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Very Low Nicotine Content Cigarettes and E-Cigarettes in Promoting Smoking Cessation in Daily and Intermittent Cigarette Smokers

Primary Purpose

Cigarette Smoking-Related Carcinoma, Tobacco-Related Carcinoma

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Cigarette
Nicotine Replacement
Nicotine Replacement
Questionnaire Administration
Survey Administration
Very Low Nicotine Content Cigarette
ECIG-Hi
ECIG-Lo
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Cigarette Smoking-Related Carcinoma

Eligibility Criteria

21 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Sign consent and agree to all study procedures
  • Have an address where he/she can receive mail
  • Have a device available to conduct telehealth visit (e.g., smartphone, computer, tablet, internet access, etc.)
  • Able to follow verbal and written instructions in English
  • Willing and able to complete two spirometry sessions (this criterion waived during COVID-19 pandemic)
  • Be the only participant in their household
  • Interested in trying novel nicotine products
  • Daily smokers: >= 1 cigarette/little cigar per day
  • Intermittent smokers: >= 1 cigarette/little cigar per day 4 to 27 days per month
  • Agrees to comply with all MD Anderson institutional policies related to COVID-19 screening prior to each in-person research visit
  • The individual agrees to not engage in study procedures or interactions with study personnel while operating a vehicle

Exclusion Criteria:

  • Unwilling to refrain from other e-cigarette use for the duration of the study, other than what is provided to them for study purposes
  • Current/recent use of certain medications:

    • Smoking cessation meds (past 90 days; e.g., wellbutrin, bupropion, Zyban, nicotine replacement therapy [NRT], Chantix)
    • Certain medications to treat depression (last 14 days; e.g., amitriptyline)
    • A case by case determination will be made by study physician for medication on the precautionary list, (e.g. nitroglycerin)
    • Self-reported daily use of opioids for 30 days or more on phone screen or at screening is exclusionary however pro re nata (PRN) use is allowed (e.g., 3 to 7 days per week or less or if more frequent, use less than a month's duration
  • Unstable medical condition as determined by the medical team
  • Self-reported bronchial or respiratory infection in the last 14 days (this criterion waived during COVID-19 pandemic)
  • Subject's spirometry forced expiratory volume in 1 second (FEV1) percentage reading is < 50 (severe to very severe obstruction) (this criterion waived during COVID-19 pandemic)
  • Self-reported abnormal heart rhythms or cardiovascular disease (stroke, chest pain, heart attack) in the last 3 months
  • Meet criteria for major depressive syndrome or suicidality on the Patient Health Questionnaire-9 (PHQ-9)
  • Self report of past or current diagnosis of bi-polar disorder or schizophrenia/schizoaffective disorder
  • Self-reported other tobacco use besides cigarettes or little cigars (e.g., hookah, cigarillos, smokeless tobacco, chewing tobacco, pipes, cigars, etc.) on 10 or more days in the last month
  • Recent (past 90 days), current, or planned (within the next 45 days) involvement in smoking cessation activities
  • Positive urine pregnancy test at screening. Women who are two years post-menopausal, or who have had a tubal ligation or a partial or full hysterectomy will not be subject to a urine pregnancy test
  • Women that are breastfeeding or of childbearing potential and not protected by a medically acceptable, effective method of birth control while enrolled in the study. Medically acceptable contraceptives include:

    • Approved hormonal contraceptives (such as birth control pills, patches, implants or injections)
    • Barrier methods (such as condom or diaphragm) used with a spermicide, or
    • An intrauterine device (IUD)
    • Contraceptives sold for emergency use after unprotected sex are not acceptable methods for routine use
  • Subject considered by the investigator to be unsuitable to participate in the study (e.g., due to cognitive deficits or instability to last the entire duration of the study)

Sites / Locations

  • M D Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm I (usual cigarettes, VLNCC, ECIG-Hi, ECIG-Lo)

Arm II (usual cigarettes, VLNCC, ECIG-Hi, ECIG-Lo)

Arm Description

PHASE I: Patients smoke their usual cigarettes brand during week 1. PHASE II: Patients smoke VLNCC cigarettes provided during weeks 2-4. PHASES III-IV: Patients smoke ECIG-Hi for 3 weeks and then ECIG-Lo for 3 weeks.

