Supplementary material 5 to: Electronic cigarettes for smoking cessation

Lindson N, Livingstone-Banks J, Butler AR, McRobbie H, Bullen CR, Hajek P, Wu AD, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Fanshawe T, Hartmann-Boyce J
https://doi.org/10.1002/14651858.CD010216.pub10

The material in this section has been supplied by the author(s) for publication under a Licence for Publication and the author(s) are solely responsible for the material. Cochrane has reviewed this material, but Cochrane has not copyedited, formatted or proofread. Cochrane accordingly gives no representations or warranties of any kind in relation to, and accepts no liability for any reliance on or use of, such material.

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Characteristics of ongoing studies

Table of contents

Studies ordered by Study ID

ACTRN12619001787178

Study name

Project NEAT: NicotinE As Treatment for tobacco smoking following discharge from residential withdrawal services

Methods

RCT

Project NEAT: A randomized controlled trial to examine the efficacy of vaporised nicotine products and telephone quitline support compared with nicotine replacement therapy and telephone quitline support when used following discharge from residential withdrawal services

Setting: Australia (New South Wales, Queensland, Victoria)

Recruitment 4 hospital sites: Belmont Hospital, Belmont; St Vincent's Hospital, Darlinghurst; Turning Point Drug and Alcohol Centre, Richmond; Royal Brisbane & Womens Hospital, Herston

Participants

Target sample size: 926

Inclusion criteria:

  • Aged 18 or over
  • Daily tobacco smoker (10 or more cigarettes) on entering withdrawal unit
  • Accessing treatment from participating services
  • Want to quit smoking in the next 30 days
  • Has capacity to consent and able to understand the participant materials and follow the study instructions and procedure (e.g. sufficient English language ability and not too unwell as judged by medical staff)

Exclusion criteria:

  • Pregnant or breastfeeding
  • Enrolled in another study
  • Scheduled to be transferred to a long-term residential rehabilitation service following discharge from the withdrawal unit
  • Used VNP (containing nicotine) in the last 30 days
  • Currently engaged in Quitline’s call-back services
  • No ready access to a phone

Interventions

Condition 1: vaporised nicotine products and Quitline

Condition 2: current best practice treatment for tobacco smoking (combination nicotine replacement therapy and Quitline)

Outcomes

9 months after inpatient withdrawal unit discharge:

  • Self-reported 7 months continuous abstinence from tobacco smoking
  • Biochemically verified 7-month continuous abstinence from tobacco smoking

3 and 9 months after inpatient withdrawal unit discharge:

  • 30-day point prevalence abstinence
  • 7-day point prevalence abstinence
  • Abstinence from all nicotine/tobacco products

Starting date

Anticipated enrolment: 19 December 2019. Anticipated date last data collection: 19 September 2022

Contact information

Prof Billie Bonevski, Billie.Bonevski@newcastle.edu.au

Notes

Funding: National Health and Medical Research Council (grant number: G1800272), Canberra ACT 2601

ACTRN12621000148875

Study name

HARMONY: HARM reduction for Opiates, Nicotine and You

Methods

Design: randomized, single-blinded, parallel-group trial

Participants

Inclusion criteria: written, informed consent; 18 to 65 years; accessing opioid agonist treatment from a participating service; current daily tobacco smokers on self-report; want to quit or cut down their tobacco smoking; willing and able to comply with requirements of study (including having access to a phone)

Exclusion criteria: breastfeeding or pregnant; severe medical disorder assessed by study medical officer (such as, but not limited to, unstable cardiovascular/peripheral vascular disease, poorly controlled hypertension); severe and unstable psychiatric disorder assessed by study medical officer (such as, but not limited to, acute psychosis, severe anxiety and/or mood disorder, intent to harm self or others); current enrolment in a clinical trial involving any investigational drug; gular use (more than one day per week) of VNP or EC containing nicotine in the last 30 days; not available for FU

Motivated to quit

Interventions

Comparison of a 12-week course of liquid nicotine delivered via EC or Vaporised Nicotine Product (VNP) to best practice Nicotine Replacement Therapy (NRT)

Condition 1: EC (VNP) (Innokin Endura T18‐II starter kit) • Device loaded with one bottle of 12 mg/mL e-liquid • An additional seven (7) bottles of 12 mg/mL e-liquid • A brief information session on how to use the VNP • A VNP information pack including safe storage of e-liquid nicotine and disposal • 1-week supply of nicotine patches • Training on the use of NRT patches • Where possible, ensure that participant uses the VNP before leaving and leaves wearing an NRT patch. Adherence will be measured via questionnaires. In addition to the VNP, liquid nicotine and NRT patches, participants will be shown the New Zealand website vapingfacts.health.nz/ and encouraged to visit the site as an online resource throughout the trial. Participants will also receive training in the forms of brief videos, information pamphlets, user manuals and interactive discussions with research staff.

Outcomes

Baseline, 12, 24 weeks

Primary outcome: self-reported 7-day PPA from tobacco smoking assessed in the following dichotomous question “In the last 7 days, have you smoked a cigarette, even a puff?" (Week 12)

Secondary outcome: a cost consequence study setting out detailed comparative costs of treatments - from the perspective of healthcare provider and primary and secondary outcomes of the VNP and NRT

Adverse events recorded

Biochemically verified PPA: this will be measured via a CO monitor breath test for participants who self-report 7-day PPA at end of treatment (Week 12)

Changes in nicotine craving and withdrawal symptoms

Starting date

Registered Feb 2021. Record updated Jan 2024.

Contact information

Adrian Dunlop, adrian.dunlop@health.nsw.gov.au

ACTRN12625000179437

Study name

Puff vs Pill: break the Habit Study: effect of Nicotine Vaping Products vs Varenicline on Smoking Cessation Among People Experiencing Social Disadvantage

Methods

RCT

Participants

Target N = 872

Inclusion: Aged 18 years or older; Receiving a government pension, support, or allowance (proxy for low-SES)*; Person who currently smokes tobacco daily** and wanting to quit tobacco smoking; Willing to use varenicline or NVPs in next quit attempt; Willing to make a quit attempt on designated quit day (~8-14 days post-randomisation);

Exclusion: Pregnant / breast-feeding; participation in another quit smoking program or study, or previously enrolled in this study; Current use of any quit smoking medications or products (i.e., NRT, bupropion [Zyban], varenicline [Varenapix], cytisine, NVPs/ e-cigarettes containing nicotine, nicotine inhalers or any other quit smoking medications or products); Allergies or hypersensitivity to either varenicline or nicotine-containing e-liquids, or any excipients; End stage or severe renal diseased; Deemed medically unfit.

