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Vaping THC From Electronic Cigarettes

Vaping THC From Electronic Cigarettes: a Novel Evaluation of Intake and Pharmacokinetics

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02955329
Acronym
V-PAX
Enrollment
8
Registered
2016-11-04
Start date
2019-03-20
Completion date
2019-11-30
Last updated
2023-06-29

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

Conditions

Marijuana Dependence

Keywords

THC, Tobacco, Vaping

Brief summary

This study aims to understand THC pharmacology and the safety of cannabis vaping, including the pharmacology and safety of co-administration of nicotine and THC. The study is designed as a within-subjects single-blinded crossover study. Fourteen smokers of tobacco cigarettes and cannabis will switch between three conditions, namely: (a) vaping cannabis leaf, (b) vaping tobacco containing nicotine and (c) vaping a combination of cannabis leaf and tobacco containing nicotine. All participants will vape each product with the PAX loose-leaf vaporizer. The study will be conducted during three outpatient visits separated by at least 48 hours. The order of treatment (cannabis leaf, tobacco with nicotine, cannabis leaf & tobacco with nicotine) will be counterbalanced between subjects. Subjects will be blinded to the content of the vaporizer on the study day but will be told during screening that they will vape cannabis alone, tobacco alone, and cannabis plus tobacco with nicotine.

Detailed description

Electronic cigarettes (e-cigarettes) have proliferated at a rapid rate since their introduction into the US market in 2007, and their use as a form of nicotine delivery far outpaced the science base. Although the design of these devices continues to evolve, we have previously described nicotine intake, systemic retention, pharmacokinetics, and vaping behavior associated with self-administration of e-cigarettes. We demonstrated that while the shape of the plasma nicotine concentration-time curve for e-cigarettes is similar to tobacco cigarettes, the maximum plasma nicotine concentration is, on average, lower for e-cigarettes. During ad libitum access, e-cigarettes were vaped intermittently in groups of 2-5 puffs or single puffs such that plasma nicotine levels rose gradually and peaked at the end of the 90-minute session. This differs from the rapid increase in plasma nicotine observed during controlled use of e-cigarettes or during tobacco cigarette smoking. Taken together, these results indicate that e-cigarettes have the potential to produce and sustain nicotine addiction but their use and abuse liability may differ from tobacco cigarettes. The study is designed as a within-subjects, single-blinded crossover study. Fourteen smokers of tobacco cigarettes and cannabis will switch between three conditions, namely: (a) vaping cannabis leaf, (b) vaping tobacco containing nicotine and (c) vaping a combination of cannabis leaf and tobacco containing nicotine. All participants will vape each product with the PAX loose-leaf vaporizer, which will be purchased by the study team. The cannabis leaf will be obtained through the National Institute on Drug Abuse Drug Supply Program. The tobacco-containing nicotine, used in conditions (b) and (c) will come from commercially available Marlboro brand cigarettes. The same amount of cannabis or tobacco will be used in all conditions. The study will be conducted during three outpatient visits separated by at least 48 hours. The order of treatment (cannabis leaf, tobacco with nicotine, cannabis leaf & tobacco with nicotine) will be counterbalanced between subjects. Subjects will be blinded to the content of the vaporizer on the study day but will be told during screening that they will vape cannabis alone, tobacco alone, and cannabis plus tobacco with nicotine. While scientists struggle to keep up with the latest electronic cigarette trends, the use of these devices for cannabis rather than nicotine is increasingly prevalent. Electronic cigarette use is not restricted to nicotine. Marijuana, the most widely used illicit drug has traditionally been combusted but the vaping of loose-leaf marijuana and THC oil has been increasing. the latest national data show that 7.6% of current marijuana users (past 30 days) and 9.9% of ever cannabis users (lifetime) administered THC through a vaporizer or electronic device (the study did not differentiate between vaporizers and electronic devices like e-cigarettes). The prevalence of vaped marijuana or THC is higher among younger adults. Prevalence of vaped marijuana/THC among 18-24 and 25-34 year-old ever marijuana users was 19.3% and 16.3%, respectively, compared to 8.8% for 35-49 year-olds and 5.7% for those 50 years and over. A recent study also showed high rates of cannabis vaping among high school students (18.0% among ever e-cigarette users). Smoking of a combination of tobacco and marijuana in cigarette form is also common, particularly in Europe. However, very little is known about the safety and pharmacokinetics of this co-administration making it a critical area of research.

