced by conventional cigarette. Lastly, participants noted that the e-cigarette
drew attention from by-standers who were interested in knowing more about the
product, and some were uncomfortable with the attention the product elicited,
opting to use the e-cigarette in private locations only. Conclusions: Understanding
the consumer acceptability of using ENDS has important implications as to how
these products could be used as smoking cessation devices and how they could
potentially be prescribed to help smokers quit.
Supported by NIH/NIDA Grant #5R21DA030622.
CORRESPONDING AUTHOR: Blair N. Coleman, MPH, University of Maryland,
Behavioral and Community Health, 2387 SPH Building, Valley Drive, College Park,
MD 20742, United States, Phone: 3014058740, Email: bcolema2@umd.edu
POS2-134
USE OF ELECTRONIC CIGARETTES AMONG ADULTS ENROLLED IN A
GROUP RANDOMIZED SMOKING CESSATION TRIAL IN APPALACHIAN
OHIO
Amy M. Wermert, M.P.H.*, Nancy E. Hood, Ph.D., Sherry T. Liu, M.P.H., and Mary
Ellen Wewers, Ph.D., The Ohio State University, College of Public Health
Electronic cigarette (ecig) use is growing in popularity. Little is known about the
use of ecigs among adult smokers in Appalachian Ohio. The purpose of this study
was to describe the use of ecigs among participants living in Appalachian Ohio
enrolled in a group randomized cessation trial (n=467 participants) that included
behavioral counseling and free nicotine replacement therapy (NRT) (i.e., 21 mg
patch) over a 10 week protocol. Study eligibility criteria included: resident of a
participating Appalachian county, 18 years or older, self-reported daily cigarette
use, willing to quit in the next 30 days, no medical contraindication to NRT use,
and if female, not pregnant. Data collection started in November 2010; items to
assess ecig use were added to the existing survey in April 2012. As a result, ecig
use was not collected for all participants. This abstract reports on a subset of the
sample (n=252 participants) and includes data collected at baseline, 3, 6, or 12
months post-intervention. Of the subset of participants, 10% reported currently
using an ecig every day or some days. Most ecig users were between 25-54 years
old (54%), female (65%) and had more than a HS/GED education (50%). Most
were not employed (69%) but had health care coverage (77%). Most ecig users
were living at 200% below poverty (77%). For those interviewed post-intervention,
5.9% (n=15 participants) reported use of ecigs, primarily to assist in efforts to quit
smoking. Most were using ecigs with nicotine (67%) and most believed that ecigs
are less harmful than regular cigarettes (87%). The primary reasons given for ecig
use included: they make it easier for you to cut down on the number of cigarettes
you smoke (53%), they might help you quit (47%). These findings support
previous studies that demonstrate ecigs being used as a smoking cessation
aid. Limitations of this study include a small sample size and a homogenous
study population (i.e., those trying to quit, living in Appalachia, Ohio). This study
emphasizes the importance of continued research into the efficacy and safety of
the use of ecigs as a long-term smoking cessation aid.
This study was conducted while the first author was at The Ohio State University.
Supported by NIH grant # R01 CA129771.
CORRESPONDING AUTHOR: Amy Wermert, MPH, Program Manager, The Ohio
State University, College of Public Health, Health Behavior Health Promotion,
359-4 Cunz Hall, Columbus, OH 43210, United States, Phone: 614-292-8193,
Email: awermert@cph.osu.edu
POS2-135
SMOKERS WHO TRY E-CIGARETTES TO QUIT SMOKING: ARE THEY
SERIOUS ABOUT QUITTING?
Pallav Pokhrel, Ph.D., M.P.H.*, COPYRIGHTDMCA Fagan, Ph.D., M.P.H., Melissa Little,
Ph.D., Crissy Terawaki Kawamoto, B.S., and Thaddeus A. Herzog, Ph.D., Cancer
Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI
Electronic cigarettes or e-cigarettes are commonly marketed as smoking
cessation aids and their popularity appears to be on the rise. But little is known
about the characteristics of smokers who use e-cigarettes to quit smoking,
including their motivation to quit, quitting self-efficacy, and experience with Food
and Drug Administration (FDA) approved cessation aids. In this study, we tested
the associations between smokers ever use e-cigarettes for cessation and their
demographic characteristics (e.g., gender, ethnicity), motivation to quit, and
other smoking- and cessation-related characteristics. Cross-sectional data were
obtained from 1567 adult daily smokers in Hawaii using paper-and-pencil survey
in 2010-2012, as part of a smoking cessation study. Participants represented 50%
women, 21% Asian, 31% Native Hawaiian, 34% White, and 14% Other ethnicity.
e-Cigarette use was significantly associated with age (OR= 0.98, 95% CI [0.97,
0.99]), Native Hawaiian ethnicity (OR= 0.68, 95% CI [0.45, 0.99]), motivation to
quit (OR= 1.14, 95% CI [1.08, 1.21]), quitting self-efficacy (OR= 1.18, 95% CI
[1.06, 1.36]), and the use of conventional cessation products or medications such
as nicotine replacement gum (OR= 3.72, 95% CI [2.67, 5.19]) and Bupropion
(OR=2.29, 95% CI [1.38, 3.79]). Our data suggests that smokers who use
e-cigarettes appear to be serious about wanting to quit. Research is needed to
clarify the effectiveness of e-cigarette use in smoking cessation. Clinicians and
public health practitioners need to be prepared to clearly communicate the risks
and benefits of e-cigarette use to smokers who are highly motivated to quit.
This study was supported by an R01 grant (# CA2079905) from the National
Cancer Institute to T.A. Herzog.
