Evaluating Use Patterns of a Closed Electronic Nicotine Delivery System Among Adults in the United States Who Smoke Cigarettes Daily: 8-Week Actual Use Study
Bibliographic record
Abstract
Background: Adults who smoke cigarettes may reduce their exposure to cigarette smoke by switching completely or partially to an electronic nicotine delivery system (ENDS). Objective: This study investigated the use of a novel ENDS over 8 weeks, under near real-world conditions, among adults who smoke cigarettes daily and are living in the United States. The objectives were to assess the proportion of participants who switched completely to the novel ENDS and changes in cigarette consumption. Methods: This actual use study assessed the use of the novel ENDS among exclusive cigarette smokers (n=353) and dual users of cigarettes and ENDS (n=367). Participants were required to be aged 21 to 64 years old, had smoked 100+ cigarettes in their lifetime, smoked cigarettes daily at the time of enrollment, and reported positive intention to try, use, and buy the study product (SP). Participants were recruited from consumer databases. During the baseline period, participants self-reported their daily use of cigarettes and ENDS using an electronic diary. During the observational period, self-reporting also included daily use of SP. The SP was available in 2 variants (tobacco and menthol) at one nicotine concentration (3.5%; 39 mg/mL nicotine). Participants obtained 10 cartridges at the beginning of the observational period and could select either SP variant or both and were allowed to obtain additional SP. SP use patterns and sensory experiences were assessed at the end of the observational period, and cigarette consumption was compared to baseline. SP variant use and its impact on complete switching and cigarette consumption were also assessed. Results: The average age of enrolled exclusive cigarette smokers and dual users was 47 (SD 10.4) years and 44.3 (SD 9.6) years, respectively, and there were more female than male participants (227/353, 64.3% and 186/367, 50.7%). Participants smoked on average 13.3 (SD 7.3) and 12.1 (SD 7.2) cigarettes per day, and mostly menthol cigarettes (197/353, 55.8% and 201/367, 54.8%). Most participants had no plan to quit cigarette smoking in the next 6 months (261/353, 73.9% and 328/367, 89.4%). At the end of the observational period, 86.2% (304/353) of exclusive cigarette smokers and 92.1% (338/367) of dual users used the SP; 4% (14/353) of exclusive cigarette smokers and 4.1% (15/367) of dual users switched completely to the SP. Furthermore, 25.8% (91/353) of exclusive cigarette smokers and 28.1% (103/367) of dual users substantially reduced their cigarette consumption (50% or more) compared to baseline. Finally, around half of the participants (exclusive cigarette smokers: 166/304, 54.6%; dual users: 167/338, 49.4%) used only the menthol SP variant, which was also more positively evaluated in taste, smell, and aftertaste than the tobacco SP variant. Conclusions: This study indicates that adults who smoke cigarettes can switch completely to the novel ENDS or substantially reduce their cigarette consumption. These results complement the scientific evidence suggesting that ENDS are an acceptable alternative to cigarettes for adults who smoke in the United States.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".