Interventions

DRUGNicotine

Participants will vape tobacco leaves with nicotine out of the PAX device.

DRUGCannabis

Participants will vape marijuana leaves with nicotine out of the PAX device.

In all three arms, the participant will be using the same PAX electronic cigarette device. The only difference is whether the participant will be vaping nicotine only, THC only, or nicotine and THC.

Sponsors

National Institutes of Health (NIH)
CollaboratorNIH
National Institute on Drug Abuse (NIDA)
CollaboratorNIH
University of California, San Francisco
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
SINGLE (Subject)

Eligibility

Sex/Gender
ALL
Age
21 Years to 70 Years
Healthy volunteers
Yes

Inclusion criteria

Inclusion * Age \>=21 years \<=70 years * Regular user of tobacco cigarettes (daily or most days) * Regular user of cannabis in any form (combusted or ingested) at least 5 days out of the month. * Positive for Tetrahydrocannabinol (THC) on screening toxicology test * Willing to abstain from tobacco smoking and all other combustible products (ex: cigars) for 12 hours prior to each outpatient hospital admission. * Willing to abstain from smoking/ingesting cannabis for 12 hours prior to each outpatient hospital admission. * Willing to abstain from using any kind of nicotine products for 12 hours prior to each outpatient hospital admission (ex: electronic cigarettes, nicotine replacement therapy). * Saliva cotinine ≥ 30 ng/mL and/or NicAlert of 6 * Healthy (based on limited physical examination and medical history collected during screening) * Heart rate \< 105 beats per minute (BPM) * Systolic Blood Pressure \< 160 and \> 90 (considered out of range if both machine and manual readings are above/below these thresholds) * Diastolic Blood Pressure \< 100 and \> 50 (considered out of range if both machine and manual readings are above/below these thresholds) * Body Mass Index ≤\<=38.0 Exclusion * Medical (The following unstable medical conditions): * Heart disease * Uncontrolled hypertension * Thyroid disease (okay if controlled with medication) * Diabetes * Hepatitis B or C or Liver disease * Glaucoma * Prostatic hypertrophy * History of paranoia after marijuana use * Psychiatric conditions * Current or past schizophrenia, and/or current or past bipolar disorder * Adult onset Attention-deficit/hyperactivity disorder (ADHD) (if being treated) * Participants with current or past depression and/or anxiety disorders will be reviewed by the study physician and considered for inclusion * History of psychiatric hospitalizations are not exclusionary, but study participation will be determined as per study physician's approval * Drug/Alcohol Dependence * Alcohol or illicit drug dependence within the past 12 months with the exception of those who have recently completed an alcohol/drug treatment program and are currently abstaining from drug and alcohol * Positive toxicology test at the screening visit (THC & prescribed medications okay) * Methadone replacement therapy * Scoring a 2 or higher on the Severity of Dependence Scale for cannabis use. * Psychiatric medications * Current regular use of any psychiatric medications with the exception of Selective Serotonin Reuptake Inhibitors (SSRIs) and serotonin-norepinephrine reuptake Inhibitors (SNRIs) and current evaluation by the study physician that the participant is otherwise healthy, stable, and able to participate. * Other Medications * Use of medications that are inducers of nicotine metabolizing enzyme CYP2A6 (Example: rifampicin, dexamethasone, phenobarbital, and other anticonvulsant drugs). * Concurrent use of nicotine-containing medications * Other/Misc. Chronic Health Conditions * Oral thrush * Fainting * Untreated thyroid disease * Other life threatening illnesses as per study physician's discretion * Use of Other Tobacco Products (OTP); any of the following products in combination more than 15 times in the past month * smokeless tobacco * pipes * cigars, cigarillos * blunts, spliffs * Pregnancy * Pregnancy (self-reported and urine pregnancy test) * Breastfeeding (determined by self-report) * Concurrent participation in another clinical trial * Inability to communicate in English * Planning to quit smoking or cannabis use within the next 60 days

