Electronic Cigarettes as a Harm Reduction Strategy Among Patients With COPD

Inclusion Criteria: 1. an ambulatory ICD-10 code for COPD in the last 12 months and a COPD Assessment Tool (CAT) score on the screening ≥10. 2. ages 21-75 (the legal age for purchasing e-cigarettes is 21) 3. current CC smokers (more than 5 packs in a lifetime; smokes 4 or more days/week) 4. smokes at least 10 cigarettes per day on days they smoke CC 5. motivated to quit smoking (at least a 5 on a 10-point Likert scale) 6. Participants must be able to provide consent, agree to be randomized and followed-up with, a working telephone number and/or a system with teleconferencing capabilities (e.g. smartphone or computer), a phone with text messaging capabilities, and be willing to use an e-cigarette or NRT for 12 weeks. To reduce attrition, participants will be asked to provide one additional contact as a backup for follow up on appointments. Exclusion Criteria: 1. A CAT score \>30 representing severe COPD 2. are pregnant (as determined by urine pregnancy test for women under age 52) or breastfeeding (self-reported). Women of childbearing age must also be willing to use an approved form of birth control during the course of the study if not practicing abstinence. Approved birth control methods include: hormonal birth control (e.g. "the pill"), barrier methods (e.g. condoms, diaphragm), and intrauterine devices (IUDs). 3. diagnosis of any medical condition (unstable angina/heart disease) or psychiatric condition precluding use of nicotine patch or gum as determined by the MD of this study, Dr. Scott Sherman (NYS license #171632), or by the subject's primary care doctor. 4. reporting using NRTs or e-cigarettes within the last 30 days