A Preliminary Examination of Nicotine-Free Electronic Cigarette Use During Cessation From Combustible Cigarettes

Despite the availability of smoking cessation strategies, smoking cue-induced craving remains a relatively untreated relapse risk factor. Utilizing nicotine-free electronic cigarettes (e-cigarettes) to extinguish the motivational influence of smoking cues may be a viable approach to address cue reactivity. In this pilot study, 26 daily tobacco smokers used nicotine-free e-cigarettes while being maintained on daily transdermal sustained-release nicotine replacement therapy (NRT) to mitigate pharmacological withdrawal. Sensitivity to cue-induced craving, measured by the rise in craving after a visual cue exposure task, was assessed at a baseline visit after smoking as usual and again after 2 weeks of nicotine-free e-cigarette and NRT use. Participants' pattern and amount of tobacco cigarette smoking were evaluated on both visits and 1 month posttreatment. Cue-induced craving significantly decreased after the 2-week intervention, yet withdrawal scores increased during this time. One month after study completion, participants continued to report significantly lower overall cigarette craving and conventional tobacco cigarette use. Including the 34.8% that were totally abstinent, 65.2% reported smoking fewer than 10 cigarettes per week (compared to 87.2 per week at baseline for the entire group). A linear regression revealed that greater baseline cue-induced craving predicted better outcomes, whereas more withdrawal at the e-cigarette visit was related to more smoking at 1 month. This proof-of-concept pilot study suggests that the addition of ad libitum nicotine-free e-cigarettes to an existing strategy of transdermal NRT may attenuate cue-induced craving for tobacco smoking. A larger sample that is powered for detecting additional factors and longer-term outcomes is warranted

Abstinence · Addiction · Craving · Cue reactivity · Electronic cigarette · Nicotine · Nicotine replacement therapy · Nicotine withdrawal · Psychiatry · Smoking cessation · Medicine · Nicotinic Acetylcholine Receptors Study · Olfactory and Sensory Function Studies · Smoking Behavior and Cessation

• Electronic cigarettes for smoking cessation

  Chris Bullen, Christopher Bullen et al.•The Lancet•2013

  Add to list

• Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment

  Open Access•KARL‐OLOV FAGERSTROM, Karl-Olov Fagerström•Addictive Behaviors•1978

  Add to list

• Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings

  Lisa Sanderson Cox, Stephen T Tiffany et al.•Nicotine & Tobacco Research•2001

  Add to list