Low Nicotine Cigarettes Plus Electronic Cigarettes

Exclusion Criteria

• •Women who are pregnant and/or nursing or trying to become pregnant
• •Unstable or significant medical condition in the past 3 months (e.g., recent heart attack or other serious heart condition, stroke, severe angina, high blood pressure \[systolic \>159 mmHg or diastolic \>99 mmHg during screening)
• •Respiratory diseases (e.g., exacerbations of asthma or COPD, require oxygen, require oral prednisone), kidney (e.g., dialysis) or liver disease (e.g., cirrhosis), severe immune system disorders (e.g., uncontrolled HIV/AIDS, multiple sclerosis symptoms) or any medical disorder/medication that may affect participant safety or biomarker data
• •Uncontrolled mental illness or substance abuse, or inpatient treatment for these in the past 6 months
• •Current suicide risk on clinical assessment (above "low risk" score (or ≥ 9) on MINI diagnostic interview suicide module during screening (34))
• •Use of any non-cigarette nicotine delivery product (e.g., pipe, cigar, dip, chew, snus, hookah, e-cig, strips or sticks, IQOS) in the past 7 days at screening
• •Use of an e-cig for 5 or more days in the past 28 days or any use in the past 7 days at screening
• •Use of marijuana or other illegal drugs/prescription drugs for non-medical use daily/almost daily or weekly in the past 3 months per NIDA Quick Screen
• •Any known allergy to propylene glycol or vegetable glycerin
• •Surgery requiring general anesthesia in the past 6 weeks
• •Unwilling to remain on one flavor of cigarette (regular or menthol) for the duration of the trial
• •Previous use of SPECTRUM research cigarettes in the past 6 months
• •Other member of household currently participating in the study
• •History of a seizure disorder or had a seizure in the past 12 months
• •Currently taking or have taken medications prescribed to prevent seizures (such as Carbamazepine or Phenobarbital). Using seizure medications for off-label use (indications other than treatment for seizures) will not be included as an exclusion, these will be assessed on a case-by-case basis