# Methadone-Maintained Smokers Switching to E-Cigarettes

> **NIH NIH R01** · BUTLER HOSPITAL (PROVIDENCE, RI) · 2021 · $364,626

## Abstract

Abstract
Persons with opioid use disorder (OUD) enrolled in methadone maintenance programs continue to have
smoking prevalence rates of 80-90% and high rates of tobacco-related morbidity and mortality. Multiple clinical
trials of pharmacotherapy have documented that methadone-maintained smokers (MMS) have very low
smoking cessation rates. These low rates of successful quitting and the significant health consequences of
smoking combustible cigarettes (CC), it is critical to identify harm-reduction strategies in this at-risk population.
Electronic cigarette (EC) use has grown rapidly and substituting combustible cigarettes with EC use may
decrease health risks in MMS. We propose to take a first step in examining the risks and benefits associated
with EC use among MMS. Of particular interest would be the health effects of ECs among MMS because of
MMS’ difficulty with prolonged CC quitting, the severity of their nicotine dependence, greater tobacco demand,
and the precedent of harm reduction wherein opioid users substitute a lower risk opioid (methadone) for illicit
drug use. Thus, we are proposing to utilize a fourth generation EC (JUUL) to examine behavioral and health
biomarker changes of MMS smokers interested in switching from combustible cigarettes to ECs. Given the
continuing popularity of ECs, there is an urgent need to improve our understanding of both the potential
benefits and risks of EC use in this vulnerable population. We propose to conduct a 4-year randomized clinical
trial of 240 MMS who are interested in switching to another nicotine alternative. Participants will be randomly
assigned (2:1) to either 6-weeks of EC (JUUL; n=160) or to 6-weeks of nicotine replacement therapy (NRT; in
the form of nicotine lozenges; n=80). Participants in both conditions will attend weekly assessment sessions
where smoking status is confirmed. At the end of 6 weeks, we will assess biomarkers of total nicotine intake
and tobacco toxicant exposure, respiratory symptoms, and spirometry-determined lung functioning as well as
rates of complete switching, EC, NRT, and CC use (including dual use), tobacco demand and self-efficacy for
quitting CC. Continued use of EC, NRT, and CC will be examined at the 12- and 24-week follow-ups. This
study will be the first to test the potential behavioral and health effects of ECs in smokers with opioid use
disorder, a population that is highly dependent on nicotine, highly vulnerable to smoking-related morbidity and
mortality, and searching for novel methods to lower smoking-related risks.

## Key facts

- **NIH application ID:** 10235132
- **Project number:** 1R01DA052907-01A1
- **Recipient organization:** BUTLER HOSPITAL (PROVIDENCE, RI)
- **Principal Investigator:** Ana M Abrantes
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $364,626
- **Award type:** 1
- **Project period:** 2021-09-30 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10235132

## Citation

> US National Institutes of Health, RePORTER application 10235132, Methadone-Maintained Smokers Switching to E-Cigarettes (1R01DA052907-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10235132. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*