Evaluation of Appeal and Impact of E-Cigarettes Among Chronic Smokers With Smoking-Related Cancers

The aim of the study is to determine the appeal of e-cigarettes compared to combustible cigarettes as measured by the degree to which patients succeed in reducing their cigarette consumption over the 9 weeks they are supplied with product, along with their consumption of e-cigarettes. We will measure past use of e-cigarettes and cigarettes at baseline, 3, 6, 9, and 12 weeks. We will also assess the effect of e-cigarette substitution on toxicity by measuring expired carbon monoxide and urine NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) , a carcinogenic metabolite of cigarette smoke.

Inclusion criteria

• Histological or cytological diagnosis of lung, head & neck, or bladder cancer within the past 5 years.
• AJCC (American Joint Committee on Cancer) stages I-IV
• Daily Smoking (at least 10 cigarettes per day for 10 years) and breath CO (carbon monoxide) greater than or equal to 9 ppm
• Does not wish to quit smoking now (anyone wishing to quit smoking will be referred for smoking cessation counselling through the DHMC (Dartmouth Hitchcock Medical Center) program)
• May be receiving anti-cancer agents
• Age 18 or older
• Fluent in English;
• Patient must be capable and willing to provide informed written consent for study participation;
• Able to participate in study visits

Exclusion criteria

• Cancer surgery planned in the next 9 weeks;
• Treatment with radiation planned for the next 9 weeks,
• Actively trying to quit smoking, or planning to in the next 30 days. (If a subject reports that they plan to quit smoking in the next 30 days, we will call them after the 30 days to see if they are still trying to quit.)
• Any use of e-cigarettes in the past 30 days,
• Pregnant or trying to get pregnant.