PHASE I: Patients smoke their usual cigarettes brand during week 1. PHASE II: Patients smoke VLNCC cigarettes provided during weeks 2-4. PHASES III-IV: Patients smoke ECIG-Lo for 3 weeks and then ECIG-Hi for 3 weeks.

Outcomes

Primary Outcome Measures

To characterize the effects of switching to VLNCCs plus ECIG-Hi or ECIG-Lo nicotine doses on abuse liability among daily and intermittent smokers.
Our primary measures of abuse liability will be CPD (product use) and nicotine equivalent (TNE) levels (nicotine compensation).

Secondary Outcome Measures

Full Information

First Posted
November 11, 2016
Last Updated
September 15, 2023
Sponsor
M.D. Anderson Cancer Center
Collaborators
National Institute on Drug Abuse (NIDA)
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1. Study Identification

Unique Protocol Identification Number
NCT02964182
Brief Title
Very Low Nicotine Content Cigarettes and E-Cigarettes in Promoting Smoking Cessation in Daily and Intermittent Cigarette Smokers
Official Title
Evaluating Concomitant Use of Very Low Nicotine Content Cigarettes and E-Cigarettes Among Daily and Non-Daily Smokers
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 26, 2017 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center
Collaborators
National Institute on Drug Abuse (NIDA)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This trial studies what would happen if the nicotine levels in cigarettes are greatly reduced, but electronic cigarettes containing different amount of nicotine are available. Different levels of nicotine may effect certain behaviors, including withdrawal symptoms, nicotine cravings, and mood and may lead to changes in smoking behavior in current daily and intermittent smokers..
Detailed Description
PRIMARY OBJECTIVES: I. To characterize the effects of switching to VLNCCs plus ECIG-Hi or ECIG-Lo nicotine doses on abuse liability among daily and intermittent smokers. EXPLORATORY OBJECTIVES: I. To explore the effects of switching to VLNCCs plus ECIG-Hi or ECIG-Lo nicotine doses on abuse liability using biochemical measures of product use, compensation, and toxicant exposure, and self-reported measures of withdrawal, craving, affect, and satisfaction. II. To explore the effects of switching from usual-brand cigarettes to VLNCCs, and from VLNCCs to VLNCC+ECIGs on measures of abuse liability. III. To characterize the effects of dual use of VLNCC and JUUL ECIGs on abuse liability. OUTLINE: PHASE I: Patients smoke their usual cigarettes brand during week 1. PHASE II: Patients smoke VLNCC cigarettes provided during weeks 2-4. PHASES III-IV: Patients are randomized to 1 of 2 arms. ARM I: Patients smoke ECIG-high (Hi) for 3 weeks and then ECIG-low (Lo) for 3 weeks ARM II: Patients smoke ECIG-Lo for 3 weeks and then ECIG-Hi for 3 weeks. After completion of study, patients are followed up for 30 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cigarette Smoking-Related Carcinoma, Tobacco-Related Carcinoma