CORRESPONDING AUTHOR: Pallav Pokhrel, Ph.D., M.P.H., Assistant Professor,
University of Hawaii Cancer Center, Cancer Prevention & Control, 677 Ala Moana
Blvd., Suite 200, Honolulu, HI 96813, United States, Phone: 8084417711, Email:
ppokhrel@cc.hawaii.edu
POS2-136
YOUNG ADULTS EXPOSURE TO PRO-SNUS AND PRO-ELECTRONIC
CIGARETTE MESSAGES AND USE OF THESE PRODUCTS
Kelvin Choi, M.P.H., Ph.D.*, and Jean L. Forster, Ph.D., M.P.H., University of
Minnesota
Objective: Young adults are experimenting with new tobacco products like
snus and electronic cigarettes (e-cigarettes), and exposure to pro-snus and
pro-e-cigarette messages may contribute to this phenomenon. We conducted
the first analysis to examine young adults exposure to these messages and its
associations with trying these products. Methods: Young adults (ages 20-25)
from the U.S. upper Midwest region were surveyed in 2009 and again in 2011
(n=2339). In 2011, participants were asked if they have received advertisements
and coupons for non-cigarette products in the mail, have seen Facebook pages/
groups and advertisements for snus and e-cigarettes, and have seen kiosks in
shopping malls promoting e-cigarettes. Ever use of these products was assessed
in 2011. Baseline tobacco use behaviors were assessed in 2009 (before these
products were available nationwide). Using multivariate logistic regression
models, we assessed characteristics associated with exposure to different types
of pro-snus and pro-e-cigarette messages in 2011, and the associations between
message exposure and ever use of these products in 2011. Results: Regarding
snus, 8% and 7% of the participants had received advertisements and coupons
for non-tobacco products in the mail, respectively; <1% had seen snus Facebook
pages/groups. Regarding e-cigarettes, 14% of the participants had seen kiosk
at shopping malls promoting e-cigarettes; 7% and 1% had seen e-cigarettes
advertisements and pages/groups on Facebook, respectively. Male, less educated
participants, those who had friends who smoke, tobacco users were more likely
to have received advertisements and coupons for non-cigarette products in the
mail (p<.05). For every additional type of exposure to pro-snus and pro-e-cigarette
messages, there was a 79% and 96% higher odds that participants had used
snus and e-cigarettes, respectively, adjusted for demographics, peer smoking and
tobacco use behaviors (p<.05). Conclusions: Exposure to pro-snus and pro-ecigarette
messages were associated with experimenting with these products in our
sample. Longitudinal studies are needed to confirm our findings.
This research was funded by the National Cancer Institute (R01 CA86191; J.
Forster - PI).
CORRESPONDING AUTHOR: Kelvin Choi, M.P.H., Ph.D., Research Associate,
University of Minnesota, Division of Epidemiology and Community Health, 1300
South Second Street, Minneapolis, MN 55454, United States, Phone: 612-626-
1799, Email: choix137@umn.edu
POS2-137
ELECTRONIC-CIGARETTES (E-CIGARETTES) IN GERMANY: A SMOKING
CESSATION TOOL?
Tobias Rüther, M.D., Ph.D.*, Franziska Wissen, Andrea Linhardt, M.D., Désirée
Aichert, Oliver Pogarell, M.D., Ph.D., and Hein de Vries, Ph.D.
Introduction: The use of an electronic-cigarette (e-cigarette) resulted in some
previous studies in reduction and cessation of conventional cigarette smoking.
Therefore, this study aims to examine the reasons of using e-cigarettes instead of
and in addition to conventional cigarettes in Germany. Furthermore it is determined
to what extent e-cigarettes are used as a smoking cessation tool. Method: A
cross-sectional study was conducted in April � May 2012 in Munich, Germany. The
I-Change Model was used as theoretical framework and existing questionnaires
were used to build up the present questionnaire. 320 Smokers participated
in the study, divided in three groups: E-cigarette smokers (e-smokers) (33%),
conventional cigarette smokers (c-smokers) (37%) and smokers of both cigarettes
(b-smokers) (30%). Pearson Chi Square tests and analyses of variance were used
to assess differences among the group of smokers on demographic variables,
smoking behaviour and the constructs of the I-Change Model. Results: About half
of the e-cigarette users used the e-cigarette in addition to c. cigarettes and the
other half instead of c. cigarettes. It seemed that e-smokers and b-smokers had
the same reasons for using e-cigarettes overall. E-cigarette users were most often
men, were less addicted to nicotine and had a higher motivation to stop smoking
than c-smokers. In addition, e-smokers reported a more positive health and had
a lower carbon monoxide concentration compared to c-smokers. Furthermore,
e-smokers had a more positive attitude towards e-cigarettes, a higher self-efficacy
in terms of being abstinent from c. cigarettes in certain situations and a higher
self-efficacy of using an e-cigarette instead of c. cigarettes. E-cigarettes were used
more frequently if the social environment of a person vaporized as well or preferred
the respondent to vaporize e-cigarettes instead of c. cigarettes. Discussion: The
results confirmed most of the hypotheses and also important results of previous
studies. In addition, a well-conducted randomized-control trial is needed to confirm
the efficacy of e-cigarettes as a smoking cessation aid.
No funding.
CORRESPONDING AUTHOR: Tobias Rüther, MD PhD, Physician, University
of Munich Department of Psychiatry, Tobacco Dependence Outpatient Clinic,
Nussbaumstr.7, Munich, 80336, Germany, Phone: +49-89-5160-5707, Email:
tobias.ruether@med.uni-muenchen.de
POS2-138
AWARENESS AND USE OF ELECTRONIC CIGARETTES AMONG COLLEGE
STUDENTS IN NEW YORK STATE
Jill Murphy*1, Sarah Beshers1, Brian Fix2, and Martin Mahoney2, 1State University
of New York at Cortland, Cortland, NY; 2Roswell Park Cancer Institute, Buffalo, NY
Electronic cigarettes (e-cigarettes) have been available in the United States
for about five years. Recent studies have found that awareness and ever use
of e-cigarettes among adults is increasing. To our knowledge, to date there are
no published reports of e-cigarette awareness and use among college students
in the United States. Some tobacco control advocates express concerns with
e-cigarettes, including that e-cigarettes could be used as a starter product for
younger or never smokers or they could delay cessation and result in a pattern
of dual use of tobacco products. The objective of this study was to assess
college students awareness, use, and perceptions of e-cigarettes. In October
and November of 2011, we conducted a cross-sectional survey among 1,187
undergraduate students attending two public universities in New York State.