Design outcomes

Primary

MeasureTime frameDescription
Mean Delivered and Retained DosesStudy Day 1-3Delivered Tetrahydrocannabinol (THC) and nicotine doses are estimated as the change in e-cigarette weight × concentration of THC or nicotine in e-liquid. The amount of THC or nicotine systemically retained is estimated as delivered dose minus amount in gas traps.
Median Peak THC Concentration (Cmax)Study Day 1-3Median peak concentration of THC between vaped loose-leaf cannabis, mixture of cannabis and tobacco containing nicotine, and the tobacco alone treatment condition will be reported
Median Peak Nicotine Concentration (Cmax)Study Day 1-3Median peak concentration of nicotine between vaped loose-leaf cannabis, mixture of cannabis and tobacco containing nicotine, and the tobacco alone treatment condition will be reported
Median THC ExposureStudy Day 1-3Median exposure of nicotine using area under the blood/plasma concentration-time curve(AUC) between vaped loose-leaf cannabis, mixture of cannabis and tobacco containing nicotine, and the tobacco alone treatment condition will be reported
Median Nicotine ExposureStudy Day 1-3Compare median exposure of nicotine using AUC (area under the blood/plasma concentration-time curve) between vaped loose-leaf tobacco containing nicotine vs. mixture of cannabis and tobacco containing nicotine.
Mean Heart RateStudy Day 1-3Heart rate monitoring by pulse oximeter
Mean Score on the Drug Effects Questionnaire (DEQ)Study Day 1-3The Drug Effects Questionnaire (DEQ) is widely used in studies of acute subjective response (SR) to a variety of substances which assessed the extent to which participants (1) feel any substance effect(s), (2) feel high, (3) like the effects, (4) dislike the effects, and (5) want more of the substance by instructing participants to place a mark on a 100mm vertical, visual, analog scale with scores ranging from 0 =not at all to 100 = extremely for each question. The mean of the individual responses is used to general a total score with a range from 0 to 100, with higher scores indicate a greater liking of the effects of the substance. The mean and standard deviation of each treatment condition will be reported.
Mean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Study Day 1-3This 12-item multidimensional measure assesses cannabis craving based on 4 factors: Compulsivity, Emotionality, Expectancy, Purposefulness. Each item asks about the respondent's feelings and thoughts about smoking marijuana as he or she is completing the questionnaire (i.e., right now). Each response is scored a number ranging from 1 (strongly disagree) to 7 (strongly agree) with higher scores indicating a greater level of craving. The calculation of each subscale is as follows: Compulsivity: Mean of items 2, 7, and 10; Emotionality: Mean of items 4, 6, and 9; Expectancy: Mean of items 5, 11, and 12; Purposefulness: Mean of items 1, 3, and 8 with the minimum possible score = 1 and the maximum possible score = 7 for any subscale. The mean and standard deviation of each subscale for each treatment condition will be reported.
Mean Scores on the Modified Cigarette Evaluation Questionnaire (mCEQ)Study Day 1-3The modified Cigarette Evaluation Questionnaire (mCEQ) uses three multi-item subscales and two single items: Smoking Satisfaction (items 1, 2, and 12);Psychological Reward (items 4 through 8); Aversion (items 9 and 10);Enjoyment of Respiratory Tract Sensations (item 3); and Craving Reduction(item 11). Scores for each subscale are calculated as the mean of the individual item responses or the single item. Higher scores indicate greater intensity on that scale. Items are rated on a seven-point scale ranging from 1 (not at all) to 7 (extremely) and total scores are averaged across all items with a minimum average score of 1 and a maximum average score of 7. Higher scores indicate greater intensity of each smoking effect with, for example, greater satisfaction or psychological reward after smoking. The mean and standard deviation for each treatment condition will be reported.
Mean Scores on the Positive Affect Negative Affect Schedule (PANAS)Study Day 1-3The Positive and Negative Affect Schedule (PANAS) is a brief scale is comprised of 20 items, with 10 items measuring positive affect (e.g., excited, inspired) and 10 items measuring negative affect (e.g., upset, afraid). Each item is rated on a five-point Likert Scale, ranging from 1 = Very Slightly or Not at all to 5 = Extremely, to measure the extent to which the affect has been experienced in a specified time frame and the final score is derived out of the sum of the ten items on both the positive and negative side. Scores can range from 10-50 for both the Positive and Negative Affect with the lower scores representing lower levels of Positive/Negative Affect and higher scores representing higher levels of Positive/Negative Affect.
Mean Scores on the Minnesota Nicotine Withdrawal Scale (MNWS)Study Day 1-3The Minnesota Nicotine Withdrawal Scale is an 7-item self - report scale designed to measure the severity of craving and withdrawal symptoms experienced during smoking cessation. Each item is rated on a scale of 0 to 4 with 0=none,1= Slight, 2= Mild, 3= Moderate, and 4=Severe. Seven of the items are symptoms derived from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Tobacco Withdrawal diagnosis and are as follows: depression, insomnia, irritability/frustration/anger, anxiety/nervousness, difficulty concentrating, restlessness, increased appetite and at least five of seven items must have responses in order to generate a reliable score. The responses to each item are summed to produce a total withdrawal summary score with greater scores indicating a higher level of severity in nicotine withdrawal symptoms overall. The mean and standard deviation of each treatment condition will be reported with a minimum mean score of 0 and a maximum mean score of 4.

