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Electronic Nicotine Delivery Systems as a Smoking Cessation Treatment (ENDS-P50)

Primary Purpose

Nicotine Dependence

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Nicotine patch
ENDS
Placebo patch
Placebo ENDS
Sponsored by
Duke University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nicotine Dependence focused on measuring Nicotine addiction, Cigarette smoking, Smoking cessation, Nicotine patches, E-cigarettes

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Have no known serious medical conditions;
  • Smoke an average of at least 10 cigarettes per day;
  • Have an expired air CO reading of at least 15 ppm;
  • Able to read and understand English;
  • Express a desire to quit smoking in the next thirty days;
  • Higher than median rating of enjoyment of airway sensory effects of inhaling smoke on Cigarette Evaluation Questionnaire.

Exclusion Criteria:

  • Hypertension;
  • Hypotension;
  • Coronary heart disease;
  • Lifetime history of heart attack;
  • Cardiac rhythm disorder (irregular heart rhythm);
  • Chest pains (unless history, exam, and ECG clearly indicate a non-cardiac source);
  • Cardiac (heart) disorder (including but not limited to valvular heart disease, heart murmur, heart failure);
  • History of skin allergy;
  • Active skin disorder (e.g., psoriasis) within the last five years;
  • Liver or kidney disorder (except kidney stones, gallstones);
  • Gastrointestinal problems or disease other than gastroesophageal reflux or heartburn;
  • Ulcers;
  • Lung disorder/disease (including but not limited to Chronic obstructive pulmonary disease (COPD), emphysema, and asthma);
  • Brain abnormality (including but not limited to stroke, brain tumor, and seizure disorder);
  • History of migraine headaches in the past 5 years;
  • History of fainting;
  • Problems giving blood samples;
  • Difficulty passing urine;
  • Diabetes treated with insulin; non-insulin treated diabetes (unless glucose is less than 180mg/dcl and HbA1c is less than 7%);
  • Current cancer or treatment for cancer in the past six months (except basal or squamous cell skin cancer);
  • Other major medical condition;
  • Current psychiatric disease (with the exception of anxiety disorders, Obsessive Compulsive Disorder (OCD) and ADHD);
  • Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide;
  • Current depression;
  • Bulimia or anorexia;
  • Pregnant or nursing mothers;
  • Use (within the past 30 days) of:

    • Illegal drugs (or if the urine drug screen is positive for tetrahydrocannabinol (THC), Cocaine, Amphetamine, Opiates, Methamphetamines, phencyclidine (PCP), Benzodiazepines, or Barbiturates),
    • Experimental (investigational) drugs;
    • Psychiatric medications including antidepressants, anti-psychotics or any other medications that are known to affect smoking cessation (e.g. clonidine);
    • Smokeless tobacco (chewing tobacco, snuff), cigars, pipes, nicotine replacement therapy, e-cigarettes or other smoking cessation treatment;;
  • Alcohol abuse;
  • Significant adverse reaction to nicotine patches in the past;
  • Current participation or recent participation (in the past 30 days) in another smoking study at our Center or another research facility;
  • Current participation in another research study.

Potential subjects must agree to use acceptable contraception.

Potential subjects must agree to avoid the following:

  • participation in any other nicotine-related modification strategy outside of this protocol;
  • use of tobacco products other than cigarettes, including pipe tobacco, cigars, e-cigarettes, snuff, and chewing tobacco;
  • use of experimental (investigational) drugs or devices;
  • use of illegal drugs;
  • use of opiate medications.

Sites / Locations

  • Duke Center for Smoking Cessation

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

Nicotine ENDS + Nicotine Patch

Nicotine ENDS + Placebo Patch

Placebo ENDS + Nicotine Patch

Arm Description

Participants will initially receive 1 week of 21 mg nicotine skin patches while continuing to smoke their usual cigarettes ad lib. Starting with week 2, they will receive nicotine-containing ENDS devices and will be instructed to substitute ENDS for as many cigarettes as possible in this week. The target quit-smoking date will occur at the beginning of week 3. Treatments will continue until week 8 post-quit, at which time participants will be instructed to reduce ENDS use over the next 4 weeks, at which time ENDS will no longer be dispensed. Subsequently, the nicotine patch dose will be gradually reduced according to standard weaning regimen from 21 mg/24 h to 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. All nicotine-based treatments will end at week 16 after the quit date.

Participants will initially receive 1 week of placebo skin patches while continuing to smoke their usual cigarettes ad lib. Starting with week 2, they will receive nicotine-containing ENDS devices and will be instructed to substitute ENDS for as many cigarettes as possible in this week. The target quit-smoking date will occur at the beginning of week 3. Treatments will continue until week 8 post-quit, at which time participants will be instructed to reduce ENDS use over the next 4 weeks, at which time ENDS will no longer be dispensed. Subsequently, the placebo patch size will be gradually reduced to mirror standard weaning regimen from 21 mg/24 h to 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. All nicotine-based treatments will end at week 16 after the quit date.

Participants will initially receive 1 week of 21 mg nicotine skin patches while continuing to smoke their usual cigarettes ad lib. Starting with week 2, they will receive placebo ENDS devices and will be instructed to substitute ENDS for as many cigarettes as possible in this week. The target quit-smoking date will occur at the beginning of week 3. Treatments will continue until week 8 post-quit, at which time participants will be instructed to reduce ENDS use over the next 4 weeks, at which time ENDS will no longer be dispensed. Subsequently, the nicotine patch dose will be gradually reduced according to standard weaning regimen from 21 mg/24 h to 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. All nicotine-based treatments will end at week 16 after the quit date.

Outcomes

Primary Outcome Measures

Continuous four-week abstinence from smoking during treatment
The primary outcome measure will be continuous four-week abstinence from smoking during weeks 4-8 post target Quit Day while treatment is ongoing. This will be determined by a composite of self-report of no smoking on daily diaries and expired air carbon monoxide (CO) <10 ppm (measured at Week 8). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.

Secondary Outcome Measures

Continuous four-week abstinence from smoking after withdrawal of ENDS
A secondary outcome measure will be continuous four-week abstinence from smoking during weeks 9-12 post target Quit Day while participants are decreasing their use of ENDS. This will be determined by a composite of self-report of no smoking on daily diaries and expired air carbon monoxide (CO) <10 ppm (measured at Week 12). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Continuous four-week abstinence from smoking after withdrawal of nicotine patches
A secondary outcome measure will be continuous four-week abstinence from smoking during weeks 13-16 post target Quit Day while participants are using decreasing doses of nicotine patches. This will be determined by a composite of self-report of no smoking on daily diaries and expired air carbon monoxide (CO) <10 ppm (measured at Week 16). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Seven-day point abstinence from smoking at 6 months post Quit Day
A secondary outcome measure will be seven-day abstinence from smoking at six months post target Quit Day. This will be determined by self-report of no smoking for the previous seven days when called for 6-month follow-up, verified by expired air carbon monoxide (CO) <10 ppm (measured at 6-month follow-up visit). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.

Full Information

First Posted
June 30, 2015
Last Updated
September 11, 2018
Sponsor
Duke University
Collaborators
National Institute on Drug Abuse (NIDA)
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1. Study Identification

Unique Protocol Identification Number
NCT02487953
Brief Title
Electronic Nicotine Delivery Systems as a Smoking Cessation Treatment
Acronym
ENDS-P50
Official Title
Electronic Nicotine Delivery Systems (ENDS) as a Smoking Cessation Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Study design changed significantly; was submitted as a different protocol.
Study Start Date
July 2018 (Anticipated)
Primary Completion Date
January 2020 (Anticipated)
Study Completion Date
January 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Duke University
Collaborators
National Institute on Drug Abuse (NIDA)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this research study is to determine whether combining electronic nicotine delivery systems (ENDS) with nicotine patch treatment will augment abstinence rates compared to either treatment alone.
Detailed Description
Cigarette smokers, who are motivated to quit smoking but who rate the inhalation aspects of smoking as important will be randomized to three groups: Group 1. Nicotine ENDS + nicotine patch; Group 2: Nicotine ENDS + placebo patch; Group 3: Placebo ENDS + Nicotine patch. Participants will initially receive 1 week of 21 mg nicotine (or placebo) skin patches while continuing to smoke their usual cigarettes ad lib, in order to assess responsiveness to Nicotine Replacement Therapy (NRT). Starting with week 2, participants will receive nicotine-containing (or placebo) ENDS devices (menthol or non-menthol versions in accordance with their baseline preference). They will also be instructed to substitute ENDS for as many cigarettes as possible in this week. The target quit-smoking date will occur at the beginning of week 3. Treatments will continue until week 8 post-quit, at which time participants will be instructed to reduce ENDS use over the next 4 weeks, at which time ENDS will no longer be dispensed. Subsequently, the nicotine patch dose will be gradually reduced according to standard weaning regimen from 21 mg/24 h to 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. All nicotine-based treatments will end at week 16 after the quit date.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nicotine Dependence
Keywords
Nicotine addiction, Cigarette smoking, Smoking cessation, Nicotine patches, E-cigarettes