Participants completed an online survey that included questions on demographics,
cigarette smoking behavior, smokeless tobacco use, awareness and use of
e-cigarettes, beliefs about the harmfulness of e-cigarettes, and interest in using
an e-cigarette. The prevalence of current cigarette smoking was 10.5%, and the
prevalence of smokeless tobacco use (including chewing tobacco, snuff, or snus)
was 2.7%. Current cigarette smokers were more likely than non-smokers to have
heard of e-cigarettes (86% vs. 71%, p<0.01), ever try an e-cigarette (47% vs.
5%, p<0.01), and use an e-cigarette in the past month (4% vs. 0.1%, p<0.01),
respectively. Only one participant reporting daily use of the e-cigarette. The vast
majority (97%) of college students perceived that e-cigarettes were either less
harmful or no different in terms of harm when compared to regular cigarettes.
Among participants who had not tried an e-cigarette, cigarette smokers were more
likely than non-smokers to report they would be interested in trying an electronic
cigarette (39% vs. 5%, p < 0.01). We found the majority of college students were
aware of e-cigarettes. While ever use of e-cigarettes was much more common
in current cigarette smokers than non-smokers, past month use was much less
common in the sample overall, and daily use was rare.
No funding.
CORRESPONDING AUTHOR: Jill Murphy, PhD, Associate Professor, SUNY
Cortland, Health, PO Box 2000 Graham Ave, Cortland, NY 13045, United States,
Phone: 6077535613, Email: murphyj@cortland.edu
POS2-139
A PROSPECTIVE RANDOMIZED CONTROL DESIGN STUDY TO EVALUATE
LONG TERM SAFETY, ABSTINENCE, AND REDUCTION RATES IN
SMOKERS NOT WILLING TO QUIT: THE ECLAT STUDY
Pasquale Caponnetto, Ph.D.1,2, Davide Campagna, M.D.1,2, Fabio Cibella, Ph.D.3,
Jaymin B. Morjaria, M.D.4, Cristina Russo, M.D.1,2, and Riccardo Polosa, M.D.,
Ph.D.*1,2, 1Centro per la Prevenzione e Cura del Tabagismo, Azienda Ospedaliero-
Universitaria Policlinico-V. Emanuele, Università di Catania, Catania, Italy;
2Institute of Internal Medicine, S. Marta Hospital, Azienda Ospedaliero-Universitaria
Policlinico-V. Emanuele, Università di Catania, Catania, Italy; 3Istituto di
Biomedicina e Immunologia Molecolare del Consiglio Nazionale delle Ricerche,
Palermo, Italy; 4IIR Division, School of Medicine, University of Southampton,
Southampton General Hospital, Southampton, UK
E-cigarettes are becoming increasingly popular with smokers worldwide.
Carefully conducted research on e-cigarettes is urgently needed in order to ensure
that the decisions of regulators, healthcare providers and consumers are based
on science. We designed a prospective 12-month double-blind, randomized,
controlled trial to evaluate smoking reduction, smoking abstinence and adverse
events in 300 smokers not intending to quit experimenting 2 different nicotine
strengths of a very popular brand compared to the non nicotine alternative from
the same brand. Study Group A (n =100) used 7.2 mg nicotine cartridges, Group
B (n =100) used 5.4 mg nicotine cartridges and Group C (n =100) was given
no-nicotine cartridges. Study participants were invited to attend a total of 9 study
visits during which number of cigarettes smoked, and eCO levels were measured.
Smoking reduction and abstinence rates were calculated. Adverse events and
product preferences were also reviewed. Lastly, classic and novel static and
dynamic factors predicting abstinence and reduction rates will be investigated.
A significant reduction (p<0.001) cig/day use and eCO levels from baseline was
observed at each study visits in all 3 study groups. By and large, no difference
between study groups was observed in terms of changes in cig/day use and in
eCO levels. A mean of 2.0 cartridges/day was used in each study group up to the
3-month time point, but falling thereafter. Smoking reduction was shown in 21%
and 9% participants in group A, in 16% and 8% in group B and in 19% and 10% in
group C, at 3- and 12-months respectively. Smoking abstinence was observed in
11 % and 13% participants in group A, in 17% and 9% in group B and in 4% and
4% in group C, at 3- and 12-months respectively. Only minor and transient adverse
were reported, including mouth and throat irritation, and dry cough. They seem
to attenuate over time. By and large, participants perception and acceptance of
the product was positive. In smokers not intending to quit, the use of e-Cigarette
decreased cigarette consumption and elicited enduring tobacco abstinence at 1-yr
without causing significant side effects.
No funding.
CORRESPONDING AUTHOR: Pasquale Caponnetto, University of Catania, c/o
Policlinico Vittorio Emanuele, Catania, 95123, Italy, Phone: 0039 7436413, Email:
p.caponnetto@unict.it
POS4-70
SMOKERS RATING OF ELECTRONIC CIGARETTES: WOULD MORE
SMOKERS QUIT IF ELECTRONIC CIGARETTES WERE ON SALE?
