A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation.

BACKGROUND: Whether financial incentives, pharmacologic therapies, and electronic cigarettes (e-cigarettes) promote smoking cessation among unselected smokers is unknown. METHODS: We randomly assigned smokers employed by 54 companies to one of four smoking-cessation interventions or to usual care. Usual care consisted of access to information regarding the benefits of smoking cessation and to a motivational text-messaging service. The four interventions consisted of usual care plus one of the following: free cessation aids (nicotine-replacement therapy or pharmacotherapy, with e-cigarettes if standard therapies failed); free e-cigarettes, without a requirement that standard therapies had been tried; free cessation aids plus $600 in rewards for sustained abstinence; or free cessation aids plus $600 in redeemable funds, deposited in a separate account for each participant, with money removed from the account if cessation milestones were not met. The primary outcome was sustained smoking abstinence for 6 months after the target quit date. RESULTS: Among 6131 smokers who were invited to enroll, 125 opted out and 6006 underwent randomization. Sustained abstinence rates through 6 months were 0.1% in the usual-care group, 0.5% in the free cessation aids group, 1.0% in the free e-cigarettes group, 2.0% in the rewards group, and 2.9% in the redeemable deposit group. With respect to sustained abstinence rates, redeemable deposits and rewards were superior to free cessation aids (P<0.001 and P=0.006, respectively, with significance levels adjusted for multiple comparisons). Redeemable deposits were superior to free e-cigarettes (P=0.008). Free e-cigarettes were not superior to usual care (P=0.20) or to free cessation aids (P=0.43). Among the 1191 employees (19.8%) who actively participated in the trial (the "engaged" cohort), sustained abstinence rates were four to six times as high as those among participants who did not actively engage in the trial, with similar relative effectiveness. CONCLUSIONS: In this pragmatic trial of smoking cessation, financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone. Among smokers who received usual care (information and motivational text messages), the addition of free cessation aids or e-cigarettes did not provide a benefit. (Funded by the Vitality Institute; ClinicalTrials.gov number, NCT02328794 .).

Versatile thin-film reactor for photochemical vapor generation.

A novel thin-film reactor is described and evaluated for its analytical performance with photochemical vapor generation (TF-PVG). The device, comprising both the generator and a gas-liquid separator, utilizes a vertical central quartz rod onto which the sample is pumped to yield a thin liquid film conducive to the rapid escape of generated hydrophobic species. The rod is housed within a concentric quartz tube through which a flow of argon carrier/stripping gas is passed to remove and transport the generated species to a detector, which in this study is an inductively coupled argon plasma optical emission spectrometer (ICP-OES). The concentric quartz tube is itself surrounded by a 78-turn 0.5 m long quartz coil low-pressure mercury discharge lamp operating at 20 W. The performance of this thin-film photoreactor was evaluated through comparison of analytical figures of merit for detection of a number of elements undergoing PVG in the presence of formic or acetic acid with those arising from conventional solution nebulization under optimized conditions. The TF-PVG reactor provided sensitivity enhancements, of 110-, 120-, 130-, 250-, 120-, 230-, 78-, 1.3-, 16-, and 32-fold for As, Sb, Bi, Se, Te, Hg, Ni, Co, Fe, and I, respectively, and detection limit enhancements of 110-, 140-, 170-, 270-, 200-, 300-, 160-, 2.7-, 50-, and 44-fold for these same elements. Vapor generation efficiencies ranged from 20-100% for this suite of analytes. The utility of this technique was demonstrated by the determination of Fe and Ni in Certified Reference Materials DORM-3 (fish protein) and DOLT-4 (dogfish liver tissue).

High-yield UV-photochemical vapor generation of iron for sample introduction with inductively coupled plasma optical emission spectrometry.

A novel approach to the generation of volatile iron compounds (likely the pentacarbonyl) with high efficiency is described, wherein solutions containing either Fe(2+) or Fe(3+) and low molecular weight organic acids such as formic, acetic or propionic are exposed to a UV source. An optimum generation efficiency of 60 +/- 2% was achieved in 50% formic acid at pH 2.5 with an irradiation time of 250 s by use of a 17 W low-pressure mercury grid lamp. Compared to conventional solution nebulization, sensitivity and limit of detection were improved 80- and 100-fold, respectively, at the 238.204 nm Fe II emission line. A precision of 0.75% RSD was achieved at a concentration of 100 ng/mL. Photochemical vapor generation sample introduction was used for the determination of trace iron in several environmental Certified Reference Materials, including National Research Council Canada DORM-3 fish muscle tissue, DOLT-3 and DOLT-4 fish liver tissues, and SLRS-5 river water, providing analytical results in excellent agreement with certified values based on a simple external calibration.