Vapes more effective for smoking cessation than nicotine gum and lozenges

Embargoed for release until 5:00 p.m. ET on Monday 14 July 2025   

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.    

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1. Vapes more effective for smoking cessation than nicotine gum and lozenges

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-03531

URL goes live when the embargo lifts             

A randomized controlled trial (RCT) evaluated whether vaporized nicotine products (VNPs) are more effective than nicotine replacement therapies (NRT) for smoking cessation among people experiencing social disadvantage. The researchers found that VNPs were more effective than NRT for smoking cessation in a low socioeconomic status (low-SES) population. As this population is disproportionately affected by the harms of smoking, VNPs may have a critical role in promoting smoking abstinence. The study is published in Annals of Internal Medicine.

Researchers from the National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, AU and colleagues conducted a two-group, open-label RCT of 1,045 low-SES participants in New South Wales, AU between March 30, 2021 and December 8, 2022. Eligible participants smoked daily, were aged 18 years and over, were willing to make a quit attempt within two weeks of screening and were receiving a government pension or allowance (indicator of low-SES). They were randomly assigned to the VNP or NRT group in a 1:1 ratio. The NRT group had the choice of receiving 8 weeks’ supply of either nicotine gum or lozenges, and the VNP group received 8 weeks’ supply of nicotine e-liquid to use in either a tank device or a pod device. VNP participants could receive the e-liquid in tobacco, menthol, and fruit flavors. All participants received behavioral support via automated text messages for five weeks. The primary outcome was six-month continuous abstinence from smoking. The researchers found that the six-month continuous abstinence was 9.6% in the NRT group and 28.4% in the VNP group. Subgroup analyses of age, sex, nicotine dependence and mental illness also found that VNP was more effective than NRT. The results suggest VNPs may have a role in promoting smoking abstinence among groups experiencing socioeconomic disadvantage, as well as the general population.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Ryan J. Courtney, PhD, please email the NDARC media team at NDARC.media@unsw.edu.au.    

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2. Risk for GERD is higher with GLP-1 RA use compared to SGLT-2 inhibitor use

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-03420   

URL goes live when the embargo lifts             

A population-based cohort study emulating a target trial estimated the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) compared with sodium-glucose cotransporter-2 (SGLT-2) inhibitors on the risk for gastroesophageal reflux disease (GERD) and its complications in patients with type 2 diabetes. The study found that incidence of GERD and its complications was higher among GLP-1 RA users, risk of GERD-related complications higher for smokers, patients with obesity, and patients with gastric-related comorbidities. The results are published in Annals of Internal Medicine. 

Researchers from McGill University and Lady Davis Institute, Jewish General Hospital in Montreal used the U.K. Clinical Practice Research Datalink to create a target trial emulation framework that evaluated the risk for GERD and its complications in patients aged 18 years or older with type 2 diabetes initiating GLP-1 RAs or SGLT-2 inhibitors. The study included 24,708 new users of GLP-1 RAs who had a median follow-up of 3 years and 89,096 new users of SGLT-2 inhibitors who had a median follow-up of 2.7 years. The primary outcome was diagnosis of GERD and secondary outcome was complications of GERD. The researchers found that during follow-up the incidence rate for GERD was 7.9 per 1,000 person years. 138 total complications of GERD were observed, with over 90% of them being Barrett esophagus. At three-year follow-up, the risk ratio (RR) was 1.27 for GERD and 1.55 for GERD complications in GLP-1 RA users compared with SGLT-2 inhibitor users. Secondary analyses found that risks for GERD were higher overall for each GLP-1 RA type except lixisenatide, and risks for GERD complications were higher in ever-smokers, patients with obesity, and patients with gastric comorbidities. The results suggest the risk for GERD and its complications is higher among patients with type 2 diabetes using GLP-1 RAs versus SGLT-2 inhibitors. Clinicians and patients should be aware of the possible adverse effect of GLP-1 RAs on GERD. 

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Laurent Azoulay, PhD, please email John Johnston at john.johnston@ladydavis.ca.    

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3. Pilot hospital-based violence intervention program suggests a more sustained, multi-dimensional approach is needed to prevent violent reinjury

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-01576

URL goes live when the embargo lifts             

A multicenter, retrospective, observational cohort study evaluated violent reinjury one year after an initial violent injury among participants in the St. Louis area hospital-based violence intervention program (HVIP), Life Outside of Violence (LOV), during its pilot phase. The findings did not provide informative evidence of differences in reinjury probability for LOV participants; however, they suggest that the overwhelming risk of violent reinjury cannot be overcome by an individual-level approach. The study is published in Annals of Internal Medicine.  

The LOV program is a unique patient care partnership between Washington University in St. Louis, Saint Louis University, and their four associated adult and pediatric level 1 trauma hospitals and is the first multisystem, region-wide HVIP in the United States. A study team from Washington University in St. Louis and Saint Louis University evaluated the implementation and reinjury outcomes among 233 participants aged 8 to 24 years in the LOV program between 15 August 2018 (the program’s start) and 31 December 2022. Eligible participants had to live in the St. Louis, MO area, present to a LOV partner hospital with a nonfatal violent injury (firearm, stabbing, blunt assault), and enroll in the program. Control participants were violently injured patients who were eligible for LOV but did not enroll in the program. After violent injury, LOV case managers were connected with eligible program participants and their families. Case managers worked with participants for six to 12 months after injury to coordinate medical care, develop goals for an individual treatment plan, provide counseling, and connect them to community resources. The final participant sample included 198 LOV-enrolled participants matched to 388 nonenrolled control participants. LOV-enrolled participants had a median age of 18 years, were most likely non-Hispanic Black, male, had Medicare or Medicaid, and had a firearm injury. 8% of LOV participants experienced violent reinjury within one year compared with 7% of matched control participants. 60% of LOV participants were reinjured by firearms. Estimates for 1-year probability of reinjury were 7.6% among LOV participants and 7.4% among control participants. The results suggest that patient engagement in HVIPs is a substantial challenge, and reducing reinjury rates may require a more sustained, multidimensional approach at the individual, community, and systemic levels. The researchers note that systems and programs should address the health and behavioral issues associated with violence and the social inequities that contribute to community violence, such as unemployment, poverty, and unsafe housing.  

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Kristen L. Mueller, MD please email Kristen.Mueller@wustl.edu.            

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Also new this issue:

Single-Arm Trials Can Provide Randomized Real-World Evidence: The Random Invitation Single-Arm Trial Design

Perrine Janiaud, PhD; John P.A. Ioannidis, MD, DSc; Benjamin Kasenda, MD, PhD; Atle Fretheim, MD, PhD; Steven N. Goodman, MD, PhD; and Lars G. Hemkens, MD, MPH

Research and Reporting Methods

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-02979