June 2023 Sarah Pratt

Let's talk e-cigarettes

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Associate Sarah Pratt, Department of Psychiatry, Geisel School of Medicine, Dartmouth University, New Hampshire, USA. Associate Professor Jamie Hartmann-Boyce and Dr Nicola Lindson discuss the new evidence in e-cigarette research and interview Associate Professor Sarah Pratt from Dartmouth University. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and shares the evidence from the monthly searches. Sarah Pratt discusses her research and her study of e-cigarette provision to people with serious mental illness to support them transitioning away from combustible tobacco. This research is funded by the US National Institute on Drug Abuse. An abstract of this work was presented at the Society for Research into Nicotine and Tobacco, SRNT, meeting in 2023 and published in Nicotine & Tobacco Research last year. People with serious mental illness (SMI) have great difficulty quitting and sustaining abstinence, warranting novel harm reduction strategies, including switching to potentially reduced-harm nicotine products, such as e-cigarettes. Sarah Pratt and her team conducted the first-ever trial of e-cigarette provision with instructions on their safe use versus usual care in 240 chronic smokers with SMI. They tested whether substitution of e-cigarettes could reduce harm as measured by the cigarette metabolite and carcinogen NNAL (the nitrosamine (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol). The e-cigarette group had significantly lower NNAL at 4 weeks but the group difference was attenuated at 8 weeks. This study demonstrated rapid short-term harm reduction among chronic smokers with SMI assigned to receive e-cigarettes. The attenuation of this effect at 8 weeks suggests that smokers with SMI require more than e-cigarette provision alone to maintain reduced smoking. Sarah and her team conclude that development of a behavioural intervention in addition to e-cigarette provision seems warranted to prevent morbidity and early mortality in this high-risk group of smokers. For more information on the study see: Pratt SI, Ferron JC, Brunette MF, Santos M, Sargent J, Xie H. E-Cigarette Provision to Promote Switching in Cigarette Smokers with Serious Mental Illness-A Randomized Trial. Nicotine Tob Res. 2022 Aug 6;24(9):1405-1412. doi: 10.1093/ntr/ntac082. PMID: 35363874; PMCID: PMC9356685. SRNT 2023, abstract PPS22-5, RCT assessing the effect of e-cigarettes versus usual smoking on NNAL among chronic smokers with serious mental illness.