Health Behavior
Conditions
Keywords
smoking
Brief summary
This study will examine whether nicotine levels increase with electronic cigarettes. It will also examine whether electronic cigarettes alter lung function tests. The study will obtain preliminary data on the medical effects of electronic cigarettes, with two different nicotine flavors, tobacco and tobacco with menthol, which are available for over the counter purchase. The electronic cigarettes and juice used in this study is available for purchase through the internet. An investigational new drug application (IND) is not needed for this study.
Detailed description
This is a randomized two-period cross-over study in which subjects who smoke greater than 10 cigarettes will be instructed to quit smoking and use either Joye (Ego C brand) with an 18 mg cartridge containing either a tobacco or tobacco mentholated flavor for one week. Prior to starting e-cig use we will collect one blood sample for nicotine/cotinine as a measure of overall nicotine exposure. Subjects will use the device for one week and at the end of approximately one week of use, we will assess nicotine/cotinine concentrations (before and 5, 10, 15, 20 and 30 minutes after the onset of ECIG use), pulmonary function tests (before and 5 minutes after ECIG use), and subjective impressions of satisfaction. At the end of one week, subjects will be crossed over to the other condition and assessments will be repeated after another week of E-cigarette use. A total of 30 smokers will be recruited from the surrounding areas via advertisements in newspapers and radio advertisements and University of Connecticut Health Center (UCHC) broadcast e-mail. Posters will be placed in clinical areas to recruit from physician practices. Current smokers are being proposed for three reasons: 1) we wish to determine whether nicotine levels from e-cigarettes rise to the levels of regular cigarettes when used by regular smokers; 2) we wish to determine if there are any differences seen in pulmonary function when a person switches from regular cigarettes to e-cigarettes; 3) we wish to evaluate the level of satisfaction that regular smokers have with e-cigarettes. All of these questions will have implications for later, more extensive studies of e-cigarettes, particularly in regard to their utility as a smoking cessation modality. Once a potential study subject calls and expresses interest in the study, preliminary inclusion criteria will be assessed over the phone. Inclusion criteria include 1) at least 18 years of age; 2) current use of at least 10 cigarettes daily; 3) willing to abstain from cigarette smoking, and substitute e-cigs, for approximately 2 weeks; 4) able to read and sign a consent form; Exclusion criteria: 1) unstable medical or psychiatric disorders as determined by the principal investigator; 2) pregnancy; 3) known hypersensitivity to nicotine or propylene glycol or menthol; 4) previous myocardial infarction (M.I.) or stroke; 5) uncontrolled hypertension \[Blood pressure (BP) \>160/100); 6) insulin dependent diabetes; 7) known chronic obstructive pulmonary disease (COPD) or asthma.
Interventions
Subjects randomized to either Tobacco Flavor group for 7-10 days than crossed over to Tobacco & Menthol Flavor for 7-10 days or Tobacco & Menthol Flavor group for 7-10 days than crossed over to Tobacco Flavor for 7-10 days
Sponsors
Study design
Eligibility
Inclusion criteria
* Smoking 10 cigarettes daily * Agree to abstain from smoking and use electronic cigarettes for 2 weeks
Exclusion criteria
* Unstable medical or psychiatric disorders as determined by the principal investigator * Pregnancy * Known hypersensitivity to nicotine or propylene glycol or menthol * Recent M. I. or stroke * Uncontrolled hypertension (BP.\>160/100) * Insulin dependent diabetes * Known COPD or asthma * Alcohol or other drug abuse or dependence
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Effects E-cig Use on Venous Nicotine Concentrations Before and 5 Minutes After Use | 7-10 days | To determine the effects of acute E-cig use on venous nicotine concentrations 5 minutes before and 5 minutes after 7-10 days of e-cigarette use. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Nicotine With Tobacco Flavor and With Tobacco & Menthol Flavor Smokers were assigned to electronic cigarettes containing 18mg/mL of nicotine in either a tobacco flavor solution or a tobacco and menthol flavor solution and then switched to other flavor for an additional 7 to 10 days. Monitoring sessions occurred on the last day of trial period of each flavor. | 27 |
| Total | 27 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| First 7-10 Days | Adverse Event | 0 | 1 |
| First 7-10 Days | concerns with using IV | 1 | 2 |
| First 7-10 Days | family emergency | 0 | 1 |
| First 7-10 Days | time commitment | 0 | 2 |
| Second 7-10 Days | concerns with using IV | 0 | 1 |
| Second 7-10 Days | time commitment | 0 | 1 |
Baseline characteristics
| Characteristic | Nicotine With Tobacco Flavor and With Tobacco & Menthol Flavor |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 27 Participants |
| Age, Continuous | 43 years STANDARD_DEVIATION 10.24 |
| Sex: Female, Male Female | 14 Participants |
| Sex: Female, Male Male | 13 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 1 / 13 | 0 / 12 | 6 / 14 | 2 / 8 |
| serious Total, serious adverse events | 0 / 13 | 0 / 12 | 0 / 14 | 0 / 8 |
Outcome results
Effects E-cig Use on Venous Nicotine Concentrations Before and 5 Minutes After Use
To determine the effects of acute E-cig use on venous nicotine concentrations 5 minutes before and 5 minutes after 7-10 days of e-cigarette use.
Time frame: 7-10 days
Population: Nicotine Concentrations Before and 5 Minutes After Ecig Use were intended to be analyzed, regardless of flavor, as pre-specified in the study protocol,
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Tobacco Flavor | Effects E-cig Use on Venous Nicotine Concentrations Before and 5 Minutes After Use | Before Ecig used | 4.30 ng/ml | Standard Error 0.66 |
| Tobacco Flavor | Effects E-cig Use on Venous Nicotine Concentrations Before and 5 Minutes After Use | 5 minutes after ecig use | 8.66 ng/ml | Standard Error 0.08 |
| Tobacco & Menthol Flavor | Effects E-cig Use on Venous Nicotine Concentrations Before and 5 Minutes After Use | Before Ecig used | 4.11 ng/ml | Standard Error 1.23 |
| Tobacco & Menthol Flavor | Effects E-cig Use on Venous Nicotine Concentrations Before and 5 Minutes After Use | 5 minutes after ecig use | 8.77 ng/ml | Standard Error 1.53 |