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The Effects of Menthol as Delivered by an Electronic Cigarette on the Desirability of Nicotine in Tobacco Users

Menthol's Effects on Nicotine Reinforcement in Smokers

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02102100
Enrollment
57
Registered
2014-04-02
Start date
2014-03-26
Completion date
2016-07-11
Last updated
2020-03-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Nicotine Dependence

Keywords

menthol, electronic cigarette, nicotine, smoking, tobacco

Brief summary

This study will help determine if menthol administered by inhalation via electronic cigarettes (e-cigarette) changes the reinforcing effects of pure nicotine administered intravenously in cigarette smokers who smoke mentholated or non-mentholated cigarettes.

Detailed description

Male and female smokers will be recruited from the New Haven area through newspaper advertisements, radio advertisements, and fliers. Interested subjects will have the study described over the telephone, and they will be asked to answer a brief tobacco use history and medical screening questionnaire. If subjects pass the telephone screening, they will be invited to come to the West Haven VA clinic for a screening evaluation. This screening evaluation will be for the menthol / nicotine reinforcement study as described in detail in this project description. The dose-finding study was conducted at the John B. Pierce Laboratory. The dose finding study concluded with the establishment of the high and low dose of menthol that will be used in this protocol Menthol's Effects on Nicotine Reinforcement in Smokers. The screening of these subjects used the same inclusion and exclusion criteria as described below. Inclusion criteria: Female and male smokers, aged 18 to 30 years; history of smoking for the past 12 months, at least one cigarette per day; smoking status is verified with urinary cotinine levels above 10 ng/ml; not seeking treatment for nicotine dependence at the time of study entry; in good health as verified by medical history, screening examination, and screening laboratory tests; for women, not pregnant as determined by pregnancy screening, nor breast feeding, and using acceptable birth control methods. Exclusion criteria: History of major medical illnesses that the physician investigator deems as contraindicated for the patient to be in the study; regular use of psychotropic medication (antidepressants, antipsychotics, or anxiolytics); psychiatric diagnosis and / or treatment for Axis I disorders including major depression, bipolar affective disorder, schizophrenia or panic disorder in the past month and abuse of alcohol or any other recreational or prescription drugs in the past 30 days. Any allergy to propylene glycol or menthol. This outpatient, double-blind, placebo-controlled study consisted of an adaptation session followed by three test sessions. All participants were randomized to a test session order and received control menthol (0.0% + tobacco flavor), low menthol (0.5% + tobacco flavor), and high menthol (3.2% + tobacco flavor) by standardized inhalation from an e-cigarette just prior to each nicotine infusion (a single menthol condition for each test session). Within each test session, all 3 IV nicotine conditions were tested, one hour apart, by delivering saline, nicotine at 0.25 mg nicotine/70 kg and nicotine at 0.5 mg nicotine/70 kg, in a random order, just after last inhalation. For each participant, the randomized nicotine infusion sequence was fixed across the three test sessions, each performed at least 24 hours apart.

Interventions

DRUGnicotine

In each of 3 test sessions, subjects in each arm will receive a randomized sequence of three intravenous infusions (30 sec each), one hour apart. The infusions will consist of saline, nicotine (.25 mg / 70kg) and nicotine (0.5 mg / 70 kg). The randomized sequence will remain the same between test sessions for a given subject.

In each of 3 test sessions, subjects will take 6 inhalations from the study e-cigarette, one inhalation every 15 seconds, of the randomized menthol condition for that test session ust prior to each intravenous infusion. The menthol conditions are: 3.2% menthol, 0.5% menthol and tobacco-flavor only (0.0% menthol)

Sponsors

National Institute on Drug Abuse (NIDA)
CollaboratorNIH
Yale University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Investigator)

Intervention model description

Subjects in each of the 2 arms received a random sequence of 3 different inhaled menthol conditions across 3 test sessions (a single menthol condition for each test session). In each test session, a random order of one saline, and 2 nicotine (0.25 mg and 0.5 mg /70 kg) infusions were given one hour apart, concurrent with the randomized menthol inhalation condition for that test session. The randomized sequence of nicotine infusions was the same for each test session.

Eligibility

Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes

Inclusion criteria

* Female and male smokers, aged 18 to 30 years; * History of smoking for the past 12 months, at least one cigarette per day; smoking status is verified with urinary cotinine levels above 10 ng/ml; * Not seeking treatment for nicotine dependence at the time of study entry; * In good health as verified by medical history, screening examination, and screening laboratory tests; * For women, not pregnant as determined by pregnancy screening, nor breast feeding, and using acceptable birth control methods.

Exclusion criteria

* History of major medical illnesses that the physician investigator deems as contraindicated for the patient to be in the study * Regular use of psychotropic medication (antidepressants, antipsychotics, or anxiolytics); * A psychiatric diagnosis and / or treatment for Axis I disorders including major depression, bipolar affective disorder, schizophrenia or panic disorder in the past month * Abuse of alcohol or any other recreational or prescription drugs in the past 30 days. * Any allergy to propylene glycol or menthol.

Design outcomes

Primary

MeasureTime frameDescription
Drug Effects Questionnaire (DEQ)- 'Good Drug Effects'up to 55 minutes post-infusionThe Drug Effects Questionnaire (DEQ) is used in studies of acute subjective response (SR) to a variety of substances. The DEQ consists of 11 questions: cooling effect, dislike the sensation, any sensations, feel a drug effect, high, feel stimulated, feel a head rush, like drug effect, dislike any effects, craving a cigarette, and like more of the drug. To calculate the DEQ- 'Good Drug Effects', peak values from post-infusion time points were calculated for the change in the intensity of positive subjective effects as measured with 2 DEQ questions - DEQ question #6 'like drug effect' and DEQ question #11 'would like more of the drug'. Each question was measured on a scale with a minimum score of 0 and a maximum score of 100.The peak values for like and I want more were averaged to obtain a summary score to represent the feel 'Good Drug Effects' composite factor. DEQ measures were skewed and square root transformations were used. Higher scores indicate more positive effects.