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
380 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm I (usual cigarettes, VLNCC, ECIG-Hi, ECIG-Lo)
Arm Type
Experimental
Arm Description
PHASE I: Patients smoke their usual cigarettes brand during week 1. PHASE II: Patients smoke VLNCC cigarettes provided during weeks 2-4. PHASES III-IV: Patients smoke ECIG-Hi for 3 weeks and then ECIG-Lo for 3 weeks.
Arm Title
Arm II (usual cigarettes, VLNCC, ECIG-Hi, ECIG-Lo)
Arm Type
Experimental
Arm Description
PHASE I: Patients smoke their usual cigarettes brand during week 1. PHASE II: Patients smoke VLNCC cigarettes provided during weeks 2-4. PHASES III-IV: Patients smoke ECIG-Lo for 3 weeks and then ECIG-Hi for 3 weeks.
Intervention Type
Drug
Intervention Name(s)
Cigarette
Intervention Description
Smoke usual brand of cigarettes
Intervention Type
Drug
Intervention Name(s)
Nicotine Replacement
Other Intervention Name(s)
Nicotine Replacement Therapy, NRT
Intervention Description
Received NRT (Electronic Cigarette - ECIG-Hi)
Intervention Type
Drug
Intervention Name(s)
Nicotine Replacement
Other Intervention Name(s)
Nicotine Replacement Therapy, NRT
Intervention Description
Received NRT (Electronic Cigarette - ECIG-Hi)
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Intervention Type
Other
Intervention Name(s)
Survey Administration
Intervention Description
Ancillary studies
Intervention Type
Drug
Intervention Name(s)
Very Low Nicotine Content Cigarette
Other Intervention Name(s)
VLNCC
Intervention Description
Smoke very low nicotine content cigarette
Intervention Type
Device
Intervention Name(s)
ECIG-Hi
Intervention Description
Patients smoke ECIG-Hi for 3 weeks and then ECIG-Lo for 3 weeks.
Intervention Type
Device
Intervention Name(s)
ECIG-Lo
Intervention Description
Patients smoke ECIG-Lo for 3 weeks and then ECIG-Hi for 3 weeks
Primary Outcome Measure Information:
Title
To characterize the effects of switching to VLNCCs plus ECIG-Hi or ECIG-Lo nicotine doses on abuse liability among daily and intermittent smokers.
Description
Our primary measures of abuse liability will be CPD (product use) and nicotine equivalent (TNE) levels (nicotine compensation).
Time Frame
up to 10 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Sign consent and agree to all study procedures Have an address where he/she can receive mail Have a device available to conduct telehealth visit (e.g., smartphone, computer, tablet, internet access, etc.) Able to follow verbal and written instructions in English Willing and able to complete two spirometry sessions (this criterion waived during COVID-19 pandemic) Be the only participant in their household Interested in trying novel nicotine products Daily smokers: >= 1 cigarette/little cigar per day Intermittent smokers: >= 1 cigarette/little cigar per day 4 to 27 days per month Agrees to comply with all MD Anderson institutional policies related to COVID-19 screening prior to each in-person research visit The individual agrees to not engage in study procedures or interactions with study personnel while operating a vehicle Exclusion Criteria: Unwilling to refrain from other e-cigarette use for the duration of the study, other than what is provided to them for study purposes Current/recent use of certain medications: Smoking cessation meds (past 90 days; e.g., wellbutrin, bupropion, Zyban, nicotine replacement therapy [NRT], Chantix) Certain medications to treat depression (last 14 days; e.g., amitriptyline) A case by case determination will be made by study physician for medication on the precautionary list, (e.g. nitroglycerin) Self-reported daily use of opioids for 30 days or more on phone screen or at screening is exclusionary however pro re nata (PRN) use is allowed (e.g., 3 to 7 days per week or less or if more frequent, use less than a month's duration Unstable medical condition as determined by the medical team Self-reported bronchial or respiratory infection in the last 14 days (this criterion waived during COVID-19 pandemic) Subject's spirometry forced expiratory volume in 1 second (FEV1) percentage reading is < 50 (severe to very severe obstruction) (this criterion waived during COVID-19 pandemic) Self-reported abnormal heart rhythms or cardiovascular disease (stroke, chest pain, heart attack) in the last 3 months Meet criteria for major depressive syndrome or suicidality on the Patient Health Questionnaire-9 (PHQ-9) Self report of past or current diagnosis of bi-polar disorder or schizophrenia/schizoaffective disorder Self-reported other tobacco use besides cigarettes or little cigars (e.g., hookah, cigarillos, smokeless tobacco, chewing tobacco, pipes, cigars, etc.) on 10 or more days in the last month Recent (past 90 days), current, or planned (within the next 45 days) involvement in smoking cessation activities Positive urine pregnancy test at screening. Women who are two years post-menopausal, or who have had a tubal ligation or a partial or full hysterectomy will not be subject to a urine pregnancy test Women that are breastfeeding or of childbearing potential and not protected by a medically acceptable, effective method of birth control while enrolled in the study. Medically acceptable contraceptives include: Approved hormonal contraceptives (such as birth control pills, patches, implants or injections) Barrier methods (such as condom or diaphragm) used with a spermicide, or An intrauterine device (IUD) Contraceptives sold for emergency use after unprotected sex are not acceptable methods for routine use Subject considered by the investigator to be unsuitable to participate in the study (e.g., due to cognitive deficits or instability to last the entire duration of the study)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Cinciripini
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
M D Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.mdanderson.org
Description
M D Anderson Cancer Center

Learn more about this trial

Very Low Nicotine Content Cigarettes and E-Cigarettes in Promoting Smoking Cessation in Daily and Intermittent Cigarette Smokers

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