Population: low SES

EC use at baseline: no

Willing to quit CC: yes

Interventions

Arm 1. EC / Nicotine vaping products (NVPs) in the form of two “pod” devices either prefilled [Alt] and refillable [Rift] with nicotine salt e-liquids containing nicotine (4%;40mg/ml) in tobacco or mint flavours for 12 weeks. For each device a USB charger will be provided, as well as a shared wall adaptor. Participants will be provided with detailed instructions on how to use the vaping products, along with a wallet card and fridge magnet with product use and safety information for quick access. Participants are advised to use the study product ad libitum throughout the day to either mitigate or satiate the urge to smoke tobacco products. They are encouraged to stop using the devices once they no longer feel the urge to smoke.

The alt. device has replaceable pre-filled 2ml pods that contain 40mg/ml nicotine salt e-liquid in either tobacco or mint flavour. The Rift device has a refillable 2ml pod, and is supplied alongside 40mg/ml nicotine salt e-liquid (provided in 30ml bottles) in tobacco and mint flavours.

Arm 2. Varenicline

Outcomes

Baseline, 12 months

Carbon monoxide (CO) verified 6-month continuous abstinence at 12-month follow-up. [Only participants self-reporting continuous abstinence from smoking tobacco at final follow-up will be biochemically verified]. Bedfont iCO Smokerlyzer®, or administered by a trained researcher using a hand-held Micro+™ Smokerlyzer® with a disposable, one-use mouthpiece. CO level of less-than-or-equal-to 5 parts per million will be considered abstinent.

Change in number of cigarettes smoked from baseline to final follow up at 12 months

Self-reported AEs and SAEs.

Use of varenicline or NVP at final follow up

Change in self-reported respiratory symptoms.[ Modified Medical Research Council (MRC) dyspnoea scale

Participants’ treatment adherence and compliance.

Self-reported: 7-day point prevalence abstinence; and continuous abstinence for 6 months

Change in self-reported respiratory symptoms

Starting date

Registered 14 February 2025.

Contact information

Ryan Courtney, National Drug and Alcohol Research Centre, The University of New South Wales, Sydney NSW 2052 Australia. r.courtney@unsw.edu.au

Notes

Added as ongoing study 2025.

Berlin 2019

Study name

Randomized, placebo-controlled, double-blind, double-dummy, multicentre trial comparing electronic cigarettes with nicotine to varenicline and to electronic cigarettes without nicotine: the ECSMOKE trial protocol

Methods

3-arm, randomized, placebo-controlled, multicentre, double-blind, double-dummy, parallel-group phase III type trial

Setting: smoking cessation clinics of both academic and community hospitals

Recruitment is either local (a) directly by the centres or centralized (b) using a web page and a centralized study-specific phone number and email address.

  • People who smoke, intending to quit smoking, are recruited by advertisement in pharmacies, physicians’ offices situated in the catchment area of each investigator’s centre, by local newspapers and in public places of the centres’ healthcare facilities.
  • Candidates to participate can register by the study’s website, unique email address, and phone number. Registration is followed by a phone screening before dispatching to the study centres. Only 1 person by household will be recruited.

Participants

Estimated enrolment: 650 participants

Inclusion criteria: people who smoke, ≥ 10 CPD (factory-made or roll-your-own) in the past year; aged 18 to 70; motivated to quit, defined as a score > 5 on a visual rating scale ranging from 0 (not motivated at all) to 10 (extremely motivated); informed consent; understanding and speaking French; women of childbearing age can be included if they use an effective contraceptive method: either hormonal contraception or an intrauterine device started at least 1 month before the first research visit; individual affiliated to a health insurance system; previous failure of NRT for smoking cessation

Exclusion criteria: any unstable disease condition within the last 3 months defined by the investigator as major change in symptoms or treatments, such as recent myocardial infarction, unstable or worsening angina, severe cardiac arrhythmia, unstable or uncontrolled arterial hypertension, recent stroke, cerebrovascular disease, obliterative peripheral arterial disease, cardiac insufficiency, diabetes, hyperthyroidism, pheochromocytoma, severe hepatic insufficiency, history of seizures, severe depression, COPD; any life-threatening condition with life expectancy of < 3 months; alcohol use disorder defined as a score ≥ 10 on the Alcohol Use Disorders Identification Test (AUDIT)-C questionnaire; abuse of or dependence on illegal drugs in the last 6 months, revealed by medical history; regular use of tobacco products other than cigarettes; current or previous (last 6 months) use of EC; pregnancy/breastfeeding; protected adults; current or past 3 months participation in another interventional research; current or past 3 months use of smoking cessation medication such as varenicline, bupropion, NRTs; known lactose intolerance (placebo tablets contain lactose); hypersensitivity to the active substance or to any of the excipients; known severe renal failure

Interventions

A) EC without nicotine (ECwoN) plus placebo tablets of varenicline (0.50 mg) administered by oral route: placebo condition

B) EC with nicotine (ECwN) plus placebo tablets of varenicline: ECwN condition.

C) Reference: ECwoN plus 0.5 mg varenicline tablets: varenicline condition. Varenicline administered according to the marketing authorization

E-cigarette details:

  • EC device Mini iStick kit (20 W) Eleaf, clearomzser: GS Air M with resistance of 1.5 ohm. To keep the blinding, the clearomizer’s Pyrex window is of grey colour not allowing to distinguish the colouration of the e-liquid containing nicotine. Liquid for EC is manufactured by GAIATREND SARL (www.gaiatrend.fr/fr/).
  • All participants will be delivered a short manual and a video specifically developed for this study explaining the use of EC. At each visit, participants receive verbal counselling about the use of the EC device and answers to their questions about handling the EC device.

Behavioural support:

  • Brief behavioural smoking cessation counselling for all participants is administered at all visits by the investigators specialized in smoking cessation. It is based on the national guidelines for smoking cessation.

Treatment duration: 1 week + 3 months

Outcomes

Week 2, 4, 8, 10, 12, 24 after target quit day

Primary outcome:

  • Continuous smoking abstinence rate (CAR) (abstinence from conventional/combustible cigarettes) during the last 4 weeks (weeks 9 to 12) of the treatment period of 3 months

Secondary outcomes:

  • Safety profile
  • PPA rate
  • CAR confirmed by urinary anabasine concentration
  • Changes in cpd consumption
  • Craving for tobacco and withdrawal symptoms with respect to baseline

Starting date

17 October 2018. Trial suspended (March 2025) due to unavailabilty of varenicline. Due to re-start as soon as varenicline is available.

