Smoking
Conditions
Keywords
smoker, smoking, nicotine levels, tobacco, nicotine
Brief summary
Smoking remains a leading cause of preventable disease and premature death worldwide. Approximately 1 out of every 5 deaths is associated with cigarette smoking, and roughly half of all daily smokers will die prematurely from tobacco-related illness. Reducing the nicotine in cigarettes to the point that they are rendered non-addictive can potentially be an effective public policy measure that can significantly reduce tobacco-related mortality and morbidity by decreasing the initiation of smoking and promoting cessation. The Family Smoking Prevention and Tobacco Control Act (FSPTCA) enables the FDA to establish tobacco product standards including placing limits on the allowable nicotine content of cigarettes. Currently, no reduced nicotine cigarettes are available that will allow studying the feasibility of this policy measure. The National Institute on Drug Abuse has contracted with Research Triangle Institute to assist in the development of cigarettes with varying nicotine content that can be made available to researchers. They have established a contract that will result in the manufacture of 9 million cigarettes to be distributed to the research community. Prior to full production, the palatability and nicotine intake of these cigarettes in smokers must be determined.
Detailed description
Phase 3: This descriptive study will use a between subjects, double blind design. This study will test 3 nicotine levels of nicotine, tar and ventilation. Subjects and research assistants will be blind to the cigarette type.
Interventions
OTHERLow level nicotine cigarette
smoke the study cigarette exclusively for one week
OTHERIntermediate nicotine level cigarette
smoke the study cigarette exclusively for one week
OTHERHigh level nicotine cigarette
smoke the study cigarette exclusively for one week
Sponsors
University of Minnesota
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-64 years old * Regular smokers (10+ cigarettes per day and has done so for the last year) * Inhaling when smoking * Carbon monoxide (CO) \> 8 ppm
Exclusion criteria
* In the past year, suffered from any cardiovascular disease such as: heart disease, heart attack, stroke or angina, any respiratory diseases such as chronic bronchitis or chronic obstructive pulmonary disease (COPD), any type of cancer * Currently suffering from Bipolar Disorder, General Anxiety Disorder, Schizophrenia, or a major depressive episode * Taken any of the following drugs more than twice per week during the past month: antidepressants, anti-anxiety medications. * Consumed more than 15 alcoholic drinks per week for the past month * Pregnant, trying to become pregnant, or lactating (assessed by self-report) * In the past 3 months, used nicotine replacement products (like the patch, gum, or inhaler), or the medications bupropion varenicline * Currently trying or planning to reduce or quit tobacco use in the next 30 days * Used other forms of tobacco 10 or more days in the past 30 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in UrineTotal Nicotine Equivalent (TNE) Between Baseline and Week 1 | Second Visit (Week 1) minus Baseline (Day 1) | Two urine TNE levels are taken, one at baseline and one at week 1, to assess TNE levels for nicotine exposure. TNE is the sum of nicotine, cotinine, trans 3'-hydroxycotinine and their respective glucuronide conjugates. Values reported in nmols/ml. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Responses on Modified Cigarette Evaluation Scale | Baseline usual brand cigarettes (Day 1) compared to when using study cigarettes (Week 1) | Modified Cigarette Evaluation Scale \[CES\] is a 100 mm visual analog scale (0=not at all or very little nicotine; 100=extremely or high in nicotine) of 20 questions assessing different dimensions of responses to usual brand cigarettes (e.g., psychological reward, satisfaction and aversiveness) and includes additional 5 point likert-type questions (definitely agree to definitely disagree) on perceptions of satisfaction and willingness to use the product. Results satisfaction subscale. |
| Change From Baseline of Perceived Health Risk Scale Response to Test Cigarettes | Baseline (Day 1) Compared to Second Visit (Week 1) | Questionnaire: Perceived Health Risk Scale asks subjects to rate their perception of health risks for lung cancer for the study product to which they have been randomly assigned. This is a 100 mm visual analog scale; 0=very low risk of disease, 100=very high risk of disease. |
| Comparison of Number of Cigarettes Smoked | 1 week | Subjects were given a daily diary to collect the number of study and/or conventional cigarettes they have smoked each day. Cigarettes smoked (both usual brand and experimental) in a given week were summed over the first 7 reported days. If the number of cigarettes smoked was missing for 1 day, the average of the other days in that week was used in its place and reported as total number of cigarettes per week. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Arm 1 Low Level Nicotine Cigarette Low level nicotine cigarette (0.400 mg/g; menthol 0.405 mg/g): smoke the study cigarette exclusively for one week | 12 |
| Arm 2 Intermediate Nicotine Level Cigarette Intermediate nicotine level cigarette (5.86 mg/g menthol 5.87 mg/g): smoke the study cigarette exclusively for one week | 11 |
| Arm 3 High Level Nicotine Cigarette High level nicotine cigarette (10.4 mg/g; menthol: 12.3): smoke the study cigarette exclusively for one week | 12 |
| Total | 35 |
Baseline characteristics
| Characteristic | Arm 1 Low Level Nicotine Cigarette | Arm 2 Intermediate Nicotine Level Cigarette | Arm 3 High Level Nicotine Cigarette | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 12 Participants | 11 Participants | 12 Participants | 35 Participants |
| Age, Continuous | 37.0 years STANDARD_DEVIATION 12.4 | 32.7 years STANDARD_DEVIATION 10.8 | 43.6 years STANDARD_DEVIATION 9.6 | 37.9 years STANDARD_DEVIATION 11.6 |
| Cigarettes per day | 16.8 Cigarettes per day STANDARD_DEVIATION 5.1 | 16.1 Cigarettes per day STANDARD_DEVIATION 3.5 | 18.7 Cigarettes per day STANDARD_DEVIATION 4.3 | 17.2 Cigarettes per day STANDARD_DEVIATION 4.4 |
| Menthol Menthol | 4 participants | 3 participants | 4 participants | 11 participants |
| Menthol Non Menthol | 8 participants | 8 participants | 8 participants | 24 participants |
| Region of Enrollment United States | 12 participants | 11 participants | 12 participants | 35 participants |
| Sex: Female, Male Female | 8 Participants | 7 Participants | 5 Participants | 20 Participants |
| Sex: Female, Male Male | 4 Participants | 4 Participants | 7 Participants | 15 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 0 / 12 | 0 / 11 | 0 / 12 |
| serious Total, serious adverse events | 0 / 12 | 0 / 11 | 0 / 12 |
Outcome results
Primary
Change in UrineTotal Nicotine Equivalent (TNE) Between Baseline and Week 1
Two urine TNE levels are taken, one at baseline and one at week 1, to assess TNE levels for nicotine exposure. TNE is the sum of nicotine, cotinine, trans 3'-hydroxycotinine and their respective glucuronide conjugates. Values reported in nmols/ml.