Countries

United States

Participant flow

Pre-assignment details

A total of 8 total participants received all 3 interventions over the course of 3 days, with the sequence of the interventions varied for each participant. The order of treatment (cannabis leaf, tobacco with nicotine, cannabis leaf & tobacco with nicotine) will be counterbalanced between subjects

Participants by arm

ArmCount
All Participants
All participants were enrolled and received each of the interventions in a different order. Each intervention lasted 1 day.
8
Total8

Baseline characteristics

CharacteristicAll Participants
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
8 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
2 Participants
Race (NIH/OMB)
More than one race
3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
3 Participants
Region of Enrollment
United States
8 participants
Sex: Female, Male
Female
1 Participants
Sex: Female, Male
Male
7 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 80 / 80 / 8
other
Total, other adverse events
0 / 80 / 80 / 8
serious
Total, serious adverse events
0 / 80 / 80 / 8

Outcome results

Primary

Mean Delivered and Retained Doses

Delivered Tetrahydrocannabinol (THC) and nicotine doses are estimated as the change in e-cigarette weight × concentration of THC or nicotine in e-liquid. The amount of THC or nicotine systemically retained is estimated as delivered dose minus amount in gas traps.

Time frame: Study Day 1-3

ArmMeasureValue (MEAN)Dispersion
Tobacco ArmMean Delivered and Retained Doses0.016 grams (g)Standard Deviation 0.003
Cannabis ArmMean Delivered and Retained Doses0.018 grams (g)Standard Deviation 0.008
Combined Cannabis and Tobacco ArmMean Delivered and Retained Doses0.026 grams (g)Standard Deviation 0.008
Primary

Mean Heart Rate

Heart rate monitoring by pulse oximeter

Time frame: Study Day 1-3

ArmMeasureValue (MEAN)
Tobacco ArmMean Heart Rate67.3 bpm
Cannabis ArmMean Heart Rate66.8 bpm
Combined Cannabis and Tobacco ArmMean Heart Rate70.5 bpm
Primary

Mean Score on the Drug Effects Questionnaire (DEQ)

The Drug Effects Questionnaire (DEQ) is widely used in studies of acute subjective response (SR) to a variety of substances which assessed the extent to which participants (1) feel any substance effect(s), (2) feel high, (3) like the effects, (4) dislike the effects, and (5) want more of the substance by instructing participants to place a mark on a 100mm vertical, visual, analog scale with scores ranging from 0 =not at all to 100 = extremely for each question. The mean of the individual responses is used to general a total score with a range from 0 to 100, with higher scores indicate a greater liking of the effects of the substance. The mean and standard deviation of each treatment condition will be reported.

Time frame: Study Day 1-3

ArmMeasureValue (MEAN)Dispersion
Tobacco ArmMean Score on the Drug Effects Questionnaire (DEQ)45.4 score on a scaleStandard Deviation 33.7
Cannabis ArmMean Score on the Drug Effects Questionnaire (DEQ)69.0 score on a scaleStandard Deviation 16.7
Combined Cannabis and Tobacco ArmMean Score on the Drug Effects Questionnaire (DEQ)73.2 score on a scaleStandard Deviation 14.4
Primary

Mean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)

This 12-item multidimensional measure assesses cannabis craving based on 4 factors: Compulsivity, Emotionality, Expectancy, Purposefulness. Each item asks about the respondent's feelings and thoughts about smoking marijuana as he or she is completing the questionnaire (i.e., right now). Each response is scored a number ranging from 1 (strongly disagree) to 7 (strongly agree) with higher scores indicating a greater level of craving. The calculation of each subscale is as follows: Compulsivity: Mean of items 2, 7, and 10; Emotionality: Mean of items 4, 6, and 9; Expectancy: Mean of items 5, 11, and 12; Purposefulness: Mean of items 1, 3, and 8 with the minimum possible score = 1 and the maximum possible score = 7 for any subscale. The mean and standard deviation of each subscale for each treatment condition will be reported.

Time frame: Study Day 1-3

ArmMeasureGroupValue (MEAN)Dispersion
Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Compulsivity2.8 score on a scaleStandard Deviation 1.7
Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Emotionality3.1 score on a scaleStandard Deviation 2.1
Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Expectancy4.1 score on a scaleStandard Deviation 1.8
Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Purposefulness4.6 score on a scaleStandard Deviation 1.8
Cannabis ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Purposefulness4.8 score on a scaleStandard Deviation 2.2
Cannabis ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Compulsivity3.0 score on a scaleStandard Deviation 1.8
Cannabis ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Expectancy4.6 score on a scaleStandard Deviation 1.8
Cannabis ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Emotionality3.5 score on a scaleStandard Deviation 1.8
Combined Cannabis and Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Purposefulness4.0 score on a scaleStandard Deviation 2.3
Combined Cannabis and Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Emotionality2.9 score on a scaleStandard Deviation 1.9
Combined Cannabis and Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Expectancy3.9 score on a scaleStandard Deviation 1.6
Combined Cannabis and Tobacco ArmMean Scores on the Marijuana Craving Questionnaire-Short Form (MCQ-SF)Compulsivity2.5 score on a scaleStandard Deviation 1.6
Primary

Mean Scores on the Minnesota Nicotine Withdrawal Scale (MNWS)

The Minnesota Nicotine Withdrawal Scale is an 7-item self - report scale designed to measure the severity of craving and withdrawal symptoms experienced during smoking cessation. Each item is rated on a scale of 0 to 4 with 0=none,1= Slight, 2= Mild, 3= Moderate, and 4=Severe. Seven of the items are symptoms derived from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Tobacco Withdrawal diagnosis and are as follows: depression, insomnia, irritability/frustration/anger, anxiety/nervousness, difficulty concentrating, restlessness, increased appetite and at least five of seven items must have responses in order to generate a reliable score. The responses to each item are summed to produce a total withdrawal summary score with greater scores indicating a higher level of severity in nicotine withdrawal symptoms overall. The mean and standard deviation of each treatment condition will be reported with a minimum mean score of 0 and a maximum mean score of 4.

Time frame: Study Day 1-3

ArmMeasureValue (MEAN)Dispersion
Tobacco ArmMean Scores on the Minnesota Nicotine Withdrawal Scale (MNWS)0.8 score on a scaleStandard Deviation 1
Cannabis ArmMean Scores on the Minnesota Nicotine Withdrawal Scale (MNWS)1.2 score on a scaleStandard Deviation 1.2
Combined Cannabis and Tobacco ArmMean Scores on the Minnesota Nicotine Withdrawal Scale (MNWS)0.9 score on a scaleStandard Deviation 1.1
Primary

Mean Scores on the Modified Cigarette Evaluation Questionnaire (mCEQ)

The modified Cigarette Evaluation Questionnaire (mCEQ) uses three multi-item subscales and two single items: Smoking Satisfaction (items 1, 2, and 12);Psychological Reward (items 4 through 8); Aversion (items 9 and 10);Enjoyment of Respiratory Tract Sensations (item 3); and Craving Reduction(item 11). Scores for each subscale are calculated as the mean of the individual item responses or the single item. Higher scores indicate greater intensity on that scale. Items are rated on a seven-point scale ranging from 1 (not at all) to 7 (extremely) and total scores are averaged across all items with a minimum average score of 1 and a maximum average score of 7. Higher scores indicate greater intensity of each smoking effect with, for example, greater satisfaction or psychological reward after smoking. The mean and standard deviation for each treatment condition will be reported.

Time frame: Study Day 1-3

ArmMeasureValue (MEAN)Dispersion
Tobacco ArmMean Scores on the Modified Cigarette Evaluation Questionnaire (mCEQ)1.5 score on a scaleStandard Deviation 3.2
Cannabis ArmMean Scores on the Modified Cigarette Evaluation Questionnaire (mCEQ)3.1 score on a scaleStandard Deviation 3.5
Combined Cannabis and Tobacco ArmMean Scores on the Modified Cigarette Evaluation Questionnaire (mCEQ)1.4 score on a scaleStandard Deviation 1.5
Primary

Mean Scores on the Positive Affect Negative Affect Schedule (PANAS)

The Positive and Negative Affect Schedule (PANAS) is a brief scale is comprised of 20 items, with 10 items measuring positive affect (e.g., excited, inspired) and 10 items measuring negative affect (e.g., upset, afraid). Each item is rated on a five-point Likert Scale, ranging from 1 = Very Slightly or Not at all to 5 = Extremely, to measure the extent to which the affect has been experienced in a specified time frame and the final score is derived out of the sum of the ten items on both the positive and negative side. Scores can range from 10-50 for both the Positive and Negative Affect with the lower scores representing lower levels of Positive/Negative Affect and higher scores representing higher levels of Positive/Negative Affect.

Time frame: Study Day 1-3

ArmMeasureGroupValue (MEAN)Dispersion
Tobacco ArmMean Scores on the Positive Affect Negative Affect Schedule (PANAS)Positive26.9 score on a scaleStandard Deviation 11.6
Tobacco ArmMean Scores on the Positive Affect Negative Affect Schedule (PANAS)Negative10.6 score on a scaleStandard Deviation 1.2
Cannabis ArmMean Scores on the Positive Affect Negative Affect Schedule (PANAS)Positive23.0 score on a scaleStandard Deviation 9.6
Cannabis ArmMean Scores on the Positive Affect Negative Affect Schedule (PANAS)Negative11.4 score on a scaleStandard Deviation 3.1
Combined Cannabis and Tobacco ArmMean Scores on the Positive Affect Negative Affect Schedule (PANAS)Positive25.8 score on a scaleStandard Deviation 11.1
Combined Cannabis and Tobacco ArmMean Scores on the Positive Affect Negative Affect Schedule (PANAS)Negative10.2 score on a scaleStandard Deviation 0.7
Primary

Median Nicotine Exposure

Compare median exposure of nicotine using AUC (area under the blood/plasma concentration-time curve) between vaped loose-leaf tobacco containing nicotine vs. mixture of cannabis and tobacco containing nicotine.

Time frame: Study Day 1-3

ArmMeasureValue (MEDIAN)
Tobacco ArmMedian Nicotine Exposure63.1 ng/mL•minute
Cannabis ArmMedian Nicotine Exposure42.7 ng/mL•minute
Combined Cannabis and Tobacco ArmMedian Nicotine Exposure134.9 ng/mL•minute
Primary

Median Peak Nicotine Concentration (Cmax)

Median peak concentration of nicotine between vaped loose-leaf cannabis, mixture of cannabis and tobacco containing nicotine, and the tobacco alone treatment condition will be reported

Time frame: Study Day 1-3

ArmMeasureValue (MEDIAN)
Tobacco ArmMedian Peak Nicotine Concentration (Cmax)0.55 ng/mL
Cannabis ArmMedian Peak Nicotine Concentration (Cmax)0.38 ng/mL
Combined Cannabis and Tobacco ArmMedian Peak Nicotine Concentration (Cmax)1.59 ng/mL
Primary

Median Peak THC Concentration (Cmax)

Median peak concentration of THC between vaped loose-leaf cannabis, mixture of cannabis and tobacco containing nicotine, and the tobacco alone treatment condition will be reported

Time frame: Study Day 1-3

ArmMeasureValue (MEDIAN)
Tobacco ArmMedian Peak THC Concentration (Cmax)1.52 mg/mL
Cannabis ArmMedian Peak THC Concentration (Cmax)9.72 mg/mL
Combined Cannabis and Tobacco ArmMedian Peak THC Concentration (Cmax)25.74 mg/mL
Primary

Median THC Exposure

Median exposure of nicotine using area under the blood/plasma concentration-time curve(AUC) between vaped loose-leaf cannabis, mixture of cannabis and tobacco containing nicotine, and the tobacco alone treatment condition will be reported

Time frame: Study Day 1-3

ArmMeasureValue (MEDIAN)
Tobacco ArmMedian THC Exposure201.6 ng/mL•minute
Cannabis ArmMedian THC Exposure306.4 ng/mL•minute
Combined Cannabis and Tobacco ArmMedian THC Exposure585.6 ng/mL•minute

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