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This is a two-site, open-label, randomized, 5-way cross-over study designed to evaluate elements of abuse liability (AL) including subjective effects and physiological measures (pharmacodynamics [PD]) and plasma nicotine uptake (pharmacokinetics [PK]) during and following ad libitum use of the study investigational products (IPs) by generally healthy smokers.
Cigarette smokers and smokers also using smokeless tobacco products (ST) will be recruited into this AL study to evaluate elements of AL of three nicotine pouches compared to combustible cigarettes (CC) and nicotine polacrilex gum. At least one-third of the study population will include smokers who also use ST.
Potential subjects may complete a pre-screening telephone interview. Subjects will complete a Screening Visit to assess their eligibility within 45 days prior to check-in and enrollment.
Starting on Day 1, subjects will check-in at the clinical site to complete procedures to confirm eligibility. Eligible subjects will be enrolled and confined for 6 days. Subjects will be randomized to one of 10 product use sequences (using a Williams Design) in which the subjects will evaluate one IP in each of five separate Test Sessions, such that each subject will evaluate five IPs, including three IPs, and both a high-AL comparator (subject's usual brand [UB] cigarette) and a low-AL comparator (a commercially available nicotine replacement therapy [NRT] nicotine gum).
On Day 2 and continuing through Day 6, subjects will participate in Test Sessions that will last for approximately 4 hours. Each Test Session will include collection of both PD measures (subjective and physiological) and PK measures prior to, during, and following IP use.
On the half day prior to each respective Test Session, a Product Acclimation Period will allow subjects ad libitum use of the randomized IP (at least two trial uses) for product familiarization prior to use in the next day's Test Session. Subjects can also use their UB cigarettes ad libitum, until the 12-hour tobacco abstinence begins prior to each Test Session, as long as the minimum use requirement for randomized IP is met.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Product usage order ABCDN | Experimental | Subjects will use each of the 5 products sequentially (ABCDN) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order ACBND | Experimental | Subjects will use each of the 5 products sequentially (ACBND) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order BADCN | Experimental | Subjects will use each of the 5 products sequentially (BADCN) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order BDANC | Experimental | Subjects will use each of the 5 products sequentially (BDANC) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order CANBD |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Product A | Other | Usual Brand (UB) filtered, non-menthol or menthol cigarette |
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| Measure | Description | Time Frame |
|---|---|---|
| (AUECPL) 5-240: area-under-the-effects curve (AUEC) for Product Liking (PL) | area-under-the-effects curve (AUEC) for PL numeric rating scale (NRS) score-versus-time curve from 5 minutes to 240 minutes after the start of IP use. Product Liking is a numeric rating scale ranging from 0 to 10. A higher score indicates a higher liking of the product. | 5 minutes to 240 minutes |
| Emax PL: Maximum product liking (PL) | Maximum product liking (PL) numeric rating scale (NRS) score after the start of IP use. Product Liking is a numeric rating scale ranging from 0 to 10. A higher score indicates a higher liking of the product. | 240 minutes |
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Inclusion Criteria:
1. Able to read, understand, and willing to sign an informed consent form (ICF) and complete questionnaires written in English.
Generally healthy males or females, 21 to 60 years of age, inclusive, at the time of consent.
Smokes combustible, filtered, non-menthol or menthol cigarettes, 83 mm to 100 mm in length as primary source of tobacco.
Smokes an average of at least 10 cigarettes per day (CPD) and inhales the smoke, for at least 6 months prior to Screening. Brief periods of abstinence due to illness, quit attempt (prior to 30 days of Screening), or clinical study participation (prior to 30 days of Screening) will be allowed at the discretion of the PI.
Smokers who also use ST products (e.g., moist snuff, snus), and have used ST within 30 days prior to screening, will be enrolled.
Agrees to smoke the same UB cigarette throughout the study period. The UB cigarette is defined as the reported cigarette brand and style currently smoked most frequently by the subject.
Expired breath carbon monoxide (ECO) level is ℠10 ppm and ⤠100 ppm at Screening and at check-in Day 1.
Positive urine cotinine test at Screening.
Response at Screening to the Fagerstrƶm Test for Nicotine Dependence (FTND) Question 1 ("How soon after you wake up do you smoke your first cigarette?") is either "Within 5 minutes" or "6-30 minutes" (Heatherton et al., 1991).
Willing to use the UB cigarette, IPs, and NicoretteĀ® nicotine gum during the study period.
Willing to abstain from tobacco and nicotine use for at least 12 hours prior to the start of each of five Test Sessions.
Females must be willing to use a form of contraception acceptable to the PI from the time of signing the informed consent until End-of-Study.
Examples of acceptable means of birth control are, but not limited to:
Agrees to an in-clinic confinement of 6 days (5 nights).
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Milly Kanobe, PhD | RAIS | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Elite Raleigh | Raleigh | North Carolina | 27612 | United States | ||
| ICON Clinical Research |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40183092 | Derived | Kanobe MN, Powell CY, Patrudu M, Baxter SA, Tapia MA, Darnell J, Prevette K, Gibson AG, Ayoku SA, Campbell L, Coffield JW, Keyser BM, Ganesh BS, Gale N, Jordan KG. Randomized crossover clinical studies to assess abuse liability and nicotine pharmacokinetics of Velo Oral Nicotine pouches. Front Pharmacol. 2025 Mar 13;16:1547073. doi: 10.3389/fphar.2025.1547073. eCollection 2025. |
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| ID | Term |
|---|---|
| D012907 | Smoking |
| D064424 | Tobacco Use |
| D000073869 | Tobacco Smoking |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| ID | Term |
|---|---|
| C476054 | HTR3D protein, human |
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| Experimental |
Subjects will use each of the 5 products sequentially (CANBD) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order CNADB | Experimental | Subjects will use each of the 5 products sequentially (CNADB) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order DBNAC | Experimental | Subjects will use each of the 5 products sequentially (DBNAC) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order DNBCA | Experimental | Subjects will use each of the 5 products sequentially (DNBCA) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order NCDAB | Experimental | Subjects will use each of the 5 products sequentially (NCDAB) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order NDCBA | Experimental | Subjects will use each of the 5 products sequentially (NDCBA) during an evaluation period, followed by a 4 hour Test Session. |
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| Product B | Other | P1012914, A nicotine pouch product with 4 mg of nicotine |
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| Product C | Other | P1012915, A nicotine pouch product with 8 mg of nicotine |
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| Product D | Other | P1012919, A nicotine pouch product with 12 mg of nicotine |
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| Product N | Other | NicoretteĀ® White Ice Mint 4 mg nicotine gum |
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| San Antonio |
| Texas |
| 78209 |
| United States |