Contact information

Ivan Berlin, ivan.berlin@aphp.fr

Cox 2022

Study name

E-cigarettes vs usual care for smoking cessation when offered at homeless centres (SCeTCH)

Methods

RCT. A multicentre, cluster-randomized controlled trial
Setting: 32 centres across 6 areas in Great Britain: Scotland; Wales; London; South-East England; South-West England and East England

Participants

Enrolment: 477.

Inclusion criteria: currently accessing homeless centre services and actively engaging with the service; > 18 years; self-reported daily smoking, then biochemically verified

Exclusion criteria: never- and ex-smokers; currently using a smoking cessation aid; unable to provide written consent; not known to centre staff; allergic to any of the e-liquid ingredients (EC arm only); pregnant

Interventions

EC: refillable

Cluster rather than individual randomization will be used.

Arm 1: Planned intervention
Delivery of the EC intervention will be as per our feasibility study. Centre staff will provide EC arm participants with a tank-style refillable EC starter kit (e.g. the PockeX as used in our feasibility study or similar model determined via our PPI work), a choice of nicotine strength e-liquids (12 mg/mL and 18 mg/mL) and flavours (tobacco, menthol or fruit) and an EC fact-sheet. E-liquids (5 x 10 mL bottles per week) will be supplied for 4 weeks at weekly intervals by centre staff.

Arm 2: Control/comparator group
Control arm will be usual care (UC). This will include very brief advice (VBA) to quit (in the form of an ‘NHS choices’ leaflet adapted for this population as used in our feasibility study) and signposting to the local SSS.

All participants (intervention and control) will be offered a GBP 15 Love2Shop gift card (which cannot be used for tobacco or alcohol purchases) for each follow-up appointment attended.

Outcomes

Baseline, 4, 12, and 24 weeks

Primary outcome measure

Current primary outcome measure as of 27/07/2022:
Sustained CO-validated smoking cessation at 24 weeks using the Russell Standard for cessation trials and intention-to-treat analysis (i.e. no more than 5 cigarettes since 2 weeks from baseline, validated by expired CO < 8 ppm

Secondary outcome measures

Current secondary outcome measure as of 27/07/2022:

  1. Smoking reduction at 24 weeks
  2. 7-day point prevalence quit rates at 4, 12, and 24 weeks self-reported and validated by expired CO < 8 ppm
  3. Changes in the frequency of risky smoking practices (e.g. sharing cigarettes, smoking discarded cigarettes)
  4. Cost-effectiveness of the intervention measured using a service use questionnaire and the EQ-5D-5L (4, 12, 24 weeks)
  5. Fidelity of intervention implementation
  6. Mechanisms of change measured quantitatively via questions (e.g. attitudes and perceptions of e-cigs)
  7. Contextual influences and sustainability telephone interviews

Starting date

Start date 23 April 2021. Estimated study end date: 31.01.2025.

Contact information

Lynne Dawkins, dawkinl3@lsbu.ac.uk

Notes

New to 2022 update

El-Khoury 2021

Study name

Preference-based tools for smoking cessation among disadvantaged smokers, a pragmatic randomised controlled trial (STOP)

Methods

RCT

France

Participants

Actual enrollment: 167. Estimated enrolment: 528.

Inclusion criteria: daily smokers (≥ 5 cigarettes/day); low socioeconomic position; available for at least 4 appointments over a 6-month period; affiliation to or benefiting from social security or state medical support

Exclusion criteria: individuals who do not speak French; major citizens protected by law, adults unable to express their consent; pregnant women; regular smokers who vape daily (at least once a day)

Interventions

EC: type not stated

Arm 1: The STOP intervention

Assisting smokers with low socioeconomic position in their smoking cessation attempt. Routine care and adapted advice supplemented with a free delivery of any or several type(s) of nicotine replacement therapy (NRT) (patches, inhalers, gum, tablets, etc.) and/or an e-cigarette + e-liquid, based on the smokers' preference and choice

Arm 2: Standard care

Participants randomised to the standard care group will be given standard care in assisting their smoking cessation attempt, but without free delivery of NRT or e-cigarettes.

Standard care includes motivational interviewing, advice to quit, and prescription for NRTs.

Outcomes

Smoking abstinence at 6 months after inclusion

Total number of days of abstinence at 6 months

Smoking abstinence at 1 and 3 months after inclusion

Number of relapses; CPD; proportion of participants who have significantly reduced daily smoking

Starting date

Start date: 26 February 2021. Study completion date: 30 August 2024 (final data collection date for primary outcome measure).

Contact information

Fabienne El-Khoury, Institut National de la Santé Et de la Recherche Médicale, France

Notes

New to 2022 update

Hameed 2024

Study name

Clinical study protocol on electronic cigarettes and nicotine pouches for smoking cessation in Pakistan: a randomized controlled trial

Methods

RCT

Setting: Pakistan

Recruitment centres in 2 metropolitan districts: Islamabad and Rawalpindi

Participants

Estimated enrolment: 600

EC + counselling: estimated 200

Nicotine pouches + counselling: estimated 200

Counselling: estimated 200

Inclusion criteria: > 18; > 10 CPD; CC use for > 1 year; willing to stop CC use; sign a written consent form; 1 applicant per household; phone

Exclusion criteria: pregnant; childbearing mothers; using other nicotine- and non-nicotine-based cessation therapies; chest pain, or another cardiovascular event or procedure (e.g. heart attack, stroke, insertion of stent, bypass surgery)

Motivated to quit

Interventions

Provision of EC or nicotine pouches for 48 weeks

3 groups:

  1. EC and liquid + 4 basic counselling sessions every 12 weeks over 48 weeks
  2. Nicotine pouches + 4 basic counselling sessions every 12 weeks over 48 weeks
  3. Counselling only: 4 basic counselling sessions every 12 weeks over 48 weeks

Outcomes

Baseline, 12, 24, 36, 48 weeks. 60 weeks FU.

AEs

CPD

Self-reported point-prevalence abstinence from CC in the previous week with biochemical validation will be used (exhaled carbon monoxide less than 10 parts per million (PPM))

7-day point-prevalence abstinence from CC (at all subsequent check-ups) (biochemically validated at weeks 12, 24, 36, 48, and 60)

Harm-reduction effect of e-cigarettes and nicotine pouches

Starting date

Estimated starting date: December 2023

Estimated completion date: April 2025

Contact information

Abdul Hameed, +923315813713, hameedleghari@gmail.com

Daud Malik, +923028560310, daud31us@yahoo.com

Notes

New to 2024

Funding: Foundation for a Smoke Free World INC. Funded by Philip Morris International.

