Vaporized Nicotine Products for Reducing Cigarette Smoking in Drug Treatment

Smoking vs Vaping. Vape Trend E-cigarette or Tobacco Cigarette. Vector illustration
Daily smokers who were interested in quitting tobacco use were recruited between 2018 and 2019 from alcohol and other drug treatment programs in New South Wales, Australia.

Using vaporized nicotine products (VNPs) may be a strategy to stop smoking. In a randomized controlled trial, both individuals assigned to gradually and abruptly quit smoking reported satisfaction with VNPs. These findings were published in Addictive Behaviors.

Daily smokers (N=56) who were interested in quitting were recruited between 2018 and 2019 from alcohol and other drug treatment programs in New South Wales, Australia. Participants were randomized in a 1:1 ratio to receive gradual (reduce cigarette use by 25% each week for 4 weeks) or abrupt (only use VNP) cessation.

At baseline, each participant received information about their quitting strategy, learned how to use the VNP device, received the device, and 2 weeks of 12 mg/10 ml nicotine liquid with a prescription for ~3 ml of nicotine liquid per day. Participants were also given 7 21 mg/day nicotine patches to reduce cravings and withdrawal during the first week. Progress was monitored via telephone calls at weeks 1, 3, 5, 7, and 10 and follow-up qualitative interviews at weeks 6 and 12.

The participants were aged mean 42.3 (SD, 8) years, 73.1% were men, they smoked 22 (SD, 14.2) cigarettes per day, 57.6% preferred to gradually reduce their cigarette intake, and 83.6% had a previous quit attempt.

At 12 weeks, 96% and 100% agreed that the VNP was effective at reducing cigarette cravings, 96% and 92% thought the VNP was easy to use, and 100% and 100% thought the VNP was enjoyable to use among the gradual and abrupt cohorts, respectively. Less than a third of participants in either group had concerns about side effects or safety.

Both groups reported high perceived usefulness (median, 9-10) and satisfaction (median 8-9) with the VNP device on a 10-point scale, and no significant differences in these measures were reported.

Throughout the study period >95% of study participants reported using the VNP.

At 12 weeks, 6-week continued abstinence from smoking was reported by 29.6% of the gradual and 39.1% of the abrupt quitting cohorts (odds ratio [OR], 1.53; 95% CI, 0.47-4.95; P =.481).

Among participants who continued to smoke (n=34), the number of cigarettes per day decreased to 8.6. The number of daily cigarettes smoked was significantly reduced among both the gradual (incidence rate ratio [IRR], 0.38; 95% CI, 0.20-0.73; P =.003) and abrupt (IRR, 0.27; 95% CI, 0.16-0.44; P <.001) cohorts.

This study was limited by not evaluating why some participants were not successful in their quitting attempt.

The study authors concluded, “Taken together, this study contributes to the emerging literature by providing the first study to assess the potential of VNPs in combination with a quit smoking strategy in the alcohol and other drug treatment setting. This study found that offering VNPs for smoking cessation was feasible and acceptable to tobacco smokers in alcohol and other drug treatment.”


Skelton E, Lum A, Robinson M, et al. A pilot randomised controlled trial of abrupt versus gradual smoking cessation in combination with vaporised nicotine products for people receiving alcohol and other drug treatment. Addict Behav. 2022;131:107328. doi:10.1016/j.addbeh.2022.107328

This article originally appeared on Psychiatry Advisor