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Nicotine ENDS + Nicotine Patch
Arm Type
Experimental
Arm Description
Participants will initially receive 1 week of 21 mg nicotine skin patches while continuing to smoke their usual cigarettes ad lib. Starting with week 2, they will receive nicotine-containing ENDS devices and will be instructed to substitute ENDS for as many cigarettes as possible in this week. The target quit-smoking date will occur at the beginning of week 3. Treatments will continue until week 8 post-quit, at which time participants will be instructed to reduce ENDS use over the next 4 weeks, at which time ENDS will no longer be dispensed. Subsequently, the nicotine patch dose will be gradually reduced according to standard weaning regimen from 21 mg/24 h to 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. All nicotine-based treatments will end at week 16 after the quit date.
Arm Title
Nicotine ENDS + Placebo Patch
Arm Type
Active Comparator
Arm Description
Participants will initially receive 1 week of placebo skin patches while continuing to smoke their usual cigarettes ad lib. Starting with week 2, they will receive nicotine-containing ENDS devices and will be instructed to substitute ENDS for as many cigarettes as possible in this week. The target quit-smoking date will occur at the beginning of week 3. Treatments will continue until week 8 post-quit, at which time participants will be instructed to reduce ENDS use over the next 4 weeks, at which time ENDS will no longer be dispensed. Subsequently, the placebo patch size will be gradually reduced to mirror standard weaning regimen from 21 mg/24 h to 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. All nicotine-based treatments will end at week 16 after the quit date.
Arm Title
Placebo ENDS + Nicotine Patch
Arm Type
Active Comparator
Arm Description
Participants will initially receive 1 week of 21 mg nicotine skin patches while continuing to smoke their usual cigarettes ad lib. Starting with week 2, they will receive placebo ENDS devices and will be instructed to substitute ENDS for as many cigarettes as possible in this week. The target quit-smoking date will occur at the beginning of week 3. Treatments will continue until week 8 post-quit, at which time participants will be instructed to reduce ENDS use over the next 4 weeks, at which time ENDS will no longer be dispensed. Subsequently, the nicotine patch dose will be gradually reduced according to standard weaning regimen from 21 mg/24 h to 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. All nicotine-based treatments will end at week 16 after the quit date.
Intervention Type
Drug
Intervention Name(s)
Nicotine patch
Other Intervention Name(s)
Nicoderm
Intervention Description
21 mg/24 h for 2 weeks before the quit date and 12 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks.
Intervention Type
Other
Intervention Name(s)
ENDS
Other Intervention Name(s)
e-cigarettes
Intervention Description
As needed for 1 week before the quit date and 8 weeks after the quit date, then reduced use for 4 weeks.
Intervention Type
Other
Intervention Name(s)
Placebo patch
Intervention Description
21 mg size for 2 weeks before the quit date and 12 weeks after the quit date, 14 mg size for 2 weeks, and 7 mg size for 2 weeks.
Intervention Type
Other
Intervention Name(s)
Placebo ENDS
Intervention Description
As needed for 1 week before the quit date and 8 weeks after the quit date, then reduced use for 4 weeks.
Primary Outcome Measure Information:
Title
Continuous four-week abstinence from smoking during treatment
Description
The primary outcome measure will be continuous four-week abstinence from smoking during weeks 4-8 post target Quit Day while treatment is ongoing. This will be determined by a composite of self-report of no smoking on daily diaries and expired air carbon monoxide (CO) <10 ppm (measured at Week 8). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Time Frame
Weeks 4-8 post target Quit Day
Secondary Outcome Measure Information:
Title
Continuous four-week abstinence from smoking after withdrawal of ENDS
Description
A secondary outcome measure will be continuous four-week abstinence from smoking during weeks 9-12 post target Quit Day while participants are decreasing their use of ENDS. This will be determined by a composite of self-report of no smoking on daily diaries and expired air carbon monoxide (CO) <10 ppm (measured at Week 12). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Time Frame
Weeks 9-12 post target Quit Day
Title
Continuous four-week abstinence from smoking after withdrawal of nicotine patches
Description
A secondary outcome measure will be continuous four-week abstinence from smoking during weeks 13-16 post target Quit Day while participants are using decreasing doses of nicotine patches. This will be determined by a composite of self-report of no smoking on daily diaries and expired air carbon monoxide (CO) <10 ppm (measured at Week 16). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Time Frame
Weeks 13-16 post target Quit Day
Title
Seven-day point abstinence from smoking at 6 months post Quit Day
Description
A secondary outcome measure will be seven-day abstinence from smoking at six months post target Quit Day. This will be determined by self-report of no smoking for the previous seven days when called for 6-month follow-up, verified by expired air carbon monoxide (CO) <10 ppm (measured at 6-month follow-up visit). An intent-to-treat criterion will be used, whereby drop-outs are considered to be non-abstinent.
Time Frame
6 months post Quit Day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have no known serious medical conditions; Smoke an average of at least 10 cigarettes per day; Have an expired air CO reading of at least 15 ppm; Able to read and understand English; Express a desire to quit smoking in the next thirty days; Higher than median rating of enjoyment of airway sensory effects of inhaling smoke on Cigarette Evaluation Questionnaire. Exclusion Criteria: Hypertension; Hypotension; Coronary heart disease; Lifetime history of heart attack; Cardiac rhythm disorder (irregular heart rhythm); Chest pains (unless history, exam, and ECG clearly indicate a non-cardiac source); Cardiac (heart) disorder (including but not limited to valvular heart disease, heart murmur, heart failure); History of skin allergy; Active skin disorder (e.g., psoriasis) within the last five years; Liver or kidney disorder (except kidney stones, gallstones); Gastrointestinal problems or disease other than gastroesophageal reflux or heartburn; Ulcers; Lung disorder/disease (including but not limited to Chronic obstructive pulmonary disease (COPD), emphysema, and asthma); Brain abnormality (including but not limited to stroke, brain tumor, and seizure disorder); History of migraine headaches in the past 5 years; History of fainting; Problems giving blood samples; Difficulty passing urine; Diabetes treated with insulin; non-insulin treated diabetes (unless glucose is less than 180mg/dcl and HbA1c is less than 7%); Current cancer or treatment for cancer in the past six months (except basal or squamous cell skin cancer); Other major medical condition; Current psychiatric disease (with the exception of anxiety disorders, Obsessive Compulsive Disorder (OCD) and ADHD); Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide; Current depression; Bulimia or anorexia; Pregnant or nursing mothers; Use (within the past 30 days) of: Illegal drugs (or if the urine drug screen is positive for tetrahydrocannabinol (THC), Cocaine, Amphetamine, Opiates, Methamphetamines, phencyclidine (PCP), Benzodiazepines, or Barbiturates), Experimental (investigational) drugs; Psychiatric medications including antidepressants, anti-psychotics or any other medications that are known to affect smoking cessation (e.g. clonidine); Smokeless tobacco (chewing tobacco, snuff), cigars, pipes, nicotine replacement therapy, e-cigarettes or other smoking cessation treatment;; Alcohol abuse; Significant adverse reaction to nicotine patches in the past; Current participation or recent participation (in the past 30 days) in another smoking study at our Center or another research facility; Current participation in another research study. Potential subjects must agree to use acceptable contraception. Potential subjects must agree to avoid the following: participation in any other nicotine-related modification strategy outside of this protocol; use of tobacco products other than cigarettes, including pipe tobacco, cigars, e-cigarettes, snuff, and chewing tobacco; use of experimental (investigational) drugs or devices; use of illegal drugs; use of opiate medications.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jed E Rose, Ph.D.
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
James M Davis, M.D.
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke Center for Smoking Cessation
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States

12. IPD Sharing Statement

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Electronic Nicotine Delivery Systems as a Smoking Cessation Treatment

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