40 Participants Needed

Vaping for Opioid Use Disorder

(SWITCHED Trial)

JM
Overseen ByJoanna M Streck, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Massachusetts General Hospital
Must be taking: Buprenorphine
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

Trial Summary

What is the purpose of this trial?

The goal of this study is 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).

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you must be stable on your current buprenorphine treatment for opioid use disorder.

What data supports the effectiveness of the treatment Standardized research e-cigarette (SREC) for opioid use disorder?

Research suggests that electronic cigarettes (e-cigarettes) may be a viable harm reduction strategy for individuals with opioid use disorder (OUD) who smoke, as traditional smoking cessation methods have low success rates in this group. Studies indicate that e-cigarettes are considered acceptable and potentially helpful for reducing cigarette harm among those receiving medication treatment for OUD.12345

Is vaping generally safe for humans, especially in the context of opioid use disorder?

The studies reviewed do not provide specific safety data on vaping for opioid use disorder, but they suggest that e-cigarettes are considered a harm reduction tool for smokers with opioid dependence. However, the safety of e-cigarettes in general remains a topic of debate, and their use should be discussed with healthcare providers.12367

How is the treatment using the Standardized Research E-Cigarette (SREC) different from other treatments for opioid use disorder?

The Standardized Research E-Cigarette (SREC) is unique because it uses vaping as a harm reduction strategy to help individuals with opioid use disorder reduce smoking, which is often difficult to achieve with traditional methods. Unlike standard treatments that focus solely on opioids, this approach targets the high smoking rates in this population, offering a novel way to address both nicotine and opioid use.12389

Research Team

JM

Joanna M Streck, PhD

Principal Investigator

Massachusetts General Hospital

Eligibility Criteria

This trial is for adults over 18 who smoke at least 10 cigarettes daily, are not planning to quit in the next month but willing to try e-cigarettes, and have been stable on buprenorphine treatment for opioid use disorder at an MGH-affiliated clinic for at least 3 months.

Inclusion Criteria

Not ready to quit smoking (not planning to quit in the next 30 days)
Willing to try e-cigarettes
I have smoked 10 or more cigarettes daily in the past week.
See 1 more

Exclusion Criteria

Using non-cigarette nicotine or tobacco products (e.g., e-cigarettes, cigarillos) recently (>3 days in past 30 days)
Deemed inappropriate for participation by their OUD provider
Pregnant or breastfeeding
See 2 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the standardized research e-cigarette (SREC) for 8 weeks

8 weeks
Weekly visits for monitoring

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks
Final follow-up assessment

Waitlist Control

Participants in the waitlist control group receive SREC after an 8-week delay

8 weeks

Treatment Details

Interventions

  • Standardized research e-cigarette (SREC)
Trial Overview The study tests if switching smokers with opioid use disorder to a standardized research e-cigarette (SREC) affects their smoking habits, dependence, withdrawal symptoms, health markers like carbon monoxide levels, and short-term health effects. Participants will be randomly assigned to start using SREC immediately or after an 8-week wait.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Immediate SREC provision (iSREC)Experimental Treatment1 Intervention
Those randomized to the iSREC group will be provided a free 8-week supply of standardized research e-cigarettes (SRECs) and asked to try to switch completely to the SREC.
Group II: Delayed SREC provision waitlist control (WLC)Active Control1 Intervention
Those in the WLC condition will receive SREC provision after an 8-week delay.

Standardized research e-cigarette (SREC) is already approved in United States for the following indications:

🇺🇸
Approved in United States as SREC for:
  • Investigational Tobacco Product (ITP) for research purposes only

Find a Clinic Near You

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials
3,066
Recruited
13,430,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials
2,658
Recruited
3,409,000+

Findings from Research

A study of 32 adolescents and young adults receiving medication treatment for opioid use disorder revealed a high prevalence of nicotine use, with 97% having tried combustible cigarettes and 90% having tried e-cigarettes, indicating early initiation of nicotine use.
Most participants (71%) reported daily use of combustible cigarettes, highlighting a significant concern for this population, and suggesting the need for targeted interventions like universal nicotine screening and tailored cessation programs.
Patterns and perceptions of nicotine use among U.S. adolescents and young adults receiving medication treatment for opioid use disorder.Watson, ML., McKnight, ER., Groner, JA., et al.[2023]
A pilot study involving 25 daily smokers with opioid use disorders showed high interest in using electronic cigarettes (ECIGs), with a 93.9% enrollment rate and 70.9% retention over two weeks.
While participants reported reduced cigarette consumption, only 8% achieved biologically-confirmed smoking abstinence, indicating that while ECIGs may be appealing, their effectiveness in promoting long-term cessation needs further investigation.
A pilot investigation of the effect of electronic cigarettes on smoking behavior among opioid-dependent smokers.Felicione, NJ., Enlow, P., Elswick, D., et al.[2020]
A significant majority of individuals receiving medication treatment for opioid use disorder (93%) view cigarettes as very harmful, while 63% also see e-cigarettes as harmful, indicating a strong awareness of health risks associated with both.
Despite concerns about health harms, 65% of participants found e-cigarettes helpful for reducing or quitting cigarette use, suggesting potential acceptability as a harm reduction strategy among those in buprenorphine treatment.
Perceptions of E-cigarettes among adults in treatment for opioid use disorder.Streck, JM., Regan, S., Kalkhoran, S., et al.[2023]

References

Patterns and perceptions of nicotine use among U.S. adolescents and young adults receiving medication treatment for opioid use disorder. [2023]
A pilot investigation of the effect of electronic cigarettes on smoking behavior among opioid-dependent smokers. [2020]
Perceptions of E-cigarettes among adults in treatment for opioid use disorder. [2023]
A Comparison of Daily Versus Weekly Electronic Cigarette Users in Treatment for Substance Abuse. [2019]
An Open Trial of Electronic Cigarettes for Smoking Cessation Among Methadone-Maintained Smokers. [2018]
E-cigarette knowledge, attitudes, and use in opioid dependent smokers. [2018]
Survey of U.S. Residents and Their Usage of Electronic Cigarettes with Drugs Other Than Nicotine. [2023]
Predictors of polysubstance vaping in emerging adults. [2023]
Association between vaping and health outcomes in patients with opioid use disorder: a systematic review protocol. [2021]
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