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This trial was the initial characterization of the blu™ products being studied, with the purpose of gaining an understanding of the exposure to nicotine and craving reduction attained following use of blu™ e-cigarettes by adult smokers. Two types of exposures were utilized: a single controlled administration and a short-term ad lib use. As smoking behaviors vary from smoker to smoker, a controlled administration allows for some standardization of nicotine "dose" for each of the study products to better understand their uptake characteristics as well as urge reduction achieved under controlled conditions. Further evaluation under ad lib product use conditions provides insight into product self-administration behaviors that will allow subjects to achieve acceptable levels of urge reduction. Comparisons were made to evaluate differences between blu™ formulations as well as to the market-leading conventional cigarette, Marlboro Gold King Size ("Marlboro cigarette').
This was a randomized, partially single-blinded, 6-period crossover study of 24 subjects.
The primary objectives of this study were to:
The secondary objectives of this study were to:
Subjects were provided blu™ Classic Tobacco and Magnificent Menthol products containing 2.4% nicotine, glycerin vehicle for 1 week prior to participation in the study to familiarize themselves with the use of the products. Subjects were confined to the clinic for the entire study duration and abstained from use of nicotine containing products for a period of at least 36 hours prior to each product administration. Each product administration included a controlled product administration and a 1 hour ad lib use of the study products. The controlled product administration consisted of 50 inhalations of the assigned e-cigarette product (5-second inhalations at 30-second intervals) or smoking one Marlboro cigarette (30-second intervals with the subjects' normal inhalation duration) with inhalations monitored by the clinical staff. The start of the ad lib product use was 30 minutes following the start of the controlled product use. During ad lib use, subjects were allowed to self-administer the e-cigarette product as desired for the entire hour and were responsible for maintaining their own inhalation counts. During the ad lib cigarette product use, subjects requested the product from the staff as desired and maintained their own inhalation counts.
Pharmacokinetics: Blood samples for the measurement of plasma nicotine concentrations were taken by direct venipuncture at 10 minutes prior to, and 5, 10, 15, 20, 25, 30, 45, 60, 75, and 90 minutes following the start of the controlled product administration. Non-compartmental PK parameters such as Peak Plasma Concentration and Area under the Plasma Concentration versus time curve were calculated from the plasma nicotine concentration-time data.
Pharmacodynamics: Smoking urge was assessed using a 100 mm visual analog scale (VAS). Assessments occurred within 1 minute prior to the -10 (pre-product administration), 5, 15, 25, 30, 60, and 90-minute PK blood draws. The following non-compartmental Pharmacodynamic parameters were calculated from the smoking urge change-from-baseline data: Emax0-30, Emaxreduction0-30, AUEC0-30, tEmax0-30, AUEC30-90, and E90.
Other Measurements: Exhaled CO measurements occurred at approximately 20 minutes prior to the start of the controlled product use and at approximately 15 minutes following the end of the ad lib product use.
Tolerability: Adverse events, physical examinations, vital signs, ECGs, and laboratory safety tests were assessed to evaluate enrolment criteria and subject safety during the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| E-cigarette 1 | Experimental | blu™ Classic Tobacco rechargeable (2.4% nicotine, glycerin vehicle) |
|
| E-cigarette 2 | Experimental | blu™ Classic Tobacco rechargeable (2.4% nicotine, glycerin/propylene glycol (PG) vehicle) |
|
| E-cigarette 3 | Experimental | blu™ Magnificent Menthol rechargeable (2.4% nicotine, glycerin vehicle) |
|
| E-cigarette 4 | Experimental | blu™ Classic Tobacco rechargeable (1.6% nicotine, glycerin vehicle) |
|
| E-cigarette 5 | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| blu™ Classic Tobacco rechargeable (2.4% nicotine, glycerin vehicle) | Other | electronic cigarettes |
|
| Measure | Description | Time Frame |
|---|---|---|
| Profile nicotine pharmacokinetics following use of e-cigs and regular cigarettes | Measure plasma nicotine PK outcome measures such as Peak Plasma Concentration and Area under the Plasma Concentration versus time curve. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Assess smoking urge scores on the Visual Analog Scale following use of electronic and regular cigarettes | Smoking urge was assessed using a 100 mm visual analog scale (VAS). Assessments occurred within 1 minute prior to the -10 (pre-product administration), 5, 15, 25, 30, 60, and 90-minute PK blood draws on Days 1, 3, 5, 7, 9, and 11. The 30-minute assessment was intended to coincide with the start of the ad lib product use. The following non-compartmental pharmacodynamic parameters were calculated from the smoking urge change-from-baseline data: Maximum smoking urge reduction and change-from-baseline from time zero to 30 minutes, area under the effect curve (smoking urge change-from-baseline) from time 0 to 30 minutes and 30 to 90 minutes,time of the maximum (positive or negative) smoking urge change-from-baseline from time 0 to 30 minutes and Observed smoking urge change-from-baseline at 90 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of the Number of Participants with Adverse Effects, Vital Signs, and Concomitant Medications | AE seriousness, severity, and relationship to study product were assessed. | 6 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael R. Gartner, MD | Celerion | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Celerion | Lincoln | Nebraska | 68502 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26424091 | Derived | D'Ruiz CD, Graff DW, Yan XS. Nicotine delivery, tolerability and reduction of smoking urge in smokers following short-term use of one brand of electronic cigarettes. BMC Public Health. 2015 Sep 30;15:991. doi: 10.1186/s12889-015-2349-2. |
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blu™ Classic Tobacco rechargeable (1.6% nicotine, glycerin/PG vehicle)
|
| Combustible Cigarette | Active Comparator | Marlboro Cigarette |
|
| blu™ Classic Tobacco rechargeable (2.4% nicotine, glycerin/PG vehicle) | Other | electronic cigarettes |
|
| blu™ Magnificent Menthol rechargeable (2.4% nicotine, glycerin vehicle) | Other | electronic cigarettes |
|
| blu™ Classic Tobacco rechargeable (1.6% nicotine, glycerin vehicle) | Other | electronic cigarettes |
|
| blu™ Classic Tobacco rechargeable (1.6% nicotine, glycerin/PG vehicle) | Other | electronic cigarettes |
|
| Marlboro Cigarette | Other | cigarettes |
|
| 6 months |
| ID | Term |
|---|---|
| D012907 | Smoking |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D009538 | Nicotine |
| D005990 | Glycerol |
| ID | Term |
|---|---|
| D012991 | Solanaceous Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D000073999 | Triose Sugar Alcohols |
| D013402 | Sugar Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D002241 | Carbohydrates |
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