Reprint of: The effects of switching to the standardized research electronic cigarette in people with HIV who smoke in the United States.

Objective: People with HIV (PWH) who smoke and report ambivalence about quitting may benefit from switching to non-combusted nicotine products. This pilot study examined the effects of providing the NIDA standardized research electronic cigarette (SREC) on smoking behaviors and inflammatory biomarkers in PWH.

Methods: Thirty-five participants in the United States were enrolled from April 2022 to January 2024 (Mean age 54.4 [13.2] years, 30.1 % female, 62.9 % White) and randomized to SREC provision (n = 17) or usual brand control (n = 18). SREC participants were asked to substitute tobacco-flavor pod-type SRECs for their combustible cigarettes. SREC use and cigarette use were assessed weekly for 6 weeks. Serum inflammatory biomarkers were measured at baseline and week 6.

Results: The effect of condition on cigarettes per day (CPD) during the 6-week period was significant, B = -5.68, 95 % CI = -10.25, -1.11: CPD were reduced by 42.7 % in the SREC condition versus 17.3 % in the control condition. Participants in the SREC condition reported significantly lower urge to smoke at week 6 compared to those in control, (B = -17.05, 95 % CI = -27.15, -6.95). One (5.9 %) participant reported that they transitioned completely from CCs to SREC at week 6. Significant decreases in inflammatory biomarkers were not observed.

Conclusions: Participants who were provided the SREC, compared to those in the control condition, smoked fewer CPD and had reduced urge to smoke. However, dual use was the most common outcome, indicating that additional support may be needed to improve the likelihood of complete transition from CCs to noncombustible products.