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Cigarette smokers will be randomized to E-cigarette, Nicotine Gum or Lozenge, or Control Group. Participants will enter a 1 week sampling phase. Smokers interested in continuing with the study after the sampling phase will undergo a 2 week baseline assessment phase and will then enter an 8 week intervention. Tobacco use patterns, subjective responses to product, and nicotine and toxicant exposure will be assessed.
Sampling period (1 week): Subjects will be randomized to an alternative nicotine product (E-cigarette, Nicotine Gum or Lozenge) or assigned to continue smoking their usual brand cigarettes. Subjects will complete screening assessments, asked to sample the assigned product and start recording their cigarette or other tobacco intake on a daily basis using an interactive voice response system (IVR). Smokers assigned to the control condition (smoking usual brand cigarettes) will be asked to choose the product that they would like to sample.
Baseline smoking period: After sampling, subjects who meet specific criteria will continue with the experimental intervention phase. These subjects will be required to attend 2 baseline clinic visits where baseline assessments will be captured. Records of their cigarette or other tobacco intake on a daily basis will continue using the interactive voice response system (IVR).
Experimental Period: After the baseline assessment, subjects will be instructed to either partially or completely substitute their cigarette smoking with their assigned product. They will assigned to one of six experimental conditions:
The assigned product, E-cigarette, Nic Gum or Lozenge, but not usual brand cigarettes, will be provided to subjects at the clinic visits. Subjects will attend clinic visits over the next 8 weeks where tobacco use patterns and biomarker data will be collected.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Usual Brand Cigarette | Experimental | Smoking usual brand cigarette controls, who after 8-weeks will be offered alternative nicotine products and instructed for partial or complete substitution of cigarettes (subject's choice); |
|
| Complete Substitution E-Cigarette | Experimental | Complete substitution (i.e., no smoking) with e-cigarette use |
|
| Partial Substitution E-Cigarette | Experimental | Partial substitution, encouraged to use e-cigarettes instead of smoking usual cigarettes |
|
| Complete Substitution Nic Gum or Lozenge | Experimental | Complete substitution (i.e., no smoking) to nicotine gum or lozenge use |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cigarettes | Other | Smoke their usual brand of cigarettes and follow their normal patterns of use. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Compare total nicotine equivalents (TNE) based on differing instructions for oral tobacco, nicotine replacement or e-cigarette use. | Compare the exposure to nicotine in the two instructions for use arms (complete substitution vs. partial substitution) across study products and compared to medicinal nicotine products and usual brand cigarettes. | 6 months |
| Determine stabilization of product use (e.g., cigarette, oral tobacco, e-cigarette or medicinal nicotine patterns of use). | Examining time effects for patterns of use of cigarettes, nicotine replacement, oral tobacco or e-cigarette. | 6 months |
| Consumer perception of the product and response to the product after sampling. | Consumer perception of the product evidenced by choice of which product to use in the trial after sampling. | 6 months |
| Compare NNK exposure based on differing instructions for oral tobacco, nicotine replacement or e-cigarette use. | Complete substitution vs. partial substitution of study products for cigarettes and compare the exposure to NNK by analyzing NNAL levels in subject urine. These products are compared to medicinal nicotine products and usual brand cigarettes. | 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Masonic Cancer Center, University of Minnesota | Minneapolis | Minnesota | 55455 | United States | ||
| Roswell Park Cancer Center |
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| ID | Term |
|---|---|
| D000073869 | Tobacco Smoking |
| D012907 | Smoking |
| D000072137 | Vaping |
| ID | Term |
|---|---|
| D001519 | Behavior |
| D064424 | Tobacco Use |
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| ID | Term |
|---|---|
| D062789 | Tobacco Products |
| D066300 | Electronic Nicotine Delivery Systems |
| D000074164 | Nicotine Chewing Gum |
| ID | Term |
|---|---|
| D000074602 | Smoking Devices |
| D008420 | Manufactured Materials |
| D013676 | Technology, Industry, and Agriculture |
| D002638 | Chewing Gum |
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| E-Cigarette | Other | Use of E-cigarette: multiple flavors offered. |
|
| Nicotine Gum or Lozenge | Other | Subject choice: Use of nicotine gum or nicotine lozenge, multiple flavors offered |
|
| Buffalo |
| New York |
| 14263 |
| United States |
| Ohio State University Comprehensive Cancer Center | Columbus | Ohio | 43210 | United States |
| D053149 | Plant Gums |
| D001704 | Biopolymers |
| D011108 | Polymers |
| D046911 | Macromolecular Substances |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
| D061485 | Tobacco Use Cessation Devices |
| D013812 | Therapeutics |
| D002182 | Candy |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |