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| Name | Class |
|---|---|
| Celerion | INDUSTRY |
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This is a randomized, open-label, forced-switch, parallel, proof-of-concept study to assess exposure to biomarkers of tobacco exposure following short-term ad lib use of three blu e-cigarette products. The primary objectives of this study are to:
The secondary objectives of this study are to:
Subjects checked in to the clinic on Day -2 and continued to smoke their usual brand cigarette ad lib through the evening of Day -1 upon request to the clinic staff. Baseline assessments were made from the morning of Day -1 through the morning of Day 1 prior to the start of randomized product use. On the morning of Day 1, subjects were randomized into one of the study arms noted above and post-baseline assessments were made through the morning of Day 6.
With limited exceptions, all product use was ad lib from 07:30 to 23:00 on Days -2 to 5. Smoking of cigarettes and use of the e-cigarette products were limited to separate sections of the clinic to minimize the chance for illicit product use and cross-contamination. Subjects randomized to the cessation arm were housed in a separate section of the clinic after randomization.
From Day 1 to the end of the study all subjects randomized to an e-cigarette cohort were allowed to carry the assigned product with them throughout the day and use their product ad lib within identified sections of the clinic. Subjects randomized to the dual-use cohorts were allowed to smoke no more than 50% of the number of cigarettes per day reported at Screening. Cigarettes were were provided to the subjects upon request to the study staff.
Daily product use of blu e-cigarettes and usual brand cigarettes was assessed on Days -1 through Day 5. Each blu e-cigarette was weighed prior to dispensing and following the return of the product and the estimated amount of nicotine delivered from each blu e-cigarette will be calculated by multiplying the weight difference (mg) by 2.4%.
Urine biomarkers of exposure and effect were assessed from 24-hour urine collections from the morning of Day -1 to the morning of Day 1 and from the morning of Day 5 to the morning of Day 6. Urine biomarkers of exposure included NNAL, nicotine equivalents (nic + 5), 3-HPMA, CEMA, 1-OHP, NNN, MHBMA, and S-PMA. The urine biomarker of effect included F2-isoprostane (8-iso-PGF2 Type III). Biomarker concentrations were adjusted for urine creatinine concentrations.
Blood biomarkers of exposure included COHb, nicotine, cotinine, and trans-3'hydroxycotinine. Samples were collected on Days -1, 1, 3, and 5 in the morning prior to the start of product administration and in the evening.
Other physiologic endpoints included spirometry (FVC and FEV1, assessed in the afternoon on Day -1 and Day 5, exhaled CO and NO measurements (assessed in the afternoon on Days -1, 1, 3, and 5), and blood pressure and pulse rate (assessed on Days -1 through 5 in the morning prior to the start of product administration and evening).
Questionnaires administered included the Fagerström Test for Nicotine Dependence and the Brief Wisconsin Inventory of Smoking Dependence Motives (Day -1), smoking urge (Days -1 through 5 in the morning prior to the start of product administration and evening), and the Modified Cigarette Evaluation Scale (evening of Day 5, not administered to subjects in the cessation arm).
Safety evaluations included physical examinations, vital signs, ECGs, clinical laboratory assessments (clinical chemistry, hematology, urinalysis, and serology), urine drug and alcohol screens, urine cotinine and exhaled CO screens, and pregnancy tests (females only). Adverse events spontaneously reported by the subjects or observed by the Investigator or other study personnel were monitored from the time of Check-in until the End-of-Study (or Early Termination). Any concomitant medications taken from 30 days prior to Check-in through the End-of-Study (or Early Termination) were recorded.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort A1 | Experimental | Exclusive blu™ e-cigarette A1 |
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| Cohort A2 | Experimental | Exclusive blu™ e-cigarette A2 |
|
| Cohort A3 | Experimental | Exclusive blu™ e-cigarette A3 |
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| Cohort B1 | Experimental | Dual blu™ e-cigarette and usual brand B1 |
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| Cohort B2 | Experimental | Dual blu™ e-cigarette and usual brand B2 |
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| Cohort B3 | Experimental | Dual blu™ e-cigarette and usual brand B3 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exclusive blu™ e-cigarette A1 | Other | Classic Tobacco rechargeable e cigarette |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Biomarkers of tobacco exposure as measured in urine | Excretion of each urine biomarker of exposure (NNAL, nicotine equivalents, 3-HPMA, HMPMA, CEMA, 1-OH pyrene, NNN, MHBMA, and S-PMA) will be assessed at baseline and following a 5-day forced switch to determine changes associated with product use or cessation, and differences between cohorts. | 5 days |
| Biomarkers of tobacco effect as measured in urine | Excretion of F2-isoprostane (8-iso-PGF2 Type III) will be assessed at baseline and following a 5-day forced switch to determine changes associated with product use or cessation, and differences between cohorts. | 5 days |
| Biomarkers of tobacco exposure as measured in blood | Exposure to each blood biomarker of exposure (COHb, nicotine, cotinine, and trans-3'hydroxycotinine) will be assessed at baseline and during a 5-day forced switch to determine changes associated with product use or cessation, and differences between cohorts. | 5 days |
| Measure | Description | Time Frame |
|---|---|---|
| Daily product consumption as measured by e-cigarette and combustible cigarette use | Daily nicotine consumption from blu e-cigarettes and the number of cigarettes smoked per day will be assessed at baseline and during a 5-day forced switch to determine changes associated with product use and differences between cohorts. | 5 days |
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Inclusion Criteria:
Healthy adult male and female smokers, 21 to 65 years of age, inclusive, at Screening.
