# Switching Individuals in Treatment for Opioid Use Disorder Who Smoke Cigarettes to the SREC

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $75,599

## Abstract

ABSTRACT/PROJECT SUMMARY
Tobacco use is a leading cause of preventable mortality for people receiving medication treatment for opioid
use disorder (MOUD). Individuals receiving MOUD have a five-fold higher prevalence of tobacco smoking and
substantially lower quit rates than the general population, even when using existing treatments such as FDA-
approved pharmacotherapies. Electronic cigarettes (e-cigarettes), if substituted for combusted cigarette
smoking, may offer a harm reduction strategy for individuals receiving MOUD who smoke (MOUD-TUD) who
are not ready to quit smoking. Little work has been done to test this approach in MOUD-TUD. Addressing this
knowledge gap has the potential to answer a critical question of whether e-cigarettes can reduce tobacco use
and exposure in this highly vulnerable smoker population. It can also inform clinical practice and policymaking
decisions. In this 3-year career development award, I propose to conduct a pilot randomized waitlist-controlled
trial to assess the feasibility, acceptability, and preliminary effects of substituting the NIDA standardized
research e-cigarette (SREC) for combusted cigarettes in MOUD-TUD who are not ready to quit smoking. A
waitlist controlled RCT using a mixed-methods sequential explanatory design will investigate the impact of
SREC provision on: 1) tobacco use behavior (e.g., cigarettes per day [primary outcome], SREC use), 2)
biomarkers (e.g., carbon monoxide, anabasine), 3) cigarette dependence and withdrawal, and 4) short-term
health effects and tolerability (e.g., respiratory symptoms, substance use). In the proposed RCT, N=40 adults
stable on MOUD with buprenorphine who report daily smoking recruited from MGH primary care practices will
be randomly assigned to receive the SREC for 8 weeks, either immediately (iSREC), or after an 8-week delay
(waitlist control [WLC]). They will be followed an additional 4 weeks after SREC provision ends (to 12 weeks in
iSREC and 20 weeks in WLC). Each scientific aim corresponds to a specific training goal in three competency
domains: 1) design and conduct of clinical trials, 2) longitudinal quantitative data analysis and, 3) qualitative
and mixed-methods research. The scientific and training aims will be executed with mentorship from Drs.
Nancy Rigotti and Eden Evins (co-primary mentors), Dr. Elyse Park (co-mentor), and a team of expert
advisors. The training plan for this career development award leverages mentorship from a team of
internationally recognized leaders in patient-oriented tobacco, e-cigarette, and OUD research, as well as
rigorous coursework taught by renowned Harvard faculty. I will acquire both the skillset and the feasibility data
needed to support a fully powered R01 proposal to conduct a RCT testing a smoking intervention to reduce the
burden of smoking in those with OUD. The proposed study, in addition to completion of my training goals, will
launch me towards my long-term goal of a career as an independent investigator c...

## Key facts

- **NIH application ID:** 11072259
- **Project number:** 3K23DA056583-01A1S1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Joanna Streck
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $75,599
- **Award type:** 3
- **Project period:** 2023-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11072259

## Citation

> US National Institutes of Health, RePORTER application 11072259, Switching Individuals in Treatment for Opioid Use Disorder Who Smoke Cigarettes to the SREC (3K23DA056583-01A1S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11072259. Licensed CC0.

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