A randomized controlled trial of smoking cessation treatment for young adult dual users of combustible and electronic cigarettes

每年有超过48万人死于与可燃香烟(CC)吸烟有关的疾病 美国。年轻人特别容易受到尼古丁依赖和烟草危害的影响。 电子烟(EC)的普及率在过去十年中呈指数级增长， 在年轻人中最高。ECS可以大大减少对年轻成年吸烟者的伤害 完全从容器服务切换到ECS，并保持戒除容器服务。然而，大多数使用ECS的人 继续吸食CCS(即双重吸毒者)，这可能会使尼古丁依赖持续存在，并从 密歇根吸烟。目前还没有针对双重使用者的经验性治疗方法，目前还不清楚戒烟是否 只使用CCS或同时退出CCS和ECS会更有效地实现长期 戒除CCS。尼古丁替代疗法(NRT)是一种有效的一线戒烟方法。 对成年CC吸烟者的治疗，但从未在年轻人或双重使用者中进行过测试。 鉴于强有力的证据表明，在生命早期戒烟可以完全避免与烟草有关的 为了降低死亡率，有必要测试年轻成人双重吸烟者的有效戒烟治疗。 建议的2x2阶乘RCT的总体目标是测试具有文本消息支持的NRT 两种戒烟方法在年轻成人CCS和ECS双重使用者中的应用。具体来说，我们 目的：1)测试NRT在青壮年双重吸毒者中停用CC的有效性；2)测试 是只退出CCS还是同时退出CCS和ECS更有效地实现CC 禁欲。参与者(n=390)将随机接受A)NRT加退出CCS的短信 仅B)NRT+文本消息同时退出CCS和ECS，C)仅文本消息退出 仅限CCS，或D)仅限短信同时退出CCS和ECS。我们的主要结果将是 共同验证治疗结束时(即治疗3个月后)的7天点戒毒盛行率 随机化)。 我们主要目标的发现将直接指导年轻人的戒烟治疗 吸烟者，这一群体特别容易受到尼古丁成瘾的有害影响。这是 重要的是，鉴于目前缺乏关于双重吸烟者戒烟治疗的已发表研究 年轻人的NRT。作为次要目标，我们将探索NRT使用与NO之间的相互作用 仅使用和戒除CCS与CCS和ECS同时使用和戒烟以及尼古丁的变化 未能戒烟的参与者的依赖、需求和其他与吸烟相关的结果。 总的来说，研究结果将对治疗年轻成人双重使用者和科学具有应用意义 戒除一种(CCS)尼古丁产品与两种(CCS和ECS)尼古丁产品的影响 同时。

Over 480,000 people die per year from combustible cigarette (CC) smoking related illness in the United States. Young adults are particularly vulnerable to nicotine dependence and harm from tobacco. The prevalence of electronic cigarette (EC) use has increased exponentially over the past decade and is highest among young adults. ECs could substantially reduce harm for young adult smokers who completely switch from CCs to ECs and remain abstinent from CCs. However, most who use ECs continue to smoke CCs (i.e., dual users), which could perpetuate nicotine dependence and harm from CC smoking. There are no empirically based treatments for dual users and it is unclear whether quitting CCs only or quitting both CCs and ECs simultaneously is more effective to achieve long-term abstinence from CCs. Nicotine replacement therapy (NRT) is an effective first-line smoking cessation treatment for adult CC smokers but has never been tested among young adults or among dual users. Given the strong evidence that smoking cessation early in life can completely avoid tobacco-related mortality, there is a need to test effective smoking cessation treatment for young adult dual users. The overarching aim of the proposed 2x2 factorial RCT is to test NRT with text message support for two smoking cessation approaches among young adult dual users of CCs and ECs. Specifically, we aim to 1) test the effectiveness of NRT for CC cessation among young adult dual users and 2) test whether quitting CCs only versus quitting CCs and ECs simultaneously is more effective to achieve CC abstinence. Participants (n=390) will be randomized to receive A) NRT plus text messages to quit CCs only, B) NRT plus text messages to quit CCs and ECs simultaneously, C) text messages alone to quit CCs only, or D) text messages alone to quit CCs and ECs simultaneously. Our primary outcome will be CO-verified 7-day point-prevalence abstinence at the end of treatment (i.e., 3 months after randomization). Findings from our primary aims will directly inform smoking cessation treatment for young adult dual users, a population that is particularly vulnerable to the harmful effects of nicotine addiction. This is important given the current lack of published research on smoking cessation treatment for dual users or NRT for young adults. As secondary aims, we will explore the interaction between NRT use versus no use and quitting CCs only versus CCs and ECs simultaneously as well as change in nicotine dependence, demand, and other smoking related outcomes among participants who fail to quit. Broadly, findings will have applied implications for treating young adult dual users and scientific implications regarding the effects of quitting one (CCs) versus two (CCs and ECs) nicotine products simultaneously.