Clinical Alternatives for Reducing Harm Using E-cigarettes
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Harm Reduction (E-cigarette switching), Standard of Care.
- Who it may be relevant to
- Registry conditions: Smoking, E-Cig Use, Oncology. Basic parameters: from 21 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
A Novel Harm Reduction Approach for Oncology Outpatients Who Smoke and Refuse Traditional Tobacco Treatment
Overview
For patients in cancer care, quitting smoking is critical, but a significant portion of patients in cancer care refuse all components of tobacco treatment, even when offered free of charge. The proposed clinical trial will assess one harm reduction intervention, switching completely from cigarettes to e-cigarettes, among oncology outpatients who smoke and refuse traditional tobacco treatment. This study is a type 1 hybrid effectiveness-implementation trial among oncology outpatients at an NCI-designated cancer center who smoke and refuse all components of tobacco treatment (N=208).
Detailed description
In the proposed study, we will conduct a type 1 hybrid effectiveness-implementation trial (N=208) to directly compare rates of switching to e-cigarettes to standard care, and advance understanding of key barriers and facilitators of implementation processes. Outpatients at HCC clinics who have opted out of traditional tobacco treatment will be randomly assigned to either 1) an e-cigarette switching approach (Switch), or 2) standard of care (SC; provision of additional tobacco treatment resources). We will compare rates of switching between the two groups, and conduct a mixed methods evaluation of implementation processes for the e-cigarette switching approach. To further evaluate the impact of harm reduction in this population, we will also collect exploratory data on the impact of switching to e-cigarettes on the biological effects of cancer risk (i.e., inflammation and DNA damage) and subjective effects of product use on health-related quality of life.
Potential subjects will be recruited and screened for inclusion and exclusion criteria from MUSC's telehealth TTP. Once we have determined that someone meets our eligibility criteria, we will invite them to begin the consent process. Participants who consent to participation and are randomized will complete baseline assessments, a baseline breath CO, and a blood draw for baseline biomarker assessment. Participants in the Switch group will be provided with a 13-week supply of e-cigarettes and choose a switch date.
Participants will be asked to complete Assessments remotely via REDCap survey on the Target Switch Day (Week 0 Assessment), and every 2 weeks through the end of product provision (Week 12). An additional assessment will be completed at the Week 24 follow-up. Participants will complete a blood draw at Baseline, Week 12, and Week 24. Participants will complete a remote submission of breath carbon monoxide at baseline, Week 0 (Switch Date), Week 6, Week 12, and Week 24.
We will conduct semi-structured interviews with \~20-25 participants from Switch after they complete the Week 24 follow-up to gain in-depth understanding of intervention experiences. We will also interview the primary providers from MUSC TTP who conducted the telehealth counseling component as well as other key clinic stakeholders. The providers will be interviewed on intervention acceptability including their perceptions of e-cigarettes as harm reduction tools, reach, fit within the clinic environment, resources to support and sustain the intervention in practice, and implementation barriers and facilitators.
Interventions
- Behavioral Harm Reduction (E-cigarette switching)
Participants will be assigned to receive an e-cigarette and try to switch completely from smoking to using the e-cigarette - Behavioral Standard of Care
Participants will be assigned to receive tobacco treatment referrals and the opportunity to re-enroll in the Tobacco Treatment Program
Primary outcome measures
- Complete switching [Time frame: 6 months]
Secondary outcome measures (1)
- Implementation [Time frame: 12 weeks]
Eligibility criteria
Inclusion criteria
- age 21+,
- identified as smoking in their medical record and self-report of current smoking within the past 30 days
- refused traditional treatment options through the opt-out HCC Tobacco Treatment Program
- English speaking;
Exclusion criteria
- currently taking part in any TTP or using cessation medication (i.e., taking NRT or other cessation medications, enrolled in the Quitline, or in another study),
- use of e-cigarettes in the past 30 days,
- currently imprisoned,
- pregnant women.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Prevention
Study locations
United States · 1 center
- Medical University of South Carolina — Charleston
Identifiers
NCT: NCT07039292 · Pro00138162 · 1R01CA293735-01A1