# Alternative Nicotine Delivery Systems as Potential Harm Reduction Tools for Persistent Cigarette Smokers

> **NIH CA R01** · UNIVERSITY OF PENNSYLVANIA · 2026 · $650,125

## Abstract

PROJECT SUMMARY
Nearly 70% of the ~ 30 million adult cigarette smokers in the US want to quit, and 55% report trying to quit at
least once in the past year - yet, over 90% fail despite using smoking cessation medication. The average smoker
will attempt to quit smoking at least 30 times before abstaining for 12 months or longer. These attempts typically
occur over decades of smoking, carcinogen and toxicant exposure, resulting in 480,000 deaths annually. Novel
alternatives must be considered to significantly reduce the combustible cigarette-attributable morbidity and
mortality among smokers unable to quit with traditional approaches. The Surgeon General’s Report and others
have underscored that helping smokers who cannot quit smoking switch to less harmful nicotine-containing
products – a harm reduction approach - can dramatically reduce this health burden. E-cigarettes (ECIGS), and
oral nicotine pouches (ONPs), expose users to few of the chemicals found in cigarette smoke and are thus
promising noncombustible harm reduction tools for smokers who would not otherwise quit smoking. For their
harm reduction potential to be realized, fundamental questions must be answered. One, can persistent
smokers switch from combustible cigarettes to either ECIGS or ONPS? Initial research suggests that one-
third of smokers fully switch to ECIGS, although comparable data is unavailable for ONPS. Two, what factors
influence switching? The factors affecting the transition to ECIGS or ONPS have yet to be investigated. Three,
does one of these noncombustible alternatives expose users to lower levels of harmful chemicals than
the other? Only limited, indirect, and industry-sponsored data exist. Documenting the relative success of
switching to ECIGS or ONPS, identifying drivers of switching, and quantifying the associated harm reduction will
inform research to optimize smokers’ success in transitioning from combustible cigarettes.
We propose the first longitudinal investigation of the subs

## Key facts

- **NIH application ID:** 11311928
- **Project number:** 5R01CA290541-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** JANET E AUDRAIN-MCGOVERN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** CA
- **Fiscal year:** 2026
- **Award amount:** $650,125
- **Award type:** 5
- **Project period:** 2024-04-01T00:00:00 → 2028-03-31T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11311928

## Citation

> US National Institutes of Health, RePORTER application 11311928, Alternative Nicotine Delivery Systems as Potential Harm Reduction Tools for Persistent Cigarette Smokers (5R01CA290541-03). Retrieved via AI Analytics 2026-07-02 from https://api.ai-analytics.org/grant/nih/11311928. Licensed CC0.

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