Evaluating e-cigarettes as a weight control tool for chronic smokers

e-cigarette device
An e-cigarette (or ENDS) device was distributed as part of the research study. Brittany Larsen photo

Many smokers have reported that one of the reasons they started to smoke tobacco cigarettes is for weight control. If they quit, they fear their weight will go up.

Nicotine has been shown in some studies to suppress appetite in the short-term and increase metabolism, but it seems that those who smoke the most cigarettes do not always end up being thinner, especially when they are chronic smokers.

Obtaining baseline data from chronic smokers

A National Institute of Health (NIH) study was published recently in Nutrients. In it, a master’s student in health promotion sciences, Brittany Larsen, and her mentors, Department of Allied Health Sciences Professor Valerie Duffy and UConn Health Professor Mark Litt, did a baseline study of 135 chronic smokers, who were defined as smoking 10 or more cigarettes per day for at least a year.

The research showed that about one-third of the participants were found to be obese in the baseline visit or prior to the intervention. Those obese chronic smokers reported a greater liking for foods that are rich in saturated fats, sugar/sweetness and refined carbohydrates. These participants were also more likely to say that they used cigarettes to control their appetite and eating.

e-juice for e-cigarettes
Each research participant vaped several e-juice flavors. Brittany Larsen photo

The researchers asked each person to vape four different flavors of e-cigarettes to observe if the flavoring might increase this type of cigarette’s appeal to chronic smokers who have a greater preference for unhealthy foods. Cherry flavoring was reported as the sweetest by all the smokers. In addition, obese chronic smokers said that they liked cherry e-juice the most.

Duffy said this about the results of the study, “This interdisciplinary research provides an important hypotheses for further scientific investigation. Our study only measured the relationships between dietary behaviors, food liking and e-cigarette liking. Thus, we cannot suggest a cause and effect relationship. A future clinical trial would have to be conducted.”

Asking questions with further research

A question remains, according to Larsen, the first author on the study. She asks, “Could sweet e-cigarettes assist chronic smokers in weight control by replacing some of the preference and, potentially, consumption of unhealthy foods?”

In a follow-up, researchers retested 92 of the original chronic smokers who had abstained from smoking regular cigarettes for six weeks and adopted the use of e-cigarettes in substitution for tobacco cigarettes. Measurements were taken at the first visit as a baseline and at subsequent visits to ascertain what changes were taking place in the people being studied.

Brittany Larsen
Brittany Larsen

Larsen said that, in a blinded-experiment at the first visit, smokers tried 10 different e-cigarettes of five flavors (cherry, chocolate, menthol, tobacco, flavorless), both without nicotine (0mg/ml) and with nicotine (18mg/ml). They were asked about their perceptions of the e-cigarette’s taste, including sourness or bitterness, level of sweetness, and if there was an irritating quality. Another question was, “How much do you like or dislike it?”

Focusing on the effects of flavor in e-cigarettes may be a novel idea. In 2009, the Food and Drug Administration banned tobacco cigarettes with characterizing flavors other than menthol.

At the beginning of the study, each person was given e-cigarette equipment and randomized into one of four various e-juice flavor and nicotine conditions. The participants were allowed to vape as much as they wanted and were supposed to report if they relapsed and used tobacco cigarettes at any time during the six weeks.

According to Larsen, the study will provide data to address some of these questions: Did their food preferences change? If so, did preferences for some food groups change more than others (e.g., preferences for vegetables or for sweets)? How does cigarette abstinence with the use of e-cigarettes as a substitute for cigarette abstinence reflect on food preferences? Combining these factors makes this research the first of its kind.

Commenting on preliminary findings from research

“Preliminary results suggest that flavor may play a stronger influence than nicotine level on changes in food liking during short-term cigarette smoking abstinence. In addition, the findings may have implications for understanding changes in weight with smoking cessation through use of e-cigarettes,” Duffy said.

Glossary

e-cigarettes are battery-powered electronic nicotine delivery systems (ENDS), also called electronic cigarettes or vaping devices. They were developed in 2003 and first sold in 2006 in the United States.

e-juice, or e-liquid, is the vaporized fluid inhaled through the vaping of an e-cigarette. E-juice may contain nicotine and/or artificial flavoring. Currently, there are more than 7,700 different flavor options.

Nicotine is a substance in tobacco products. It is contained in cigarettes, cigars, smokeless tobacco and many e-cigarettes.

Vaping is the inhalation and exhalation of e-juice flavor from an e-cigarette.

Larsen, Duffy and the study’s principle investigator Litt were joined by allied health sciences collaborator Associate Professor Tania Huedo-Medina, who provided statistical guidance and expertise to Larsen for the Nutrients paper.

This research was supported by the National Institutes of Health, National Institute on Drug Abuse and General Clinical Research Center grants #1R01DA036492-01 and #M01-RR06192.

By Patsy Evans