A pilot study to examine the acceptability and health effects of electronic cigarettes in HIV-positive smokers

Drug Alcohol Depend. 2020 Jan 1:206:107678. doi: 10.1016/j.drugalcdep.2019.107678. Epub 2019 Oct 28.

Abstract

Introduction: Some HIV-positive smokers report ambivalence about quitting. Switching to electronic cigarettes (ECs) may be a viable option to reduce the negative health effects for smokers who are unable or unwilling to quit smoking combustible cigarettes (CCs). This study examined the acceptability and health-related effects of ECs in HIV-positive smokers who were not seeking smoking cessation treatment.

Methods: HIV-positive smokers (N = 19) were enrolled and followed for 12 weeks. Cartridge-based ECs were provided at baseline, and E-liquid was provided weekly for 8 weeks. At baseline, weeks 1-8, and week 12, EC and CC use, cardiopulmonary function, respiratory symptoms, and carbon monoxide (CO) levels were measured.

Results: At week 8, cigarettes per day (CPD) were reduced by more than 80%, with reduction maintained at week 12 (p's < .001). Cigarette dependence scores were 40% lower at week 8 than at baseline (p < .001). Seven (36.8%) participants reported transitioning completely from CCs to ECs. Mean CO decreased significantly from BL to week 8 (p < .05) and remained significantly lower at week 12 (p < .001). Intention to quit increased significantly over time.

Conclusions: Switching from CCs to ECs in HIV-positive smokers who are not ready to quit smoking in the next 30 days appears to be feasible. Beneficial effects were seen, such as reduced CPD, reduced CO and CC dependence, and increased motivation to quit. ECs may be promising as a harm reduction approach among HIV-positive smokers who are unable or unwilling to quit smoking.

Keywords: HIV; electronic cigarettes; harm reduction; smoking.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Carbon Monoxide / metabolism
  • Cigarette Smoking / epidemiology
  • Cigarette Smoking / prevention & control
  • Cigarette Smoking / psychology*
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Female
  • HIV Infections / psychology*
  • Harm Reduction
  • Humans
  • Male
  • Middle Aged
  • Motivation*
  • Patient Acceptance of Health Care / psychology
  • Pilot Projects
  • Rhode Island / epidemiology
  • Tobacco Use Disorder / epidemiology*

Substances

  • Carbon Monoxide