Randolph C. Grace, Ph.D.1, Aimee Richardson, B.Sc.(Hons)1, Donna Ritchie,
B.A.1, Murray Laugesen, FNZCPHM*2, Bronwyn Kivell, Ph.D.3, and Nathan
Cowie, M.P.H.4, 1University of Canterbury NZ; 2Health New Zealand Ltd; 3Victoria
University of Wellington; 4University of Auckland
BACKGROUND: Nicotine electronic cigarettes (NECs) were illegal to sell
or advertise in New Zealand during 2012, where 17% of adults smoke tobacco
cigarettes daily. METHODS: Smokers age 18 and over who purchased their own
cigarettes were recruited on worksites and by newspaper publicity; 343 were
interviewed face to face in four cities and rewarded with a voucher for $15 (NZ$; 1
NZ$ = 0.85 USD) and a chance to win an electronic tablet. Participants completed
the Cigarette Purchase Task (CPT; MacKillop et al., 2008) in which they reported
how many cigarettes per day they would smoke at various price points. Then they
sampled an NEC and rated preference for it against their own brand on a 10-point
scale. The NEC used was SafeCig 18mg (SafeCig LLC. Los Angeles), notionally
priced at $5 per day. RESULTS: Participants smoked a mean 14.9 cigarettes per
day (cpd) and spent $8.72 daily on cigarettes, 33% paying $0.38 per roll-your-own
(RYO) tobacco cigarette, 67% paying $0.72 per factory-made (FM) cigarette. After
3 puffs from the NEC, smokers liked it 83% as much as their own brand: average
preference ratings for NEC and own brand were 6.26 and 7.51, respectively. If
cigarettes cost $0.70 each, smokers estimated they would smoke 14.5 cpd, but
only 7.08 cpd if they could buy NECs (t[312] = 15.39, p < .001). Using NECs,
31.6% said they would quit smoking their own brand completely. If cigarette price
doubled to $1.40, 59.5% of smokers estimated they would quit, and a further
11.1% would quit by using NECs if NECs were on sale. Those continuing to smoke
at this price would smoke 10.63 cpd; but if NECs were on sale, would smoke 6.34
cpd (t[125] = 4.29, p < .001). CONCLUSIONS: If cigarettes cost $0.70 each (20%
above the mean 2012 price), and NECs cost 36% of this ($5 a day), three in ten
smokers would use NECs to switch off tobacco smoking entirely. If the price of
cigarettes doubled, price would be the main motivator of quitting, but even more
intended to quit if NECs were on sale. Most smokers liked the NEC and given its
price advantage, especially as tobacco excise increases, many would switch to
NECs and stop smoking tobacco, if NECs were available.
Funding: End Smoking NZ from Canterbury Community Trust; Univ. of
Canterbury, Tobacco Control Research Turanga Fund, University of Auckland.
CORRESPONDING AUTHOR: Murray Laugesen, FNZCPHM, Public Health
Medicine Specialist, Health New Zealand Ltd, 36 Winchester St Lyttelton,
Christchurch, 8082, New Zealand, Phone: +64 3 3288 688, Email: hnz@healthnz.
POS4-144
A NOVEL HEATED TOBACCO CIGARETTE SYSTEM: RESULTS OF
PRELIMINARY CHEMICAL TESTING AND ANALYSIS
Vikram Kumar1, Jay Kumar1, Joseph McClernon*2, and Thangaraju Murugesan2,
1Siva Scientific, Inc., Yorba Linda, CA; 2NeuroAnalytics, LLC, Durham, NC
Aims: We report on the chemical testing and analysis of a prototype of a novel
heated tobacco cigarette system (HTCS). The HTCS works by heating tobacco at
temperatures below the point at which pyrolysis occurs, thereby producing a vapor
potentially devoid of many of the constituents found in the smoke of conventional
cigarettes (CCs). Methods: Evaluation of a number of the physical (e.g., particle
size) and chemical (e.g. nicotine content) characteristics of a novel HTCS was
made using a standard puffing regimen and chemical analysis techniques. The
HTCS was tested by heating tobacco rods from four commercially available
cigarettes, and comparing to values obtained by conventionally burning those
same cigarettes. Results: Assessment of heating element and surrounding tobacco
temperatures indicated stable attainment of temperatures of approximately 400
?C and 200 ?C in the heating element and tobacco respectively. The heating
of four different commercial cigarettes with the HTCS resulted in mean nicotine
levels in a range between 18.77 and 42.8 μg/puff (conventional burning = 131.73
to 342.88 μg/puff). The results of gas chromatography with nitrogen phosphorous
detection (GC-NPD) revealed substantial reduction in total ion chromatography
peaks for the HTCS versus CC. Finally, the mass median aerodynamic diameter
(MMAD) of vaporized particulate matter from the HTCS was calculated as 0.55μM.
Conclusion: The results of this initial assessment of a novel heated tobacco
cigarette system indicate delivery of an aerosol achieving significant levels of
nicotine at particle sizes similar to CC, but substantially reduced levels of nonnicotine
constituents as indicated by GC. Future in vivo and in vitro is warranted to
assess the biological activity of this novel HTCS and its potential to reduce harm
from smoking in humans.
This research was funded by Siva Scientific, Inc.
CORRESPONDING AUTHOR: Francis McClernon, 26 Oak Drive, Durham, NC
27707, United States, Phone: 919-260-0586, Email: joe.mcclernon@gmail.com
http://www.srnt.org/conferences/SRNT_2013_Abstracts_H.pdf
At least nine abstracts (below) are about e-cigarettes, with most finding health benefits, and none finding health hazards.
E-CIGARETTES TOPIC:
POS2-133
CONSUMER PERCEPTIONS OF ELECTRONIC NICOTINE DELIVERY
devices AS SMOKING CESSATION AIDS
Blair N. Coleman, M.P.H.*, Eva Sharma, M.P.H., Magdalena Ignaczak, B.S., and
Pamela I. Clark, Ph.D., University of Maryland-College Park
Background: Electronic nicotine delivery devices (ENDS; or e-cigarettes)
have surged in popularity in recent years, however further research is needed
to determine consumer perceptions of their acceptability as smoking cessation
aids. The aim of this pilot study was to explore smokers perceptions of the
effectiveness of using ENDS during a 2-week cessation attempt. Methods: After
a laboratory-based study that had the advantage of familiarizing participants with
use of the ENDS, smokers motivated to quit were provided with an e-cigarette and
a 2-week supply of cartridges in the style (menthol or non-menthol) of their choice.