Time frame: Second Visit (Week 1) minus Baseline (Day 1)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Arm 1 Low Level Nicotine Cigarette | Change in UrineTotal Nicotine Equivalent (TNE) Between Baseline and Week 1 | -16.2 nmols/ml | Standard Error 5 |
| Arm 2 Intermediate Nicotine Level Cigarette | Change in UrineTotal Nicotine Equivalent (TNE) Between Baseline and Week 1 | -7.6 nmols/ml | Standard Error 4.7 |
| Arm 3 High Level Nicotine Cigarette | Change in UrineTotal Nicotine Equivalent (TNE) Between Baseline and Week 1 | 1.3 nmols/ml | Standard Error 4.4 |
Secondary
Change From Baseline of Perceived Health Risk Scale Response to Test Cigarettes
Questionnaire: Perceived Health Risk Scale asks subjects to rate their perception of health risks for lung cancer for the study product to which they have been randomly assigned. This is a 100 mm visual analog scale; 0=very low risk of disease, 100=very high risk of disease.
Time frame: Baseline (Day 1) Compared to Second Visit (Week 1)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Arm 1 Low Level Nicotine Cigarette | Change From Baseline of Perceived Health Risk Scale Response to Test Cigarettes | 56.6 units on a scale | Standard Error 4.6 |
| Arm 2 Intermediate Nicotine Level Cigarette | Change From Baseline of Perceived Health Risk Scale Response to Test Cigarettes | 66.7 units on a scale | Standard Error 4.6 |
| Arm 3 High Level Nicotine Cigarette | Change From Baseline of Perceived Health Risk Scale Response to Test Cigarettes | 68.3 units on a scale | Standard Error 4.6 |
Secondary
Comparison of Number of Cigarettes Smoked
Subjects were given a daily diary to collect the number of study and/or conventional cigarettes they have smoked each day. Cigarettes smoked (both usual brand and experimental) in a given week were summed over the first 7 reported days. If the number of cigarettes smoked was missing for 1 day, the average of the other days in that week was used in its place and reported as total number of cigarettes per week.
Time frame: 1 week
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Arm 1 Low Level Nicotine Cigarette | Comparison of Number of Cigarettes Smoked | 92.1 cigarettes per week | Standard Deviation 15.9 |
| Arm 2 Intermediate Nicotine Level Cigarette | Comparison of Number of Cigarettes Smoked | 112.8 cigarettes per week | Standard Deviation 49.4 |
| Arm 3 High Level Nicotine Cigarette | Comparison of Number of Cigarettes Smoked | 157.6 cigarettes per week | Standard Deviation 15.2 |
Secondary
Responses on Modified Cigarette Evaluation Scale
Modified Cigarette Evaluation Scale \[CES\] is a 100 mm visual analog scale (0=not at all or very little nicotine; 100=extremely or high in nicotine) of 20 questions assessing different dimensions of responses to usual brand cigarettes (e.g., psychological reward, satisfaction and aversiveness) and includes additional 5 point likert-type questions (definitely agree to definitely disagree) on perceptions of satisfaction and willingness to use the product. Results satisfaction subscale.
Time frame: Baseline usual brand cigarettes (Day 1) compared to when using study cigarettes (Week 1)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Arm 1 Low Level Nicotine Cigarette | Responses on Modified Cigarette Evaluation Scale | 36.8 units on a scale | Standard Error 4.1 |
| Arm 2 Intermediate Nicotine Level Cigarette | Responses on Modified Cigarette Evaluation Scale | 54.1 units on a scale | Standard Error 4.1 |
| Arm 3 High Level Nicotine Cigarette | Responses on Modified Cigarette Evaluation Scale | 61.4 units on a scale | Standard Error 4.1 |