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Effects of Nicotine Reduction on Smoking Behavior in ADHD Smokers (ADHDenic)

Primary Purpose

Nicotine Dependence, ADHD

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Very low nicotine content cigarettes
Conventional nicotine content cigarettes
Sponsored by
Duke University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Nicotine Dependence

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Age 18 - 40
  • Smoke an average of 5-40 cigarettes per day for at least 1 year
  • Breath CO levels > 8 ppm (if ≤ 8 ppm, then NicAlert Strip > 6)
  • Primary diagnosis of ADHD, any subtype as assessed by the CAADID; T-Score > 65 on one of the DSM- V relevant scales (Inattentive Symptoms, Hyperactive-Impulsive Symptoms, Total Symptoms or ADHD Index) on the Self-Report version of the CAARS; Clinician Rated ADHD-RS score >24.
  • Cognitive functioning > 80 as assessed by the KBIT-II

Exclusion Criteria:

  • Intention to quit smoking in the next 30 days
  • Currently seeking treatment for smoking cessation
  • Currently using nicotine replacement therapies or other pharmacotherapies as cessation aid (intermittent use acceptable)
  • A quit attempt in the past 30 days resulting in greater than 3 days of abstinence
  • Using other tobacco products more than 9 days in the past 30 days
  • Significant unstable medical conditions (any significant change in a serious medical condition occurring during the past 3 months including cardiovascular disease, COPD, and cancer, as determined by the study physician at each site)
  • Significant unstable psychiatric conditions (any significant change in psychiatric symptoms during the past 3 months as determined by the study physician at each site)
  • Any Axis I Psychiatric Disorder as assessed by the MINI that is significantly impairing and/or would contraindicate participation in the study
  • Psychiatric medication changes in the past 3 months including new prescriptions, changes in dosages or discontinuation of medications
  • Positive toxicology screen for any of the following drugs: cocaine, opiates, methadone, benzodiazepines, barbiturates, amphetamines, methamphetamines, and PCP (Marijuana will be tested for but will not be an exclusionary criterion, participants with valid prescriptions for opiates, benzodiazepines, barbiturates, amphetamines or methadone will not be excluded, participants failing the toxicology screen will be allowed to re-screen once. These participants will need to be re-consented before being rescreened to ensure they have received adequate informed consent.)
  • Breath alcohol level > 0.01 (Participants failing the breath alcohol screen will be allowed to re-screen once. These participants will need to be re-consented before being rescreened to ensure they have received adequate informed consent.)
  • Current diagnosis of DSM alcohol or drug use disorder (except for nicotine)
  • Pregnant, trying to become pregnant or breastfeeding
  • Smoking 'roll your own cigarettes' exclusively
  • Currently taking anticonvulsant medications including: Phenytoin [Brand Name: Dilantin], Carbamazepine [Brand Name: Tegretol, Carbatrol, Equetro, Epitol], Oxcarbazepine [Brand Name: Trileptal], Primidone [Brand Name: Mysoline], Phenobarbital
  • CO reading >80 ppm
  • Systolic BP between 90 and 160 (If below 90 then asymptomatic. Participants failing for blood pressure will be allowed to re-screen once.)
  • Diastolic BP between 50 and 100 (If below 50 then asymptomatic. Participants failing for blood pressure will be allowed to re-screen once.)
  • Heart rate between 45 and 115 bpm (If below 45 then asymptomatic. Participants failing for heart rate will be allowed to re-screen once.)
  • Indicating any suicidal ideation in the past month or suicide attempts in the past 10 years.
  • Inability to independently read and comprehend the consent form and other written study materials and measures.
  • Having participated in a research study during the past three months in which the participant: Smoked a cigarette that was not his/her usual brand cigarette for more than one day, used any tobacco products beyond normal use for more than one day, used any nicotine replacement products or smoking cessation medications for more than one day
  • Any previous experience using SPECTRUM cigarettes

Sites / Locations

  • Duke University Medical Center
  • University of Pittsburgh

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Other

Arm Label

Very low nicotine content cigarettes

Conventional nicotine content cigarettes

Arm Description

Reduced nicotine content cigarettes.

Conventional nicotine content cigarettes.

Outcomes

Primary Outcome Measures

Number of cigarettes smoked per day
Self-reported number of cigarettes smoked per day
Composite measure of influence of reduced nicotine content on ADHD symptoms measured by ADHD Rating Scale and Clinical Global Impressions Scale along with related measures of cognition measured by the N-Back Task and the Continuous Performance Test
Composite of ADHD symptom questionnaires, inhibitory control, working memory
Composite measure of outcomes associated with acceptability; withdrawal measured by the MNWS and compliance measured by Time-Line Follow-Back questionnaire and daily self-report cigarette use
Composite of study dropout, compliance, changes in physical health

Secondary Outcome Measures

Measures of discomfort/dysfunction; withdrawal and depression
Withdrawal scale and depression measures
Measures of other health-related behaviors; dependence measures
Drug and alcohol use questionnaires

Full Information

First Posted
November 2, 2015
Last Updated
January 23, 2020
Sponsor
Duke University
Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Food and Drug Administration (FDA), University of Pittsburgh
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1. Study Identification

Unique Protocol Identification Number
NCT02599571
Brief Title
Effects of Nicotine Reduction on Smoking Behavior in ADHD Smokers
Acronym
ADHDenic
Official Title
Effects of Nicotine Reduction on Smoking Behavior in ADHD Smokers
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Terminated
Why Stopped
sponsor discontinued funding
Study Start Date
March 30, 2016 (Actual)
Primary Completion Date
September 12, 2019 (Actual)
Study Completion Date
September 12, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Duke University
Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Food and Drug Administration (FDA), University of Pittsburgh