They received two in-person behavioral counseling sessions and two telephone
counseling sessions. At the end of the two-week quit attempt, in-depth qualitative
interviews were conducted to assess the subjects perceptions of the effectiveness
of using ENDS as a cessation tool. Sessions were audio-recorded and the data
transcribed and analyzed using a thematic approach. Results: Themes that
emerged included lower perceptions of nicotine content compared to own brand
cigarettes, a higher sense of control with regards to nicotine self-administration
compared to other cessation mechanisms (e.g., nicotine gum, patch), and an
ease of transition to the e-cigarette to assist with a quit attempt. Additionally,
similarities between own brand of cigarettes and e-cigarettes generally included
similar smoking patterns (in terms of duration and time of day), but participants
found greater resistance to draw with the e-cigarette compared to conventional
cigarettes, and reported that they often failed to provide the level of satisfaction
produced by conventional cigarette. Lastly, participants noted that the e-cigarette
drew attention from by-standers who were interested in knowing more about the
product, and some were uncomfortable with the attention the product elicited,
opting to use the e-cigarette in private locations only. Conclusions: Understanding
the consumer acceptability of using ENDS has important implications as to how
these products could be used as smoking cessation devices and how they could
potentially be prescribed to help smokers quit.
Supported by NIH/NIDA Grant #5R21DA030622.
CORRESPONDING AUTHOR: Blair N. Coleman, MPH, University of Maryland,
Behavioral and Community Health, 2387 SPH Building, Valley Drive, College Park,
MD 20742, United States, Phone: 3014058740, Email: bcolema2@umd.edu
POS2-134
USE OF ELECTRONIC CIGARETTES AMONG ADULTS ENROLLED IN A
GROUP RANDOMIZED SMOKING CESSATION TRIAL IN APPALACHIAN
OHIO
Amy M. Wermert, M.P.H.*, Nancy E. Hood, Ph.D., Sherry T. Liu, M.P.H., and Mary
Ellen Wewers, Ph.D., The Ohio State University, College of Public Health
Electronic cigarette (ecig) use is growing in popularity. Little is known about the
use of ecigs among adult smokers in Appalachian Ohio. The purpose of this study
was to describe the use of ecigs among participants living in Appalachian Ohio
enrolled in a group randomized cessation trial (n=467 participants) that included
behavioral counseling and free nicotine replacement therapy (NRT) (i.e., 21 mg
patch) over a 10 week protocol. Study eligibility criteria included: resident of a
participating Appalachian county, 18 years or older, self-reported daily cigarette
use, willing to quit in the next 30 days, no medical contraindication to NRT use,
and if female, not pregnant. Data collection started in November 2010; items to
assess ecig use were added to the existing survey in April 2012. As a result, ecig
use was not collected for all participants. This abstract reports on a subset of the
sample (n=252 participants) and includes data collected at baseline, 3, 6, or 12
months post-intervention. Of the subset of participants, 10% reported currently
using an ecig every day or some days. Most ecig users were between 25-54 years
old (54%), female (65%) and had more than a HS/GED education (50%). Most
were not employed (69%) but had health care coverage (77%). Most ecig users
were living at 200% below poverty (77%). For those interviewed post-intervention,
5.9% (n=15 participants) reported use of ecigs, primarily to assist in efforts to quit
smoking. Most were using ecigs with nicotine (67%) and most believed that ecigs
are less harmful than regular cigarettes (87%). The primary reasons given for ecig
use included: they make it easier for you to cut down on the number of cigarettes
you smoke (53%), they might help you quit (47%). These findings support
previous studies that demonstrate ecigs being used as a smoking cessation
aid. Limitations of this study include a small sample size and a homogenous
study population (i.e., those trying to quit, living in Appalachia, Ohio). This study
emphasizes the importance of continued research into the efficacy and safety of
the use of ecigs as a long-term smoking cessation aid.
This study was conducted while the first author was at The Ohio State University.
Supported by NIH grant # R01 CA129771.
CORRESPONDING AUTHOR: Amy Wermert, MPH, Program Manager, The Ohio
State University, College of Public Health, Health Behavior Health Promotion,
359-4 Cunz Hall, Columbus, OH 43210, United States, Phone: 614-292-8193,
Email: awermert@cph.osu.edu
POS2-135
SMOKERS WHO TRY E-CIGARETTES TO QUIT SMOKING: ARE THEY
SERIOUS ABOUT QUITTING?
Pallav Pokhrel, Ph.D., M.P.H.*, COPYRIGHTDMCA Fagan, Ph.D., M.P.H., Melissa Little,
Ph.D., Crissy Terawaki Kawamoto, B.S., and Thaddeus A. Herzog, Ph.D., Cancer
Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI
Electronic cigarettes or e-cigarettes are commonly marketed as smoking
cessation aids and their popularity appears to be on the rise. But little is known
about the characteristics of smokers who use e-cigarettes to quit smoking,
including their motivation to quit, quitting self-efficacy, and experience with Food
and Drug Administration (FDA) approved cessation aids. In this study, we tested
the associations between smokers ever use e-cigarettes for cessation and their
demographic characteristics (e.g., gender, ethnicity), motivation to quit, and
other smoking- and cessation-related characteristics. Cross-sectional data were
obtained from 1567 adult daily smokers in Hawaii using paper-and-pencil survey
in 2010-2012, as part of a smoking cessation study. Participants represented 50%
women, 21% Asian, 31% Native Hawaiian, 34% White, and 14% Other ethnicity.
e-Cigarette use was significantly associated with age (OR= 0.98, 95% CI [0.97,
0.99]), Native Hawaiian ethnicity (OR= 0.68, 95% CI [0.45, 0.99]), motivation to
quit (OR= 1.14, 95% CI [1.08, 1.21]), quitting self-efficacy (OR= 1.18, 95% CI
[1.06, 1.36]), and the use of conventional cessation products or medications such
as nicotine replacement gum (OR= 3.72, 95% CI [2.67, 5.19]) and Bupropion
(OR=2.29, 95% CI [1.38, 3.79]). Our data suggests that smokers who use
e-cigarettes appear to be serious about wanting to quit. Research is needed to
clarify the effectiveness of e-cigarette use in smoking cessation. Clinicians and
public health practitioners need to be prepared to clearly communicate the risks
and benefits of e-cigarette use to smokers who are highly motivated to quit.
