Strasser 2016.
Study characteristics | ||
Methods | Design: Randomized, factorial trial (Participants were randomized to one of the 5 brands of e‐cigarettes – although only 4 brands analyzed) Recruitment: Media ads Setting: Recruitment from the community, study took place at University, USA. Study start date/Study end date: Not specified. |
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Participants | Total N: Analysis based on 24 (28 originally recruited, but the first 4 participants enrolled experienced malfunctioning NJOY e‐cigs and withdrew – the project was removed from the market before the 5th participant was randomized) N per arm: blu: 6; Green Smoke: 6; V2: 6; White Cloud: 6 Inclusion criteria:
Exclusion criteria:
Inclusion based on specific population characteristic: Not applicable 29% women; mean age 43.3; mean cpd 17; mean FTND 3.7 Motivated to quit: Participants had no current plans to try to quit smoking (eligibility criterion) E‐cigarette use at baseline: No more than 3 previous episodes of use and not currently using (eligibility criterion) |
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Interventions |
EC: Cig‐a‐like All participants received nicotine EC and were instructed to use them exclusively for 9 days The 5 brands selected, including brand reported nicotine levels, were: (1) NJOY (18mg nicotine) – this brand was discontinued and not analyzed as the e‐cigs provided malfunctioned; (2) V2, 18 mg nicotine; (3) Green Smoke, 18.9 ‐ 20.7 mg nicotine; (4) blu, 20 ‐ 24mg nicotine; and (5) White Cloud, 23 ‐ 24 mg nicotine. Each brand advertised the delivery of the same level of nicotine (appropriate for about a pack/day smoker), provided the standard tobacco flavor (no other flavors made available), and used a disposable cigarette‐like device |
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Outcomes | Day 10 is the only testing point of interest for us but participants were also tested at days 1 and 5 Adverse events and biomarkers:
Other outcomes measured:
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Study funding | “National Cancer Institute (NCI) of the National Institutes of Health (NIH) and FDA Center for Tobacco Products (CTP) under Award Number P50CA179546, as well as grants from the National Cancer Institute (P50 CA143187, P30 CA16520, and P30 DA12393)” | |
Author declarations | “Dr Benowitz has served on scientific advisory boards for Pfizer and GlaxoSmithKline related to smoking cessation medications and has been an expert witness in litigation against tobacco companies. Dr Schnoll receives medication and placebo free of charge from Pfizer and has provided consultation to Pfizer and GlaxoSmithKline. These companies had no involvement in this study. Dr Strasser has received funding through the Pfizer GRAND program, an independent peer‐reviewed grant program funded through Pfizer (2008‐2011); all investigators have received funding from the United States National Institutes of Health” | |
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Although participants were randomized to different brands of EC, no description on how randomization was carried out |
Allocation concealment (selection bias) | Unclear risk | Not specified |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No description of whether groups were blind to other conditions, but given similar levels of support between arms, so performance bias judged unlikely |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Unclear whether any blinding took place, some outcomes were measured using objective measures and there was no difference in contact between arms |
Incomplete outcome data (attrition bias) All outcomes | High risk | For blu, Green Smoke, and V2 groups, 83% of participants completed the 10‐day study; only 33% of participants randomized to White Cloud completed the 10‐day study; meaning loss to follow‐up was considerably higher in this group |
Selective reporting (reporting bias) | Low risk | All expected outcomes reported |