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to investigate the impact of different nicotine levels in cigarettes with individuals who have ADHD.
Detailed Description
The purpose of this study is to examine the effects of very low nicotine content (VLNC) cigarettes on smoking behavior, psychiatric symptoms and functioning, and acceptability and adverse outcomes in young adult smokers with ADHD. Participants will attend a screening session, 2 baseline sessions, 6 experimental sessions, and a 30 day follow-up visit. Participants will be asked to smoke only the study cigarettes that we provide for 6 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nicotine Dependence, ADHD

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
71 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Very low nicotine content cigarettes
Arm Type
Other
Arm Description
Reduced nicotine content cigarettes.
Arm Title
Conventional nicotine content cigarettes
Arm Type
Other
Arm Description
Conventional nicotine content cigarettes.
Intervention Type
Other
Intervention Name(s)
Very low nicotine content cigarettes
Other Intervention Name(s)
Tobacco, Cigarettes
Intervention Description
Cigarettes containing a reduced amount of nicotine
Intervention Type
Other
Intervention Name(s)
Conventional nicotine content cigarettes
Other Intervention Name(s)
Tobacco, Cigarettes
Intervention Description
Cigarettes containing a normal amount of nicotine
Primary Outcome Measure Information:
Title
Number of cigarettes smoked per day
Description
Self-reported number of cigarettes smoked per day
Time Frame
Six weeks
Title
Composite measure of influence of reduced nicotine content on ADHD symptoms measured by ADHD Rating Scale and Clinical Global Impressions Scale along with related measures of cognition measured by the N-Back Task and the Continuous Performance Test
Description
Composite of ADHD symptom questionnaires, inhibitory control, working memory
Time Frame
Six weeks
Title
Composite measure of outcomes associated with acceptability; withdrawal measured by the MNWS and compliance measured by Time-Line Follow-Back questionnaire and daily self-report cigarette use
Description
Composite of study dropout, compliance, changes in physical health
Time Frame
Six weeks
Secondary Outcome Measure Information:
Title
Measures of discomfort/dysfunction; withdrawal and depression
Description
Withdrawal scale and depression measures
Time Frame
Six weeks
Title
Measures of other health-related behaviors; dependence measures
Description
Drug and alcohol use questionnaires
Time Frame
Six weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age 18 - 40 Smoke an average of 5-40 cigarettes per day for at least 1 year Breath CO levels > 8 ppm (if ≤ 8 ppm, then NicAlert Strip > 6) Primary diagnosis of ADHD, any subtype as assessed by the CAADID; T-Score > 65 on one of the DSM- V relevant scales (Inattentive Symptoms, Hyperactive-Impulsive Symptoms, Total Symptoms or ADHD Index) on the Self-Report version of the CAARS; Clinician Rated ADHD-RS score >24. Cognitive functioning > 80 as assessed by the KBIT-II Exclusion Criteria: Intention to quit smoking in the next 30 days Currently seeking treatment for smoking cessation Currently using nicotine replacement therapies or other pharmacotherapies as cessation aid (intermittent use acceptable) A quit attempt in the past 30 days resulting in greater than 3 days of abstinence Using other tobacco products more than 9 days in the past 30 days Significant unstable medical conditions (any significant change in a serious medical condition occurring during the past 3 months including cardiovascular disease, COPD, and cancer, as determined by the study physician at each site) Significant unstable psychiatric conditions (any significant change in psychiatric symptoms during the past 3 months as determined by the study physician at each site) Any Axis I Psychiatric Disorder as assessed by the MINI that is significantly impairing and/or would contraindicate participation in the study Psychiatric medication changes in the past 3 months including new prescriptions, changes in dosages or discontinuation of medications Positive toxicology screen for any of the following drugs: cocaine, opiates, methadone, benzodiazepines, barbiturates, amphetamines, methamphetamines, and PCP (Marijuana will be tested for but will not be an exclusionary criterion, participants with valid prescriptions for opiates, benzodiazepines, barbiturates, amphetamines or methadone will not be excluded, participants failing the toxicology screen will be allowed to re-screen once. These participants will need to be re-consented before being rescreened to ensure they have received adequate informed consent.) Breath alcohol level > 0.01 (Participants failing the breath alcohol screen will be allowed to re-screen once. These participants will need to be re-consented before being rescreened to ensure they have received adequate informed consent.) Current diagnosis of DSM alcohol or drug use disorder (except for nicotine) Pregnant, trying to become pregnant or breastfeeding Smoking 'roll your own cigarettes' exclusively Currently taking anticonvulsant medications including: Phenytoin [Brand Name: Dilantin], Carbamazepine [Brand Name: Tegretol, Carbatrol, Equetro, Epitol], Oxcarbazepine [Brand Name: Trileptal], Primidone [Brand Name: Mysoline], Phenobarbital CO reading >80 ppm Systolic BP between 90 and 160 (If below 90 then asymptomatic. Participants failing for blood pressure will be allowed to re-screen once.) Diastolic BP between 50 and 100 (If below 50 then asymptomatic. Participants failing for blood pressure will be allowed to re-screen once.) Heart rate between 45 and 115 bpm (If below 45 then asymptomatic. Participants failing for heart rate will be allowed to re-screen once.) Indicating any suicidal ideation in the past month or suicide attempts in the past 10 years. Inability to independently read and comprehend the consent form and other written study materials and measures. Having participated in a research study during the past three months in which the participant: Smoked a cigarette that was not his/her usual brand cigarette for more than one day, used any tobacco products beyond normal use for more than one day, used any nicotine replacement products or smoking cessation medications for more than one day Any previous experience using SPECTRUM cigarettes
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott Kollins, Ph.D.
Organizational Affiliation
Duke ADHD Program
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
University of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Effects of Nicotine Reduction on Smoking Behavior in ADHD Smokers

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