This study was supported by an R01 grant (# CA2079905) from the National
Cancer Institute to T.A. Herzog.
CORRESPONDING AUTHOR: Pallav Pokhrel, Ph.D., M.P.H., Assistant Professor,
University of Hawaii Cancer Center, Cancer Prevention & Control, 677 Ala Moana
Blvd., Suite 200, Honolulu, HI 96813, United States, Phone: 8084417711, Email:
ppokhrel@cc.hawaii.edu
POS2-136
YOUNG ADULTS EXPOSURE TO PRO-SNUS AND PRO-ELECTRONIC
CIGARETTE MESSAGES AND USE OF THESE PRODUCTS
Kelvin Choi, M.P.H., Ph.D.*, and Jean L. Forster, Ph.D., M.P.H., University of
Minnesota
Objective: Young adults are experimenting with new tobacco products like
snus and electronic cigarettes (e-cigarettes), and exposure to pro-snus and
pro-e-cigarette messages may contribute to this phenomenon. We conducted
the first analysis to examine young adults exposure to these messages and its
associations with trying these products. Methods: Young adults (ages 20-25)
from the U.S. upper Midwest region were surveyed in 2009 and again in 2011
(n=2339). In 2011, participants were asked if they have received advertisements
and coupons for non-cigarette products in the mail, have seen Facebook pages/
groups and advertisements for snus and e-cigarettes, and have seen kiosks in
shopping malls promoting e-cigarettes. Ever use of these products was assessed
in 2011. Baseline tobacco use behaviors were assessed in 2009 (before these
products were available nationwide). Using multivariate logistic regression
models, we assessed characteristics associated with exposure to different types
of pro-snus and pro-e-cigarette messages in 2011, and the associations between
message exposure and ever use of these products in 2011. Results: Regarding
snus, 8% and 7% of the participants had received advertisements and coupons
for non-tobacco products in the mail, respectively; <1% had seen snus Facebook
pages/groups. Regarding e-cigarettes, 14% of the participants had seen kiosk
at shopping malls promoting e-cigarettes; 7% and 1% had seen e-cigarettes
advertisements and pages/groups on Facebook, respectively. Male, less educated
participants, those who had friends who smoke, tobacco users were more likely
to have received advertisements and coupons for non-cigarette products in the
mail (p<.05). For every additional type of exposure to pro-snus and pro-e-cigarette
messages, there was a 79% and 96% higher odds that participants had used
snus and e-cigarettes, respectively, adjusted for demographics, peer smoking and
tobacco use behaviors (p<.05). Conclusions: Exposure to pro-snus and pro-ecigarette
messages were associated with experimenting with these products in our
sample. Longitudinal studies are needed to confirm our findings.
This research was funded by the National Cancer Institute (R01 CA86191; J.
Forster - PI).
CORRESPONDING AUTHOR: Kelvin Choi, M.P.H., Ph.D., Research Associate,
University of Minnesota, Division of Epidemiology and Community Health, 1300
South Second Street, Minneapolis, MN 55454, United States, Phone: 612-626-
1799, Email: choix137@umn.edu
POS2-137
ELECTRONIC-CIGARETTES (E-CIGARETTES) IN GERMANY: A SMOKING
CESSATION TOOL?
Tobias Rüther, M.D., Ph.D.*, Franziska Wissen, Andrea Linhardt, M.D., Désirée
Aichert, Oliver Pogarell, M.D., Ph.D., and Hein de Vries, Ph.D.
Introduction: The use of an electronic-cigarette (e-cigarette) resulted in some
previous studies in reduction and cessation of conventional cigarette smoking.
Therefore, this study aims to examine the reasons of using e-cigarettes instead of
and in addition to conventional cigarettes in Germany. Furthermore it is determined
to what extent e-cigarettes are used as a smoking cessation tool. Method: A
cross-sectional study was conducted in April � May 2012 in Munich, Germany. The
I-Change Model was used as theoretical framework and existing questionnaires
were used to build up the present questionnaire. 320 Smokers participated
in the study, divided in three groups: E-cigarette smokers (e-smokers) (33%),
conventional cigarette smokers (c-smokers) (37%) and smokers of both cigarettes
(b-smokers) (30%). Pearson Chi Square tests and analyses of variance were used
to assess differences among the group of smokers on demographic variables,
smoking behaviour and the constructs of the I-Change Model. Results: About half
of the e-cigarette users used the e-cigarette in addition to c. cigarettes and the
other half instead of c. cigarettes. It seemed that e-smokers and b-smokers had
the same reasons for using e-cigarettes overall. E-cigarette users were most often
men, were less addicted to nicotine and had a higher motivation to stop smoking
than c-smokers. In addition, e-smokers reported a more positive health and had
a lower carbon monoxide concentration compared to c-smokers. Furthermore,
e-smokers had a more positive attitude towards e-cigarettes, a higher self-efficacy
in terms of being abstinent from c. cigarettes in certain situations and a higher
self-efficacy of using an e-cigarette instead of c. cigarettes. E-cigarettes were used
more frequently if the social environment of a person vaporized as well or preferred
the respondent to vaporize e-cigarettes instead of c. cigarettes. Discussion: The
results confirmed most of the hypotheses and also important results of previous
studies. In addition, a well-conducted randomized-control trial is needed to confirm
the efficacy of e-cigarettes as a smoking cessation aid.