Combustible cigarette smoker for at least 12 months prior to Check-in. Brief periods of non-smoking during the 90 to 14 days prior to Check-in (e.g., up to ~7 consecutive days due to illness, trying to quit, participation in a study where smoking was prohibited) will be permitted at the discretion of the Investigator.
Currently smokes an average of 10 or more king size (~83 - 85 mm) or 100s (~98 - 100 mm) manufactured combustible cigarettes per day (any brand style).
Consistent use of a single brand style for 14 days prior to Check-in.
Positive urine cotinine at Screening (≥ 500 ng/mL).
Exhaled CO > 12 ppm at Screening.
Female subjects of non-childbearing potential and of childbearing potential will be eligible. Examples of acceptable forms of contraception include, but are not limited to, the following.
Understands the study procedures and provides voluntary consent to participate in the study documented on the signed ICF.
Willing to comply with the study requirements, including potential use of any study product or smoking cessation during the study.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael R. Gartner, M.D. | Celerion | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Celerion | Lincoln | Nebraska | 68502 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27401980 | Derived | D'Ruiz CD, Graff DW, Robinson E. Reductions in biomarkers of exposure, impacts on smoking urge and assessment of product use and tolerability in adult smokers following partial or complete substitution of cigarettes with electronic cigarettes. BMC Public Health. 2016 Jul 11;16:543. doi: 10.1186/s12889-016-3236-1. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Dec 10, 2015 | |
| Reset | Jan 14, 2016 |
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| Cohort C | Experimental | Nicotine product cessation C |
|
| Exclusive blu™ e-cigarette A2 |
| Other |
Magnificent Menthol rechargeable e cigarette |
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| Exclusive blu™ e-cigarette A3 | Other | Cherry Crush rechargeable e cigarette |
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| Dual blu™ e-cigarette and usual brand B1 | Other | Classic Tobacco rechargeable e cigarette and a usual brand combustible cigarette |
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| Dual blu™ e-cigarette and usual brand B2 | Other | Magnificent Menthol rechargeable e cigarette and a usual brand combustible cigarette |
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| Dual blu™ e-cigarette and usual brand B3 | Other | Cherry Crush rechargeable e cigarette and a usual brand combustible cigarette |
|
| Nicotine product cessation C | Other | Nicotine cessation |
|
| Urge to smoke as measured by visual analog scale |
The urge to smoke will be assessed at baseline and during a 5-day forced switch to determine the effectiveness of blu e-cigarettes to determine changes associated with product use or cessation, and differences between cohorts. |
| 5 days |
| Physiologic effects as measured by spirometry | FVC and FEV1 will be assessed at baseline and during a 5-day forced switch to determine changes associated with product use or cessation, and differences between cohorts. | 5 days |
| Physiologic effects as measured by exhaled breath | Exhaled CO and NO will be assessed at baseline and during a 5-day forced switch to determine changes associated with product use or cessation, and differences between cohorts. | 5 days |
| Physiologic effects as measured by blood pressure and pulse rate | Sytolic and diastolic blood pressure and heart rate will be assessed at baseline and during a 5-day forced switch to determine changes associated with product use or cessation, and differences between cohorts. | 5 days |
| Relationship between product use and biomarker exposure | The relationship between product use and exposure to the urine and blood biomarkers of tobacco exposure and effect will be assessed. | 5 days |
| Subjective product assessments as measured by the modified cigarette evaluation scale | The Modified Cigarette Evaluation Scale will be administered to assess differences in subjective opinions of the blu e-cigarettes between cohorts. | 5 days |
| Safety and tolerability as measured by number of subjects with adverse events or changes in health status | The safety and tolerability of blu e-cigarettes during a 5-day period of use will be assessed using physical examinations, vital signs, clinical laboratory assessments, and adverse event and concomitant medication monitoring. | 5 days |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Dec 10, 2015 | Jan 14, 2016 |
| ID | Term |
|---|---|
| D000073865 | Cigarette Smoking |
| ID | Term |
|---|---|
| D000073869 | Tobacco Smoking |
| D012907 | Smoking |
| D001519 | Behavior |
| D064424 | Tobacco Use |
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