ClinicalTrials.gov NCT05715164

Holliday 2022

Study name

ENHANCE-D trial: Enhancing dental health advice

Methods

Design: RCT

A pragmatic, multicentre, definitive, open-label, 3-arm, parallel-group, individually randomized, controlled, superiority trial, comparing the clinical- and cost-effectiveness, and safety of enhanced smoking cessation interventions to usual care, and each other (with an internal pilot)

Setting: 56 NHS primary dental care setting in England and Scotland. Newcastle Clinical Trials Unit, UK

Participants

Estimated enrolment: 1460 participants, 455 periodontitis subgroup

Adult regular tobacco smokers attending an NHS dental setting. Dental patients with or without gum disease

Inclusion criteria: a basic periodontal examination completed within the last 3 months; ≥ 18 years; current smoker
Periodontitis subgroup: minimum of 16 natural teeth; diagnosis of periodontitis stage II (or greater)

Exclusion criteria: pregnant or currently breastfeeding; enrolled in another interventional research trial; used quit-smoking aid or reduce/quit alcohol; phaeocromocytoma, uncontrolled hyperthyroidism, extensive dermatitis/skin disorder; hypersensitivity to nicotine or any component of the study products; taking: clozapine, olanzapine, theophylline or aminophylline

Interventions

EC: EC starter kit. Stainless Steel Aspire PockeX e-cigarette, coil replacement pack, 3-pin plug, 10 x Halo standard 10ml e-liquids (4 flavour options available)

Condition: smoking cessation in dental patients with or without gum disease

Arm 1: E-cigarette (EC) starter kit with single-visit behavioural support (same behavioural intervention as the NRT group). Participants will be expected to source their own supply of e-liquid after the initial supply and advice will be given as to where to source suitable MHRA registered products. Duration will vary depending on use of EC.

Arm 2. Nicotine Replacement Therapy (NRT): standard 12-week course of combination NRT with single-visit behavioural support including the offer of NRT. 12-week course of combination NRT (patch plus faster-acting form such as chewing gum or lozenge), in line with current recommendations. Duration will be 12 weeks if a participant wants to continue NRT after initial 4-week supply. Nicotine transdermal patches. Option 1: NiQuitin 7 mg, 14 mg, 21 mg (24-hour patch). Option 2: Nicorette invisi 10 mg, 15 mg, 25 mg (16-hour patch) Nicorette gum 2 mg, 4 mg. Nicorette lozenge 2 mg, 4 mg

Arm 3. VBA: usual care (control) 1. VBA is usual care for smokers in dental settings usually following the 3As: Ask, Advise, Act technique. This will signpost participants to a GP, pharmacy or stop-smoking service (SSS). 2. Participants in the control group will be free to use NRT or ECs as they wish, but these will not be provided by the dental professional. 3. Conducted at baseline visit, only a 5-minute intervention

All patients will be followed up for up to 12 months from baseline.

Outcomes

6 months for periodontal health parameters and 12 months for smoking outcomes

To compare smoking abstinence at 6 months of NRT and EC to usual care and to each other (all participants). Biochemically verified smoking abstinence at 6 months, carbon monoxide monitor.

To compare the periodontal health at 6 months of NRT and EC interventions to usual care and to each other, for those with periodontitis at baseline. Percentage of periodontal sites at 6 months with PPD (Pocket Probing Depths) ≥ 5 mm

AEs; oral health, and oral health QoL; to evaluate nicotine dependence, urges to smoke, withdrawal symptoms, and longer-term smoking abstinence (12 months); cost benefit. SES inequalities

Expired air carbon monoxide (eCO). Continuous biochemically verified smoking abstinence at 12 months. Fagerstrom Test for Nicotine Dependence (FTND). Cigarette withdrawal symptoms are measured using Mood and Physical Symptoms Scale (MPSS). Oral Health Quality of Life Assessment (OHQoL-UK). Oral health is measured using number of teeth at baseline and 6 months. Health economic evaluation.

Starting date

Protocol 2022

Study start date February 2022. Estimated completion date March 2025.

Contact information

Dr Richard Holliday richard.holliday@newcastle.ac.uk

Professor Elaine McColl, Newcastle University

Notes

New to 2023 update

Howard 2022

Study name

Vaporized nicotine products (VNP) versus nicotine replacement therapy for tobacco smoking cessation among low-socioeconomic status smokers: a randomised controlled trial

Methods

Design: RCT

Recruitment: study advertisements across online and social media platforms such as Facebook advertisements. Participants in a recently completed clinical trial comparing cytisine versus varenicline for smoking cessation who consented to being contacted about future research and were receiving a government pension were also invited to take part.

Setting: National Drug and Alcohol Research Centre at the University of New South Wales, Sydney, Australia

Participants

Target N: 1058

Inclusion criteria: participants can be included if they meet the following criteria:

  • Willing to allow the research team and study clinician to access their data for quality assurance and to maintain the integrity of the trial
  • 18 years of age or older
  • Receiving a government pension or allowance (proxy for low SES)
  • Are a current daily smoker
  • Interested in quitting smoking and using the study products and willing to make a quit attempt in the next 2 weeks
  • Have a mobile phone that can receive text messages
  • Agree to use the allocated study product and refrain from using another quit-smoking medication whilst using the study products
  • Willing to receive daily quit-support text messages during the treatment period (with the option to opt out during the study)

Interventions

Vaporized nicotine product (VNP) devices (1 tank device and 1 pod device) for 8 weeks plus 5-week Text Message behavioural quit Support (TMS) with the option to opt out at any stage if desired. Participants will receive a mix of quit-smoking support text messages with content including information on how to use the study products; coping with nicotine withdrawal symptoms; study progress updates; and motivational ‘feel good’ messages. A mix of text, emojis and links to resources such as videos, websites and Graphics Interchange Format (GIF) images, will be used throughout the TMS programme to promote engagement with the programme. Each device will be charged using the provided USB charger and wall adaptor. A replacement battery and replacement coils (5 pieces per pack) will also be provided. The VNP tank device used is the Innokin Endura T18 Personal Vaporizer, which has a refillable 2.5 mL tank for the e‐liquid (18 mg/mL nicotine). 3 e-liquid flavours will be provided: tobacco, menthol and a fruit flavour. The study will have 3 e-liquid suppliers to guarantee ongoing supply throughout the study: Lumo Liquid in 10 mL bottles; VAPO e-liquid in 30 mL bottles; and DashVapes e-liquid in 30 mL bottles. All e-liquids are 18 mg/mL in strength. Lumo Liquid ingredients are as follows (w/w): tobacco flavouring (1.19%), nicotine (1.60%), vegetable glycerine (24.56%), propylene glycol (73.24%); menthol flavouring (4.83%), nicotine (1.60%), vegetable glycerine (22.99%), propylene glycol (71.18%); strawberry flavouring (0.63%), nicotine (1.60%), vegetable glycerine (33.00%), propylene glycol (71.00%). VAPO e-liquid additional flavour ingredients are as follows (w/w): tobacco flavouring (25.88%), nicotine (17.25%), vegetable glycerine (36.53%), propylene glycol (20.34).

Outcomes

Primary outcome:

CO-verified 6-month continuous abstinence at 7-month follow-up. Continuous 6-month abstinence will be defined as having remained quit for 6 months (having smoked no more than 5 cigarettes in that time), and a CO level of ≤ 5 ppm. Depending on the participant's indicated preference, the CO breath test will be self-administered using a hand-held iCO™ Smokerlyzer® (using provided instructions), or administered by a trained researcher using a hand-held iCO™ Micro+™ Smokerlyzer® with a disposable, one-use mouthpiece. Both devices are non‐invasive and require the participant to blow air into the device for 15 seconds to measure their CO level. An exhaled CO level of ≤ 5 ppm will be considered abstinent.
The final follow-up interview will occur 7 months after the baseline interview completion date.

Secondary outcome:

Change in financial stress (assessed using Index of Financial Stress)

Starting date

Start date: 30 March 2021. Date last data collection 8 Dec 2022.

Contact information

Dr Ryan Courtney, National Drug and Alcohol Research Centre The University of New South Wales Sydney NSW 2052 Australia, r.courtney@unsw.edu.au

ISRCTN14068059

Study name

E-cigarettes for smoking cessation and reduction in people with a mental illness, ESCAPE

Methods

RCT, multicentre

Setting: GP practice, hospital, England, UK

Organisation: University of York

Tees, Esk and Wear Valleys NHS Foundation Trust; Bradford District Care NHS Foundation Trust; Sheffield Clinical Commissioning Group Hq; Oxford NHS Foundation Trust; Greater Manchester Mental Health NHS Foundation Trust; South West Yorkshire Partnership NHS Foundation Trust; Nottinghamshire Healthcare NHS Foundation Trust; Lancashire and South Cumbria NHS Foundation Trust; Norfolk and Suffolk NHS Foundation Trust; CRN North East and North Cumbria; CRN East of England; The Burns Practice Bennetthorpe; Conisborough Medical Practice Conisbrough, Doncaster; Woodstock Bower Surgery, Rotherham

Participants

Target N = 616

Mental Health Trusts and GP practices mainly in Yorkshire (UK)

Inclusion: adults (aged over 18 years) receiving treatment for a mental illness in primary or secondary care, who smoke regularly, willing to quit or reduce cigarette smoking

Exclusion: inpatient admission in the last 3 months; currently using EC regularly (at least weekly); participating in other smoking cessation trials; receiving treatment for drug or alcohol use; Alzheimer’s disease or dementia; pregnant or breastfeeding

Interventions

Group 1 EC: e-cigarette and e-liquid to use for 4 weeks in addition to the usual care they are receiving. EC starter kit, a 20 mg/mL strength DOTPRO e-cigarette starter kit (https://www.liberty-flights.co.uk/DOT-PRO/DOT-PRO-Vape-Kit/) will be offered in a choice of flavours. The starter kit containing a pod-based e-cigarette, a 4-week supply of refill pods and an information leaflet. Brief face-to-face consultation with a clinician, who will explain how to use the e-cigarette and provide information to enable participants to make positive changes to their smoking behaviour. Encouraged to set a quit date. Participants will be provided with an e-liquid supply for 4 weeks.

Group 2, usual care: participants will receive care as usual but will receive an e-cigarette and some e-liquid at the end of the study at the 6-month follow-up.

Outcomes

Baseline, 1, 6 months

Questionnaire; CO monitor

Primary outcome measure

  1. Self-reported 7-day point prevalence abstinence measured using a questionnaire (question written in-house) at 6 months
  2. Co-verified quit (main outcome) measured using a CO monitor (smokylizer) at 6 months

Secondary outcome measures

  1. General smoking-related characteristics, abstinence, quit attempts and methods (including e-cigarettes), measured using a questionnaire (questions written in-house) at baseline, 1 month and 6 months
  2. Nicotine dependence measured using the Fagerstrom Test for Nicotine Dependence at baseline, 1 month and 6 months
  3. Strength of urges to smoke measured using the SUTS questionnaire at baseline, 1 month and 6 months
  4. Motivation to quit measured using the Motivation To Stop Scale (MTSS) at baseline, 1 month and 6 months
  5. Mental wellbeing measured using PHQ-9 and GAD-7 at baseline and 6 months
  6. Alcohol use measured using AUDIT-C at baseline and 6 months
  7. Health-related quality of life measured using EQ-5D-5L at baseline and 6 months
  8. Attrition measured using a questionnaire (questions written in-house) at 1 month and 6 months
  9. Adherence rate measured using a questionnaire (questions written in-house) at 1-month follow-up
  10. Cost-effectiveness measured using a questionnaire (questions written in-house) at baseline, 1 month and 6 months
  11. Adverse events measured using a questionnaire (questions written in-house) at 1 month and 6 months

Starting date

Study start date: March 2023

Estimated study end date: April 2025

Contact information

Dr Anna-Marie Marshall, a.marshall@york.ac.uk. Lion Shahab, Lion.shahab@ucl.ac.uk

Notes

New to 2024

Funding: Yorkshire Cancer Research (UK)

ISRCTN61193406

Study name

Do e-cigarettes help smokers quit when not accompanied by intensive behavioural support? A multi-center randomized controlled trial

Methods

RCT

Setting: UK

Multicentre. Participants will be recruited mainly from hospitals and GP practices across the UK by the Clinical Research Network. The study is being organized by Queen Mary University of London (QMUL).

Researchers from QMUL will provide the study treatment and conduct follow-up calls.

Participants

1170 people who smoke tobacco cigarettes

Inclusion criteria:

  • Adult daily smokers who are motivated to stop smoking
  • Must own a mobile phone and be willing to try either an online or texting treatment package, or both, or an e-cigarette with or without telephone support
  • Be happy to receive follow-up calls
  • Be able to read/write/understand English

Exclusion criteria:

  • Women who are pregnant
  • Currently using an e-cigarette

Interventions

  1. Control: NHS Quit Now programme (QN)
  2. E-cigarette starter pack with no ongoing support (EC)
  3. EC starter pack with helpline support (EC+)

The study will aim to use a refillable EC that is similar to the type used in a previous EC trial (One Kit - Innokin, UK Ecig Store), and one that is compliant with UK regulations, and not produced by a tobacco company.