Countries

United States

Participant flow

Recruitment details

Male and female smokers between the ages of 18 and 30 yrs, with a history of smoking for the past 12 months, at least one cigarette per day.

Participants by arm

ArmCount
Menthol-Preferring Smokers
Menthol smokers randomized to a test session order and received control menthol (0.0% + tobacco flavor), low menthol (0.5% + tobacco flavor), and high menthol (3.2% + tobacco flavor) by standardized inhalation from an e-cigarette just prior to each nicotine infusion (a single menthol condition for each test session). Within each test session, all three IV nicotine conditions were tested, 1 hour apart, by delivering saline, nicotine at 0.25 mg nicotine/70 kg and nicotine at 0.5 mg nicotine/70 kg, in a random order, just after last inhalation. For each participant, the randomized nicotine infusion sequence was fixed across the three test sessions, each performed at least 24 hours apart.
32
Non-Menthol-Preferring Smokers
Non-menthol smokers randomized to a test session order and received control menthol (0.0% + tobacco flavor), low menthol (0.5% + tobacco flavor), and high menthol (3.2% + tobacco flavor) by standardized inhalation from an e-cigarette just prior to each nicotine infusion (a single menthol condition for each test session). Within each test session, all three IV nicotine conditions were tested, 1 hour apart, by delivering saline, nicotine at 0.25 mg nicotine/70 kg and nicotine at 0.5 mg nicotine/70 kg, in a random order, just after last inhalation. For each participant, the randomized nicotine infusion sequence was fixed across the three test sessions, each performed at least 24 hours apart.
25
Total57

Baseline characteristics

CharacteristicMenthol-Preferring SmokersNon-Menthol-Preferring SmokersTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
32 Participants25 Participants57 Participants
Age, Continuous24.2 years
STANDARD_DEVIATION 3.6
24.0 years
STANDARD_DEVIATION 3.6
24.1 years
STANDARD_DEVIATION 3.6
Nicotine Metabolite Ratio0.29 ratio
STANDARD_DEVIATION 0.19
0.55 ratio
STANDARD_DEVIATION 0.35
0.40 ratio
STANDARD_DEVIATION 0.3
Region of Enrollment
United States
32 participants25 participants57 participants
Sex: Female, Male
Female
12 Participants1 Participants13 Participants
Sex: Female, Male
Male
20 Participants24 Participants44 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 320 / 25
other
Total, other adverse events
0 / 320 / 25
serious
Total, serious adverse events
0 / 320 / 25

Outcome results

Primary

Drug Effects Questionnaire (DEQ)- 'Good Drug Effects'

The Drug Effects Questionnaire (DEQ) is used in studies of acute subjective response (SR) to a variety of substances. The DEQ consists of 11 questions: cooling effect, dislike the sensation, any sensations, feel a drug effect, high, feel stimulated, feel a head rush, like drug effect, dislike any effects, craving a cigarette, and like more of the drug. To calculate the DEQ- 'Good Drug Effects', peak values from post-infusion time points were calculated for the change in the intensity of positive subjective effects as measured with 2 DEQ questions - DEQ question #6 'like drug effect' and DEQ question #11 'would like more of the drug'. Each question was measured on a scale with a minimum score of 0 and a maximum score of 100.The peak values for like and I want more were averaged to obtain a summary score to represent the feel 'Good Drug Effects' composite factor. DEQ measures were skewed and square root transformations were used. Higher scores indicate more positive effects.

Time frame: up to 55 minutes post-infusion

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Menthol-Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'High Menthol w Low Nicotine5.226 scores on a scaleStandard Error 0.4766
Menthol-Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Low Menthol w High Nicotine5.8971 scores on a scaleStandard Error 0.4736
Menthol-Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'High Menthol w High Nicotine5.6235 scores on a scaleStandard Error 0.4731
Menthol-Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Low Menthol w Low Nicotine5.5481 scores on a scaleStandard Error 0.4809
Menthol-Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'High Menthol w Saline5.0699 scores on a scaleStandard Error 0.4768
Menthol-Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Low Menthol w Saline4.4655 scores on a scaleStandard Error 0.4741
Menthol-Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Across Conditions (main effect)5.1979 scores on a scaleStandard Error 0.3803
Non-Menthol Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Low Menthol w Saline6.3960 scores on a scaleStandard Error 0.5307
Non-Menthol Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Across Conditions (main effect)6.8384 scores on a scaleStandard Error 0.4292
Non-Menthol Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'High Menthol w High Nicotine7.6285 scores on a scaleStandard Error 0.5287
Non-Menthol Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'High Menthol w Low Nicotine7.4351 scores on a scaleStandard Error 0.5302
Non-Menthol Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'High Menthol w Saline7.6285 scores on a scaleStandard Error 0.5287
Non-Menthol Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Low Menthol w High Nicotine7.5808 scores on a scaleStandard Error 0.5346
Non-Menthol Preferring SmokersDrug Effects Questionnaire (DEQ)- 'Good Drug Effects'Low Menthol w Low Nicotine6.7656 scores on a scaleStandard Error 0.5363
Comparison: Least square means and standard errors were calculated to describe the patterns of means for each outcome. Effect slices were tested to explain significant interactions in the models. Pairwise comparisons of least square means were used to describe significant main effects.p-value: <0.0001Mixed Models Analysis

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026