No funding.
CORRESPONDING AUTHOR: Tobias Rüther, MD PhD, Physician, University
of Munich Department of Psychiatry, Tobacco Dependence Outpatient Clinic,
Nussbaumstr.7, Munich, 80336, Germany, Phone: +49-89-5160-5707, Email:
tobias.ruether@med.uni-muenchen.de
POS2-138
AWARENESS AND USE OF ELECTRONIC CIGARETTES AMONG COLLEGE
STUDENTS IN NEW YORK STATE
Jill Murphy*1, Sarah Beshers1, Brian Fix2, and Martin Mahoney2, 1State University
of New York at Cortland, Cortland, NY; 2Roswell Park Cancer Institute, Buffalo, NY
Electronic cigarettes (e-cigarettes) have been available in the United States
for about five years. Recent studies have found that awareness and ever use
of e-cigarettes among adults is increasing. To our knowledge, to date there are
no published reports of e-cigarette awareness and use among college students
in the United States. Some tobacco control advocates express concerns with
e-cigarettes, including that e-cigarettes could be used as a starter product for
younger or never smokers or they could delay cessation and result in a pattern
of dual use of tobacco products. The objective of this study was to assess
college students awareness, use, and perceptions of e-cigarettes. In October
and November of 2011, we conducted a cross-sectional survey among 1,187
undergraduate students attending two public universities in New York State.
Participants completed an online survey that included questions on demographics,
cigarette smoking behavior, smokeless tobacco use, awareness and use of
e-cigarettes, beliefs about the harmfulness of e-cigarettes, and interest in using
an e-cigarette. The prevalence of current cigarette smoking was 10.5%, and the
prevalence of smokeless tobacco use (including chewing tobacco, snuff, or snus)
was 2.7%. Current cigarette smokers were more likely than non-smokers to have
heard of e-cigarettes (86% vs. 71%, p<0.01), ever try an e-cigarette (47% vs.
5%, p<0.01), and use an e-cigarette in the past month (4% vs. 0.1%, p<0.01),
respectively. Only one participant reporting daily use of the e-cigarette. The vast
majority (97%) of college students perceived that e-cigarettes were either less
harmful or no different in terms of harm when compared to regular cigarettes.
Among participants who had not tried an e-cigarette, cigarette smokers were more
likely than non-smokers to report they would be interested in trying an electronic
cigarette (39% vs. 5%, p < 0.01). We found the majority of college students were
aware of e-cigarettes. While ever use of e-cigarettes was much more common
in current cigarette smokers than non-smokers, past month use was much less
common in the sample overall, and daily use was rare.
No funding.
CORRESPONDING AUTHOR: Jill Murphy, PhD, Associate Professor, SUNY
Cortland, Health, PO Box 2000 Graham Ave, Cortland, NY 13045, United States,
Phone: 6077535613, Email: murphyj@cortland.edu
POS2-139
A PROSPECTIVE RANDOMIZED CONTROL DESIGN STUDY TO EVALUATE
LONG TERM SAFETY, ABSTINENCE, AND REDUCTION RATES IN
SMOKERS NOT WILLING TO QUIT: THE ECLAT STUDY
Pasquale Caponnetto, Ph.D.1,2, Davide Campagna, M.D.1,2, Fabio Cibella, Ph.D.3,
Jaymin B. Morjaria, M.D.4, Cristina Russo, M.D.1,2, and Riccardo Polosa, M.D.,
Ph.D.*1,2, 1Centro per la Prevenzione e Cura del Tabagismo, Azienda Ospedaliero-
Universitaria Policlinico-V. Emanuele, Università di Catania, Catania, Italy;
2Institute of Internal Medicine, S. Marta Hospital, Azienda Ospedaliero-Universitaria
Policlinico-V. Emanuele, Università di Catania, Catania, Italy; 3Istituto di
Biomedicina e Immunologia Molecolare del Consiglio Nazionale delle Ricerche,
Palermo, Italy; 4IIR Division, School of Medicine, University of Southampton,
Southampton General Hospital, Southampton, UK
E-cigarettes are becoming increasingly popular with smokers worldwide.
Carefully conducted research on e-cigarettes is urgently needed in order to ensure
that the decisions of regulators, healthcare providers and consumers are based
on science. We designed a prospective 12-month double-blind, randomized,
controlled trial to evaluate smoking reduction, smoking abstinence and adverse
events in 300 smokers not intending to quit experimenting 2 different nicotine
strengths of a very popular brand compared to the non nicotine alternative from
the same brand. Study Group A (n =100) used 7.2 mg nicotine cartridges, Group
B (n =100) used 5.4 mg nicotine cartridges and Group C (n =100) was given
no-nicotine cartridges. Study participants were invited to attend a total of 9 study
visits during which number of cigarettes smoked, and eCO levels were measured.
Smoking reduction and abstinence rates were calculated. Adverse events and
product preferences were also reviewed. Lastly, classic and novel static and
dynamic factors predicting abstinence and reduction rates will be investigated.
A significant reduction (p<0.001) cig/day use and eCO levels from baseline was
observed at each study visits in all 3 study groups. By and large, no difference
between study groups was observed in terms of changes in cig/day use and in
eCO levels. A mean of 2.0 cartridges/day was used in each study group up to the
3-month time point, but falling thereafter. Smoking reduction was shown in 21%
and 9% participants in group A, in 16% and 8% in group B and in 19% and 10% in
group C, at 3- and 12-months respectively. Smoking abstinence was observed in
11 % and 13% participants in group A, in 17% and 9% in group B and in 4% and
4% in group C, at 3- and 12-months respectively. Only minor and transient adverse
were reported, including mouth and throat irritation, and dry cough. They seem
to attenuate over time. By and large, participants perception and acceptance of
the product was positive. In smokers not intending to quit, the use of e-Cigarette
decreased cigarette consumption and elicited enduring tobacco abstinence at 1-yr
without causing significant side effects.