Outcomes

Follow-up at 4 weeks, 6 months and 12 months. CO at 6 and 12 months

Primary outcome measure:

Sustained smoking cessation at 6 months post-TQD. This is measured by asking participants if they have smoked since their TQD at the 6-month follow-up. To be counted as a 'quitter', participants must report smoking no more than 5 cigarettes since 2 weeks post-TQD with no smoking in the previous week, validated by carbon monoxide (CO) reading of < 8 ppm. Participants lost to follow-up will be counted as smokers.

Secondary outcome measures:

  • Validated sustained abstinence rates measured by asking smoking status and taking a carbon-monoxide reading at 12 months post-TQD
  • Validated sustained abstinence rates between 6 and 12 months, measured by asking smoking status and taking a carbon-monoxide reading at 6 and 12 months
  • Self-reported 7-day point-prevalence abstinence, measured by asking smoking status in last 7 days at 4 weeks, 6 months and 12 months post-TQD
  • Cigarette consumption in non-abstainers by vaping status, measured by questionnaire at four weeks, 6 and 12 months
  • Frequency and severity of urges to smoke and withdrawal symptoms, measured by questionnaire at 4 weeks post-TQD
  • Weight, measured by asking weight at 4 weeks, 6 months and 12 months post-TQD
  • Respiratory symptoms, measured by questionnaire, at 4 weeks, 6 months and 12 months post-TQD
  • Treatment adherence and ratings, measured by questionnaire at 4 weeks (and 6 and 12 months for EC arms)
  • Adverse reactions to EC, measured by questionnaire at 4 weeks, 6 and 12 months post-TQD
  • Cost-effectiveness of the interventions, measured by questionnaires at baseline, 6 and 12 months
  • Smokers' and healthcare professionals' views and opinions of the helpline, measured by one-off qualitative interviews separate to the main trial

Starting date

Overall trial start date: 1 September 2020

Estimated completion date January 2025

Contact information

Dr Katie Myers Smith, katie.smith@qmul.ac.uk

ISRCTN82413824

Study name

Effectiveness of electronic cigarettes compared with combination nicotine replacement therapy for smoking cessation in patients with chronic obstructive pulmonary disease and effect on lung health (ECAL Trial)

Methods

Multicentre, two-arm randomized controlled trial with embedded cost-effectiveness and cohort analyses (Prevention, Efficacy)

Setting: England, Scotland, UK

Study to look at CC abstinence, COPD and respiratory outcomes

Participants

Target sample size: 1250

Inclusion criteria: COPD diagnosis previously confirmed by post-bronchodilator spirometry (FEV1/FVC < 0.7), any GOLD stage; current smoker (= 5 cigarettes per day); motivated to stop smoking; aged 35 or over

Exclusion criteria: unable to perform spirometry to a satisfactory standard (e.g. due to dementia, lack of teeth, lack of coordination or not having a good oral seal); unsuitable to participate in the trial (e.g. terminal illness, unable to give informed consent); unable to participate in behaviour support calls; severe angina or unstable cardiovascular disease; end stage kidney disease/cirrhosis of the liver; taking NRT, bupropion, varenicline or ECs to stop or reduce smoking; in another trial of smoking cessation or COPD treatment/management; COPD exacerbation or inpatient hospital stay within the last 8 weeks; contraindications to spirometry within the last 12 weeks – tuberculosis infection, cardiac infarction, retinal detachment or surgery on the chest, abdomen, brain, ears or eyes

Interventions

EC + telephone support vs NRT + telephone support

Intervention arm: Electronic Cigarettes (EC) - At the baseline visit, participants will be given an EC starter pack and an initial supply of e-liquid (up to 20 mg nicotine/mL). Participants will be provided with instructions on how to continue sourcing further supplies themselves from reputable vendors in their preferred nicotine strength and flavours.

Comparator arm: Combination Nicotine Replacement Therapy (NRT) - Participants will receive up to a 12-week supply of a nicotine patch plus a fast-acting nicotine product to be used in combination. Participants who do not wish to use patches (e.g. due to previous experience with skin irritation) will be offered 2 types of fast-acting products.

Telephone behavioural support: All participants (intervention and comparator arm) will be advised at the baseline visit that they will receive 6 weekly behavioural support telephone calls from stop-smoking advisors which will commence within a few days of the baseline visit. During these calls, the advisor will deliver behavioural support according to the National Centre for Smoking Cessation Training Standard Programme including setting a TQD and providing further support around medication use.

Outcomes

Baseline, 4, 26, 52 weeks

Questionnaire, CO monitored. Study to look at CC abstinence, COPD and respiratory outcomes.

Primary outcome

Abstinence from smoking since target quit date (TQD) biochemically validated (exhaled CO < 8 ppm), defined in accordance with the Russell Standard. This will be measured with a questionnaire and exhaled carbon monoxide measurement at 52 weeks post-TQD.

Secondary outcomes

  1. Abstinence from smoking for at least 26 weeks biochemically validated (exhaled CO < 8 ppm) measured using a questionnaire at 52 weeks
  2. 7-day point prevalence abstinence from smoking biochemically validated (exhaled CO < 8 ppm) measured using a questionnaire at 52 weeks
  3. Self-reported abstinence from smoking for at least 26 weeks measured using a questionnaire at 52 weeks
  4. Self-reported 7-day point prevalence abstinence from smoking measured using a questionnaire at 4, 26, and 52 weeks
  5. Reduction in cigarettes smoked (self-report of any and > 50% reduction) from baseline to 52 weeks measured using a questionnaire, confirmed by reductions in expired CO readings at 52 weeks
  6. Reduction in cigarettes smoked (self-report of any and > 50% reduction) from baseline to 26/52 weeks, measured using a questionnaire
  7. Continued use of the allocated product measured using a questionnaire at 4, 26 and 52 weeks
  8. Withdrawal symptoms and urges to smoke (change from baseline to 1/2/3/4 week) measured using the mood and physical symptom scale (MPSS)
  9. COPD Symptoms (change from baseline to 4/26/52 weeks) measured using COPD Assessment Test (CAT) and the Clinical COPD Questionnaire (CCQ)
  10. Number of COPD exacerbations over the past 52 weeks (change from baseline to 52 weeks) measured using a questionnaire
  11. Number of self-reported upper respiratory tract over the past 52 weeks (change from baseline to 52 weeks) measured using a questionnaire
  12. Post bronchodilator spirometry (FEV1, FVC and MMEF change from baseline to 52 weeks). Forced Expiratory Volume in 1 Second (FEV1): The maximal volume of air that can be expired in the first second of a forced expiration from a position of full inspiration (measured in Litres (L) and also expressed as the % predicted for age, sex, height and race). Forced Vital Capacity (FVC): The maximal volume of air that can be expired during a forced and complete expiration from a position of full inspiration (measured in L and % predicted). Mean Mid-Expiratory Flow (MMEF): The average flow between 25% and 75% of the FVC manoeuvre (measured in L/sec and % predicted).

