Nicotine Dependence
Conditions
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
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
Study design
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
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
| Measure | Time frame | Description |
|---|---|---|
| Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | up to 55 minutes post-infusion | 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. |
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
| Arm | Count |
|---|---|
| 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 |
| Total | 57 |
Baseline characteristics
| Characteristic | Menthol-Preferring Smokers | Non-Menthol-Preferring Smokers | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 32 Participants | 25 Participants | 57 Participants |
| Age, Continuous | 24.2 years STANDARD_DEVIATION 3.6 | 24.0 years STANDARD_DEVIATION 3.6 | 24.1 years STANDARD_DEVIATION 3.6 |
| Nicotine Metabolite Ratio | 0.29 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 participants | 25 participants | 57 participants |
| Sex: Female, Male Female | 12 Participants | 1 Participants | 13 Participants |
| Sex: Female, Male Male | 20 Participants | 24 Participants | 44 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 32 | 0 / 25 |
| other Total, other adverse events | 0 / 32 | 0 / 25 |
| serious Total, serious adverse events | 0 / 32 | 0 / 25 |
Outcome results
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
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Menthol-Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | High Menthol w Low Nicotine | 5.226 scores on a scale | Standard Error 0.4766 |
| Menthol-Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Low Menthol w High Nicotine | 5.8971 scores on a scale | Standard Error 0.4736 |
| Menthol-Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | High Menthol w High Nicotine | 5.6235 scores on a scale | Standard Error 0.4731 |
| Menthol-Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Low Menthol w Low Nicotine | 5.5481 scores on a scale | Standard Error 0.4809 |
| Menthol-Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | High Menthol w Saline | 5.0699 scores on a scale | Standard Error 0.4768 |
| Menthol-Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Low Menthol w Saline | 4.4655 scores on a scale | Standard Error 0.4741 |
| Menthol-Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Across Conditions (main effect) | 5.1979 scores on a scale | Standard Error 0.3803 |
| Non-Menthol Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Low Menthol w Saline | 6.3960 scores on a scale | Standard Error 0.5307 |
| Non-Menthol Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Across Conditions (main effect) | 6.8384 scores on a scale | Standard Error 0.4292 |
| Non-Menthol Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | High Menthol w High Nicotine | 7.6285 scores on a scale | Standard Error 0.5287 |
| Non-Menthol Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | High Menthol w Low Nicotine | 7.4351 scores on a scale | Standard Error 0.5302 |
| Non-Menthol Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | High Menthol w Saline | 7.6285 scores on a scale | Standard Error 0.5287 |
| Non-Menthol Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Low Menthol w High Nicotine | 7.5808 scores on a scale | Standard Error 0.5346 |
| Non-Menthol Preferring Smokers | Drug Effects Questionnaire (DEQ)- 'Good Drug Effects' | Low Menthol w Low Nicotine | 6.7656 scores on a scale | Standard Error 0.5363 |