No funding.
CORRESPONDING AUTHOR: Pasquale Caponnetto, University of Catania, c/o
Policlinico Vittorio Emanuele, Catania, 95123, Italy, Phone: 0039 7436413, Email:
p.caponnetto@unict.it
POS4-70
SMOKERS RATING OF ELECTRONIC CIGARETTES: WOULD MORE
SMOKERS QUIT IF ELECTRONIC CIGARETTES WERE ON SALE?
Randolph C. Grace, Ph.D.1, Aimee Richardson, B.Sc.(Hons)1, Donna Ritchie,
B.A.1, Murray Laugesen, FNZCPHM*2, Bronwyn Kivell, Ph.D.3, and Nathan
Cowie, M.P.H.4, 1University of Canterbury NZ; 2Health New Zealand Ltd; 3Victoria
University of Wellington; 4University of Auckland
BACKGROUND: Nicotine electronic cigarettes (NECs) were illegal to sell
or advertise in New Zealand during 2012, where 17% of adults smoke tobacco
cigarettes daily. METHODS: Smokers age 18 and over who purchased their own
cigarettes were recruited on worksites and by newspaper publicity; 343 were
interviewed face to face in four cities and rewarded with a voucher for $15 (NZ$; 1
NZ$ = 0.85 USD) and a chance to win an electronic tablet. Participants completed
the Cigarette Purchase Task (CPT; MacKillop et al., 2008) in which they reported
how many cigarettes per day they would smoke at various price points. Then they
sampled an NEC and rated preference for it against their own brand on a 10-point
scale. The NEC used was SafeCig 18mg (SafeCig LLC. Los Angeles), notionally
priced at $5 per day. RESULTS: Participants smoked a mean 14.9 cigarettes per
day (cpd) and spent $8.72 daily on cigarettes, 33% paying $0.38 per roll-your-own
(RYO) tobacco cigarette, 67% paying $0.72 per factory-made (FM) cigarette. After
3 puffs from the NEC, smokers liked it 83% as much as their own brand: average
preference ratings for NEC and own brand were 6.26 and 7.51, respectively. If
cigarettes cost $0.70 each, smokers estimated they would smoke 14.5 cpd, but
only 7.08 cpd if they could buy NECs (t[312] = 15.39, p < .001). Using NECs,
31.6% said they would quit smoking their own brand completely. If cigarette price
doubled to $1.40, 59.5% of smokers estimated they would quit, and a further
11.1% would quit by using NECs if NECs were on sale. Those continuing to smoke
at this price would smoke 10.63 cpd; but if NECs were on sale, would smoke 6.34
cpd (t[125] = 4.29, p < .001). CONCLUSIONS: If cigarettes cost $0.70 each (20%
above the mean 2012 price), and NECs cost 36% of this ($5 a day), three in ten
smokers would use NECs to switch off tobacco smoking entirely. If the price of
cigarettes doubled, price would be the main motivator of quitting, but even more
intended to quit if NECs were on sale. Most smokers liked the NEC and given its
price advantage, especially as tobacco excise increases, many would switch to
NECs and stop smoking tobacco, if NECs were available.
Funding: End Smoking NZ from Canterbury Community Trust; Univ. of
Canterbury, Tobacco Control Research Turanga Fund, University of Auckland.
CORRESPONDING AUTHOR: Murray Laugesen, FNZCPHM, Public Health
Medicine Specialist, Health New Zealand Ltd, 36 Winchester St Lyttelton,
Christchurch, 8082, New Zealand, Phone: +64 3 3288 688, Email: hnz@healthnz.
POS4-144
A NOVEL HEATED TOBACCO CIGARETTE SYSTEM: RESULTS OF
PRELIMINARY CHEMICAL TESTING AND ANALYSIS
Vikram Kumar1, Jay Kumar1, Joseph McClernon*2, and Thangaraju Murugesan2,
1Siva Scientific, Inc., Yorba Linda, CA; 2NeuroAnalytics, LLC, Durham, NC
Aims: We report on the chemical testing and analysis of a prototype of a novel
heated tobacco cigarette system (HTCS). The HTCS works by heating tobacco at
temperatures below the point at which pyrolysis occurs, thereby producing a vapor
potentially devoid of many of the constituents found in the smoke of conventional
cigarettes (CCs). Methods: Evaluation of a number of the physical (e.g., particle
size) and chemical (e.g. nicotine content) characteristics of a novel HTCS was
made using a standard puffing regimen and chemical analysis techniques. The
HTCS was tested by heating tobacco rods from four commercially available
cigarettes, and comparing to values obtained by conventionally burning those
same cigarettes. Results: Assessment of heating element and surrounding tobacco
temperatures indicated stable attainment of temperatures of approximately 400
?C and 200 ?C in the heating element and tobacco respectively. The heating
of four different commercial cigarettes with the HTCS resulted in mean nicotine
levels in a range between 18.77 and 42.8 μg/puff (conventional burning = 131.73
to 342.88 μg/puff). The results of gas chromatography with nitrogen phosphorous
detection (GC-NPD) revealed substantial reduction in total ion chromatography
peaks for the HTCS versus CC. Finally, the mass median aerodynamic diameter
(MMAD) of vaporized particulate matter from the HTCS was calculated as 0.55μM.
Conclusion: The results of this initial assessment of a novel heated tobacco
cigarette system indicate delivery of an aerosol achieving significant levels of
nicotine at particle sizes similar to CC, but substantially reduced levels of nonnicotine
constituents as indicated by GC. Future in vivo and in vitro is warranted to
assess the biological activity of this novel HTCS and its potential to reduce harm
from smoking in humans.
This research was funded by Siva Scientific, Inc.
CORRESPONDING AUTHOR: Francis McClernon, 26 Oak Drive, Durham, NC
27707, United States, Phone: 919-260-0586, Email: joe.mcclernon@gmail.com