Health economic outcomes:

  1. Health-related quality of life (EQ-5D-5L) measured using a questionnaire change from baseline to 4/26/52 weeks
  2. Use of healthcare resources and costs measured using a questionnaire at 26 and 52 weeks
  3. Cost-effectiveness based on cost per quitter and cost per Quality-Adjusted Life-Year (QALY) at 52 weeks, and modelled cost per QALY over a patient's lifetime

Starting date

Study registered: October 2023. First enrolment March 2024.

Estimated study completion: September 2025

Contact information

Amanda Farley, a.c.farley@bham.ac.uk

Institute of Applied Health Research, University of Birmingham, UK

Notes

New to 2024 update.

Funding: National Institute for Health and Care Research

Lin 2024

Study name

Efficacy of Electronic Cigarettes vs Varenicline and Nicotine Chewing Gum as an Aid to Stop Smoking: A Randomized Clinical Trial

ChiCTR2100048156 (Chinese Clinical Trial Registry)

Methods

RCT 3 arm open label, multicentre

Setting: 7 sites in China. China-Japan Friendship Hospital (Beijing, China), Peking University Health Science Center (Beijing, China), Beijing Hospital (Beijing, China), Beijing Xiyuan Hospital (Beijing, China), Beijing Geriatric Hospital (Beijing, China), Beijing Dongzhimen Hospital (Beijing, China), and Wuhan Tongji Hospital (Wuhan, China)

Recruitment: Participants were recruited via trial sites, local newspapers, community events, websites, and referrals from other medical institutions.

Inclusion criteria: smoked at least 10 cigarettes per day for at least 5 years, had expired air carbon monoxide (CO) reading of 9 parts per million (ppm) or greater, were aged 25 to 45 years, and were motivated to stop smoking. Age group chosen: “Due to concerns about adverse events being more likely in older age groups, the sample was limited to adults aged 25 to 45 years. Caution is needed in generalizing the results to older smokers.”

Exclusion criteria: pregnancy or breastfeeding, use of stop-smoking medication during the previous 30 days, ever used ECs for 7 days or longer, history of severe psychiatric illness, unwillingness to use study products, and current diagnosis of cancer or in remission from cancer for less than 1 year.

Participants

Total N = 1068

EC = 409; varenicline = 409; NRT = 250

33.5% female; mean age 33.9 (SD 3.1); mean CPD 16.0 (SD5.3); mean FTND 4.1 (SD 2.1)

EC use at baseline: no

Motivation to quit: 50.4% had made previous quit attempt; 49.6% had not made previous quit attempt

Interventions

1. EC arm. A cartridge-based EC product called RELX Wuxian (RELX Technology (30 mg/mL nicotine salt for 2 weeks and 50 mg/mL after that)). Leaflet with product use instructions. Supplied for 12 weeks free. Choice of 3 flavours: mung bean, watermelon, and ice cream.

Participants were instructed to use 30 mg/mL cartridges of their preferred flavour for the first 2 weeks and 50 mg/mL cartridges after that, but were asked to continue using 30 mg/mL or reverse to it if they did not like the higher strength. One cartridge was expected to last for 3 days. At the baseline session, 10 cartridges were provided, with an option to request additional supplies at 1-month and 2-month follow-ups (up to 30 cartridges altogether). Participants were instructed to start using their EC ad lib from the next day and stop smoking completely from their TQD onward.

2. Varenicline arm (0.5 mg, once a day for 3 days; 0.5 mg, twice a day for 4 days; and 1 mg, twice a day, after that). Supplied for 12 weeks free. Participants received a 12-week supply of varenicline (Chantix; Pfizer) and a leaflet with product use instructions. Participants were instructed to take varenicline, 0.5 mg, once per day for the first 3 days, followed by 0.5 mg twice a day for the next 4 days and 1 mg twice a day from day 8, as per the China Clinical Guidelines for Tobacco Cessation. The product was purchased from the manufacturers. Participants were instructed to start using varenicline from the next day and stop smoking completely from their TQD onward.

3. NRT arm: nicotine chewing gum 2 mg (for smokers of 20 cigarettes per day) or 4 mg (> 20 cigarettes per day). Supplied for 12 weeks free

Participants received a 12-week supply of nicotine chewing gum (Johnson & Johnson) product use instruction leaflet. Nicotine gum was selected as the most widely used form of NRT in China. Three boxes containing 105 pieces of the gum each were provided at each monthly contact, with an option to request additional supplies if needed. Participants who smoked up to 20 cigarettes per day received 2 mg nicotine gum, those smoking 20 or more cigarettes per day received 4 mg nicotine gum. Both strengths were provided with the fresh mint flavour. Supplies were bought from the manufacturer. Participants were instructed to use 8 to 12 pieces per day during the first 6 weeks, 4 to 8 pieces per day during weeks 7 and 8, and 2 to 4 pieces per day during the final 4 weeks, asper China Clinical Guidelines for Tobacco Cessation. Participants were instructed to use their NRT from the next day and stop smoking completely from the TQD onward.

All groups: At the 3-month visit, participants were told that they could continue to use their products as needed, but would have to purchase them themselves. A leaflet was provided with information on where the products could be bought. At the last visit, participants received a $60 shopping voucher.

All groups: accompanied by minimal behavioural support (an invitation to join a self-help internet forum). WeChat group for motivational support

All participants set up their target quit date (TQD), normally 2 weeks after the baseline visit.

All participants received a $40 shopping voucher as compensation for their time and travel. The baseline visit took approximately 30 to 45 minutes. At the last visit, participants received a $60 shopping voucher.

Outcomes

Baseline, 1, 2, 3, 4, 5, 6 months

CO measured at all time points

Baseline and 6 months – blood pressure (BP) and heart rate

Starting date

Study start date May 2021

Contact information

Nicholas I. Goldenson, Juul Labs, Inc., 1000 F Street NW, Suite 800, Washington, DC 20004, United States. Email: Nicholas.Goldenson@juul.com

Funding: This study was funded by Juul Labs, Inc.

Notes

New to 2024 update

This study was published then withdrawn. We will monitor to see when this is re-published.

