Effect of Pod e-Cigarettes vs Cigarettes on Carcinogen Exposure Among African American and Latinx Smokers

Key Points Question What is the effect of using nicotine salt pod system (NSPS) electronic cigarettes (e-cigarettes) for replacing cigarettes (ie, switching) on biomarkers of tobacco exposure and potential harm among cigarette smokers? Findings In this randomized clinical trial including 186 African American and Latinx adult smokers, those randomized to the e-cigarette condition maintained their cotinine levels and significantly reduced urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and carbon monoxide levels and respiratory symptoms compared with controls smoking as usual at week 6. Lung function and blood pressure remained unchanged. Meaning This randomized clinical trial found that switching to NSPS e-cigarettes among adult smokers did not increase nicotine exposure and led to short-term reduction in the major pulmonary carcinogen, NNAL, compared with continued smoking.