Vaporized nicotine products for smoking cessation among people experiencing social disadvantage- A randomized clinical trial

Courtney, Ryan J., Howard, Bridget C., Barker, Daniel, Petrie, Dennis, Borland, Ron, Shakeshaft, Anthony, Gartner, Coral, Mendelsohn, Colin, Boland, Veronica C., Henderson, Alexandra, Richmond, Robyn L., Tutka, Piotr, Naughton, Felix ORCID: https://orcid.org/0000-0001-9790-2796, Hall, Wayne, Zwar, Nicholas, Farrell, Michael, Mattick, Richard P. and McRobbie, Hayden (2025) Vaporized nicotine products for smoking cessation among people experiencing social disadvantage- A randomized clinical trial. Annals of Internal Medicine, 178 (8). pp. 1085-1094. ISSN 0003-4819

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Abstract

Background: Vaporized nicotine products (VNPs) are more effective than nicotine replacement therapy (NRT) for smoking cessation in general populations, but their effectiveness among low socioeconomic groups is largely unknown.   Objective: To examine whether VNPs are more effective than NRT for smoking cessation among people experiencing social disadvantage.  Design: Two-group, open-label, randomized trial with blinded outcome ascertainment. (Australian New Zealand Clinical Trials Registry ACTRN12621000076875).   Setting: Australia, between March 2021 and December 2022.   Participants: 1045 adults who smoked daily, were willing to quit smoking, and were receiving a government pension/allowance (proxy for social disadvantage).   Intervention: Participants were randomly assigned (1:1) to either a free 8-week supply of NRT or VNPs, and all participants received text-message support.   Measurements: The primary outcome was 6-month continuous smoking abstinence verified using a carbon monoxide breath test at 7-month follow-up. Analysis included randomly assigned participants in accordance with Russell Standard criteria and the intention-to-treat principle.   Results: Among 1045 randomly assigned participants, 866 (82.9%) completed final follow-up. The verified 6-month continuous abstinence rate was 9.6% (50 of 523) in the NRT group and 28.4% (148 of 522) in the VNP group (posterior risk difference estimate, 18.7% [95% credible interval, 14.1% to 23.3%]; >99% posterior probability that VNP is superior). Self-reported adverse events occurred less frequently in the VNP group (355 events among 237 participants) compared with the NRT group (442 events among 278 participants; incident rate ratio, 0.75 [95% CI, 0.65 to 0.88]; P < 0.001).   Limitations: Biochemical verification method tested short-term exposure to cigarette smoke.   Conclusion: Findings indicate that VNPs were more effective than NRT for smoking cessation in this population. Given the challenges for cessation among these socially disadvantaged populations, VNPs present a promising treatment option for this priority group.   Primary Funding Source: Australian National Health and Medical Research Council.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) Faculty of Medicine and Health Sciences > Research Groups > Behavioural and Implementation Science (former - to 2026) Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Medicine and Health Sciences > Research Centres > Public Health
Related URLs:	https://www.scopus.com/pages/publication... https://www.acpjournals.org/doi/10.7326/...
Depositing User:	LivePure Connector
Date Deposited:	29 Jul 2025 16:30
Last Modified:	23 Aug 2026 12:58
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99993
DOI:	10.7326/ANNALS-24-03531

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