Kim Pulvers of CSU San Marcos was lead author of study on new e-cigarettes. Photo illustration by Times of San Diego. Photo via pulverslab.weebly.com

A Cal State San Marcos professor helped conduct research offering evidence that a new type of electronic cigarette is less damaging to health than traditional cigarettes, the school said Monday.

Kim Pulvers, a professor of psychology at CSUSM, was the principal investigator of a study published Nov. 18 in the American Medical Association journal JAMA Network Open on the world’s first randomized clinical trial of fourth-generation “pod” e-cigarettes.

The research shows that, in the short term, e-cigarettes are substantially safer than combustible cigarettes.

“Members of the two largest minority groups in the U.S. who have been underrepresented in previous e-cigarette studies, African American and Latino/Latina smokers, were the focus, given their high rates of tobacco-related morbidity and mortality at lower levels of smoking and their being less likely than White smokers to switch to exclusive e-cigarette use,” the study said.

“Racial and ethnic disparities in exclusive switching to e-cigarette could exacerbate the greater burden of tobacco-related death and disease among disadvantaged populations.”

In a statement, Pulvers said: “My hope is for this research to contribute to lessening the burden of preventable death and disease from cigarette smoking, particularly among those who experience tobacco-related health disparities.”

Pulvers collaborated on the study with researchers from Brown University, the University of Kansas School of Medicine and UC San Francisco. Myra Rice, a recent graduate of CSUSM, also contributed.

The study was funded by the National Institutes of Health.

The clinical trial included 186 African-American and Latinx smokers, as racial and ethnic minority groups tend to experience higher rates of tobacco-related morbidity and mortality even when they smoke at the same rates as other groups.

Two-thirds of the participants were provided nicotine salt pod system (pod) e-cigarettes for six weeks; the rest continued smoking regular cigarettes as usual.

By the end of the study, participants who switched to e-cigarettes showed significantly lower levels of the pulmonary carcinogen NNAL compared to those who continued to smoke regular cigarettes.

E-cigarette users also had significantly reduced carbon monoxide levels and reported fewer respiratory symptoms. These benefits were greatest among participants who switched completely to e-cigarettes, the study said.

“Pod e-cigarettes are a real alternative for cigarette smokers,” Pulvers said. “Switching to pod e-cigarettes was feasible: 86% of our smokers made a switch. Most critically, switching to pod e-cigarettes significantly reduced exposure to toxicants that cause disease. Smokers who made a complete switch experienced the greatest reduction in toxicant exposure. Smokers who made a partial switch also experienced reduced harm.”

Pulvers emphasized that further research is needed to establish whether smokers who switch from traditional cigarettes to e-cigarettes maintain that behavior over time, and to explore the long-term harm reduction of e-cigarettes.

Pulvers also said the study does not address smoking cessation due to the Food and Drug Administration classification of e-cigarettes as tobacco products rather than therapeutic devices.

“Our findings support using e-cigarettes as a harm reduction strategy for smokers,” she said. “Smokers who cannot or will not quit smoking would be well-served by switching to pod e-cigarettes. While our study demonstrates that pod e-cigarettes are less harmful than cigarettes, there is no safe level of tobacco use and e-cigarettes should not be used by youth or non-smokers.”

This unblinded randomized clinical trial compared toxicant exposure in smokers randomized to six weeks of e-cigarette use vs continuing to smoke cigarettes as usual. Recruitment occurred from May 10, 2018, through March 29, 2019, with follow-up completed by May 17, 2019.

Participants, aged 21 and older, were recruited from the San Diego and the Kansas City, Missouri and Kansas, metropolitan areas.

They had smoked at least five cigarettes a day on at least 25 of the previous 30 days and were willing to switch from smoking cigarettes to e-cigarettes for six weeks.

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