E-Cigarettes and Financial Incentives to Promote Tobacco Harm Reduction Among Adults Accessing Shelter Services (EXCHANGE)

University of Oklahoma (OU)

Status: Completed

Conditions: Cigarette Smoking

Treatments: Behavioral: Financial Incentives; Behavioral: E-cigarette Switching

Study type: Interventional

Funder types: Other

Identifiers

NCT03743532

10124

Details and patient eligibility

About

This randomized controlled trial evaluated the feasibility and potential efficacy of 1) e-cigarette switching (EC) or 2) e-cigarette switching + financial incentives for combustible cigarette cessation (EC+FI)

Full description

The current study examined the feasibility of e-cigarette switching and financial incentives contingent on combustible cigarette abstinence to promote combustible cigarette cessation among urban day shelter guests (N=60). A total of 60 adults who accessed the Homeless Alliance day shelter in Oklahoma City, OK were randomly assigned to 1 of 2 groups and followed weekly from 1 week prior to a scheduled EC switch date through 4 weeks post-switch date, with a final 8-week post-switch follow-up. The intervention groups were: 1) e-cigarette switching (EC) or 2) EC switching + small financial incentives for carbon monoxide (CO) verified combustible cigarette abstinence (FI + EC). The primary outcomes were self-reported combustible cigarette abstinence over the previous 7 days with carbon monoxide (CO)-verification at 4- and 8- weeks follow-up. Secondary outcomes included changes in CO from baseline, days of combustible cigarette smoking, and continued e-cigarette use. Other feasibility outcomes included study retention and perceptions of the intervention.

Enrollment: 60 patients

Sex: All

Ages: 21 to 100 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

1. ≥21 years of age
2. Expired CO level ≥8 ppm suggestive of current smoking
3. reported smoking ≥5 cigarettes per day
4. Willing and able to attend 8 study visits over a 10-week period
5. Interested in switching from CCs to ECs
6. Willing to abstain from smoking cannabis for the duration of the study
7. Able to speak and understand English
8. Demonstrated >6th grade English literacy by earning a score ≥4 on the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF),
9. Able to read a 3-sentence selection from the consent form
10. Not pregnant, breastfeeding, or planning to become pregnant.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

E-Cigarette Switching (EC)

Experimental group

Description:

Participants were provided with an e-cigarette device and nicotine pods and advised to completely switch from combustible cigarettes to e-cigarettes. Although participants in the EC group did not earn incentives for combustible cigarette abstinence, they were yoked with a participant in the EC+FI group (described below), and they earned the same weekly incentive amount as their counterpart earned for combustible cigarette abstinence credited to a reloadable study credit card.

Treatment:

Behavioral: E-cigarette Switching

E-Cigarette Switching + Financial Incentives (EC+FI)

Experimental group

Description:

Participants assigned to the EC+FI group received ECs and pods and were instructed to switch from combustible cigarettes to e-cigarettes as described above for the EC group. Participants also earned escalating financial incentives for self-reported and carbon-monoxide-verified combustible cigarette abstinence via credits to a reloadable study credit card. Participants who reported combustible cigarette use and/or had a CO level \>6 ppm did not earn incentives that week, but could earn incentives at the next visit with the incentive value reset to the starting value.

Treatment:

Behavioral: E-cigarette Switching

Behavioral: Financial Incentives