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This is a randomized, open-label, 6-way crossover, multi-site study designed to evaluate elements of abuse liability (AL) including subjective effects and physiological measures (pharmacodynamics [PD]), and nicotine uptake (pharmacokinetics [PK]) during and following ad libitum use of the Electronic Nicotine Delivery Systems (ENDS) investigational products (IPs) in generally healthy combustible cigarette (CC) smokers and dual users of CC and ENDS.
The study will evaluate elements of AL of ENDS IPs against CC and nicotine polacrilex gum in generally healthy menthol CC smokers of and dual users of CC and ENDS in a confinement setting.
Potential subjects will complete a pre-screening interview and a Screening Visit to assess eligibility within 45 days prior to enrollment, randomization and confinement.
Starting on Study Day 1, eligible subjects will be randomized to 1 of 6 IP use sequences (based on a Williams Design) and will be confined at the clinical site for 8 days and 7 nights to complete the study.
On Day 3 and continuing through Day 8, subjects in each arm will participate in six separate Test Sessions, one for each IP, that will last for approximately 4 hours following the start of IP use. During each Test Session, subjects will use one of the six IPs: four ENDS IPs, a high-AL comparator (subject's UB cigarette) and a low-AL comparator (a commercially available nicotine gum for nicotine replacement therapy), based on the assigned IP use sequences. ENDS IP cartridges will be weighed prior to and after product use in the Test Session. Each Test Session will include collection of both PD measures (subjective and physiological) and PK measures prior to, during, and following IP use.
Subjects will acclimate to the assigned products prior to each Test Session. On Study Day 1 (Pre-study Product Acclimation Period), subjects will use each of five IPs (four ENDS IPs and one nicotine gum) at least once. In addition, on the half day prior to each respective Test Session (Starting on Day 2), subjects will participate in a Product Acclimation Period in which they will use the randomized IP (to be tested during the following day's Test Session, to include ENDS or nicotine gum) at least four times . Subjects will have access to UB cigarette for ad libitum use at any time during Pre-Study Product Acclimation period and Product Acclimation Periods as long as they meet the IP acclimation criteria. At the end of each Product Acclimation Period, there will be a required 12-hour abstinence period from use of tobacco/nicotine containing products prior to the Test Session the following day. The study will complete when all six IPs have been tested.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Product usage order A B N C E D | Experimental | Subjects will use each of the 5 products sequentially (A B N C E D) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order B C A D N E | Experimental | Subjects will use each of the 5 products sequentially (B C A D N E) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order C D B E A N | Experimental | Subjects will use each of the 5 products sequentially (C D B E A N) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order D E C N B A | Experimental | Subjects will use each of the 5 products sequentially (D E C N B A) during an evaluation period, followed by a 4 hour Test Session. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Product A | Other | Usual Brand (UB) filtered, menthol combustible cigarette |
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| Measure | Description | Time Frame |
|---|---|---|
| AUECPL 3-240 | area-under-the-effects curve (AUEC) for product liking (PL) numeric rating scale (NRS) score-versus-time curve from 3 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) 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:
Able to read, understand, and willing to sign an informed consent form (ICF) and complete questionnaires written in English.
Generally healthy male or female, 21 to 60 years of age, inclusive, at the time of consent.
Expired breath carbon monoxide level is ℠10 ppm and ⤠100 ppm at Screening.
Positive urine cotinine test at Screening.
Smokes only combustible, filtered, menthol cigarettes, 83 mm to 100 mm in length.
Agrees to smoke same usual brand (UB) cigarette throughout the study period. UB cigarette is defined as the cigarette brand style currently smoked most frequently by the subject.
Subjects must meet one (a or b) of the following tobacco use conditions:
i. Smoking at least 10 cigarettes per day (on average) and inhales the smoke, for at least 6 months prior to Screening Visit. Brief periods of abstinence more than 30 days prior to screening due to illness, quit attempt or clinical study participation will be allowed at the discretion of the Investigator and ii. Using a nicotine-containing ENDS (cartridge or a tank system).
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."
Willing to use UB cigarette, ENDS, and Nicorette gum during the study period.
Willing to abstain from tobacco and nicotine use for at least 12 hours prior to each Test Session.
Females must be willing to use a form of contraception acceptable to the PI from the time of signing informed consent until End-of-Study.
Agrees to in-clinic confinement of 8 days and 7 nights.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jason Hong, MD | RAIS | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| QPS Bio-Kinetic | Springfield | Missouri | 65802 | United States | ||
| AMR Knoxville |
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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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| Product usage order E N D A C B | Experimental | Subjects will use each of the 5 products sequentially (E N D A C B) during an evaluation period, followed by a 4 hour Test Session. |
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| Product usage order N A E B D C | Experimental | Subjects will use each of the 5 products sequentially (N A E B D C) during an evaluation period, followed by a 4 hour Test Session. |
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| Product B | Other | Flavor variant P1211216 of a 1.5% nicotine ENDS product |
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| Product C | Other | Flavor variant P1211217 of a 2.4% nicotine ENDS product |
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| Product D | Other | Flavor variant P1211222 of a 5.0% nicotine ENDS product |
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| Product E | Other | Flavor variant P1213616 of a 1.5% nicotine ENDS product |
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| Product N | Other | NicoretteĀ® White Ice Mint 4 mg nicotine gum |
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| Knoxville |
| Tennessee |
| 37920 |
| United States |