Pickens

This research aims to better understand outcomes of quitting e-cigarettes in adults who also use cannabis. It focuses on how cannabis and tobacco interact during quitting attempts using varenicline, a medication approved for cigarette cessation but not for e-cigarette cessation. The study targets adults aged 18 to 40 who use both e-cigarettes and cannabis, regardless of their interest in quitting cannabis. The trial is conducted at three sites in South Carolina. Participants receive a 12-week treatment with varenicline following a standard dose schedule starting from 0.5 mg once daily and increasing to 1.0 mg twice daily, maintained for 11 weeks. Alongside medication, participants receive psychosocial counseling and financial incentives each week based on verified abstinence from e-cigarettes using urinary cotinine tests. This approach combines medication, behavioral support, and incentives. During the study, participants will attend weekly visits for assessments including urine tests to confirm tobacco abstinence and cannabis use. Researchers will track changes in cannabis use during the treatment and evaluate the impact of cannabis use severity on quitting success. The main outcome measured is 7-day tobacco abstinence at the end of 12 weeks. The total study duration per participant is 12 weeks, with monitoring throughout this period.

This research aims to evaluate whether switching completely to e-cigarettes can help people who smoke and are undergoing treatment for substance use disorders SUD quit smoking, compared to using FDA-approved nicotine replacement therapy NRT such as patches and lozenges. Tobacco use remains high among those with SUD despite declines in the general population, and quitting smoking during SUD treatment is challenging but important for better health outcomes. The study also seeks to understand implementation barriers and how these treatments affect SUD progress over 12 weeks. Participants will be randomly assigned to one of two groups one group will receive twelve weeks of e-cigarette products with instructions to switch completely from cigarettes, while the other group will receive twelve weeks of combination NRT patches plus nicotine lozenges to support quitting smoking. Both groups will also receive brief weekly counseling to support their quit or switch attempts. The study period includes 12 weeks of treatment with follow-up assessments. Participants will be involved for six months, including five in-person visits and eleven virtual assessments. They will complete a daily diary on their phones for the first twelve weeks. Researchers will monitor smoking abstinence verified biologically at the end of treatment, evaluate how acceptable the treatments are, and assess substance use outcomes through urine drug screens. Safety and participant engagement will also be tracked throughout the study.