Authors stated: “109 participants, who should be in NRT group, were wrongly placed in the EC group, while another 109 participants, who should be in EC group, were wrongly placed in the NRT group."

Malik 2023

Study name

Protocol for randomized, two arm parallel, clinical trial for effectiveness of THR products in Low and Middle Income Counties

Methods

RCT

Recruitment: outpatient clinics and advertisements will be used for the recruitment of participants and directed to contact the trial site by phone, email, or through the study website. Randomisation: A web-based application will be used to issue a computer-generated sequence for randomization by the principal investigator.

Setting: Pakistan

Participants

Target N = 258

Inclusion: Adults who smoke tobacco cigarettes among the general population in Low and Middle Income Countriss and have the motivation to quit.

Exclusion: pregnant/ breastfeeding; taking any other NRT and/or enrolled in any other smoking cessation program; any contraindications to products such as cardiovascular history; and/or suffering from a major illness with a prognosis of less than 1 year.

Interventions

(1) E-cigarettes (18mg/ml) with individual counseling

(2) Nicotine patches (21mg) with individual counseling.

Both groups: On allocated quit day, the participants will stop smoking and use study product daily for the next twelve weeks.

Outcomes

Baseline, weeks 1, 2, 4, 8, 12, 18, 24, and 52.

12 week treatment.

Abstinence from CC; Use of CC; AEs; Withdrawal;

Exhaled carbon monoxide assessment will be used at the trial site to quantify biochemically validated smoking abstinence.

Starting date

Not stated

Contact information

Madeeha Malik, ceo@cyntaxhealthprojects.com

Notes

Added in 2025. Industry funded (Foundation for a Smoke Free World)

Murray 2020

Study name

Yorkshire Enhanced Stop Smoking (YESS) study: a protocol for a randomized controlled trial to evaluate the effect of adding a personalized smoking cessation intervention to a lung cancer screening programme

Methods

RCT

Setting: Yorkshire, UK

Participants

Actual recruitment: 1001 people who smoke tobacco cigarettes (target 1040)

Participants are aged 55 to 80, registered with a general practitioner (GP) in the Leeds Clinical Commissioning Group area and registered as a current or ex-smoker in primary care databases

Inclusion criteria:

  • Attended a lung health check (LHC) and consent to participate in the Yorkshire Lung Screening Trial (YLST)
  • Have smoked within the last month
  • Have an exhaled carbon monoxide (CO) reading ≥ 6 ppm
  • Have agreed to see an SCP on the mobile unit

Exclusion criteria:

  • Any individual who does not have an LDCT scan
  • Unable to provide informed consent

Interventions

Arm 1: enhanced, personalized smoking cessation (SC) support package, including CT scan images. SC support over 4 weeks comprising behavioural support, pharmacotherapy and/or a commercially available e-cigarette

Arm 2: continued standard best practice

Outcomes

Follow-up contact will be requested at 4 weeks, 3 months, and 12 months, with a 2-week window to accommodate participant availability.

The primary objective is to measure 7-day point prevalent carbon monoxide (CO)-validated SC after 3 months.

Secondary outcomes include CO-validated cessation at 4 weeks and 12 months, self-reported continuous cessation at 4 weeks, 3 months and 12 months, attempts to quit smoking and changes in psychological variables, including perceived risk of lung cancer, motivation to quit smoking tobacco, confidence and efficacy beliefs (self and response) at all follow-up points.

Starting date

January 2019 and December 2020 with follow-up data collection ending December 2021. Study completion March 2022.

Contact information

Professor Rachael L Murray; rachael.murray@nottingham. ac.uk

NCT01842828

Study name

Spain-UK-Czech E-cigarette Study (SUKCES)

Methods

Randomized controlled trial, open-label pilot study

Setting: smoking cessation clinics in London, Madrid and Prague

Recruitment: via smoking cessation clinics

Participants

220 people who smoke, seeking help to quit

Inclusion criteria:

  • 18 years or older
  • Want help to quit

Exclusion criteria:

  • Pregnant or breastfeeding
  • Enrolled in other research
  • Currently using EC

Interventions

  • Standard care plus 4 weeks EC supply
  • Standard care only

Outcomes

  • CO-validated continuous abstinence at 4 and 24 weeks post-TQD
  • Withdrawal symptoms at 1 and 4 weeks post-TQD
  • EC use
  • EC taste and satisfaction compared to conventional cigarettes
  • Adverse events

Starting date

December 2013

Contact information

Peter Hajek, p.hajek@qmul.ac.uk

NCT02398487

Study name

Head-to-head comparison of personal vaporizers versus cig-a-like: prospective 6-month randomized control design study (VAPECIG 2)

Methods

Randomized, parallel-assignment, open-label trial

Setting: Italy, community

Participants

Estimated enrolment: 200

Inclusion criteria:

  • (People who smoke) in good general health
  • Committed to follow trial procedures

Exclude if:

  • Recent vaping history (stopped vaping < 3 months ago)
  • Use of any other form of non-combustible nicotine-containing products (chewable tobacco or nicotine replacement therapy)
  • Symptomatic cardiovascular disease
  • Clinical history of asthma and COPD
  • Regular psychotropic medication use
  • Current or past history of alcohol abuse
  • Use of smokeless tobacco or nicotine replacement therapy
  • Pregnancy or breastfeeding

Interventions

Comparison between 2 types of EC; 'personal vaporizers' and 'cig-a-like'

Outcomes

24 weeks:

  • Smoking cessation
  • Smoking reduction

Starting date

October 2014. Actual completion December 2015.

Authors unable to provide date when study will be available.

Contact information

Riccardo Polosa

NCT02590393

Study name

The role of nicotine and non-nicotine alkaloids in e-cigarette use and dependence

Methods

Randomized, parallel-assignment, double-blind trial

Setting: smoking research clinic, USA

Recruitment: volunteers

Participants

Estimated enrolment: 375

Inclusion criteria:

  • Have no known serious medical conditions
  • Are 18 to 65 years old
  • Smoke an average of at least 10 cpd
  • Have smoked at least 1 cumulative year
  • Have an expired air CO reading of at least 10 ppm
  • Are able to read and understand English

Exclude if: multiple, related to baseline health status

Interventions

  • Switch to standard nicotine EC use for 8 weeks
  • Switch to ECs with same nicotine but very low non-nicotine alkaloid levels
  • Switch to ECs with very low nicotine and non-nicotine alkaloids

Outcomes

Primary:

  • CO levels at 8 weeks

Secondary:

  • EC use
  • EC solution use
  • Cigarette use, at 8 weeks

Starting date

May 2016. Study completion 2022.

Emailed author Feb and March 2024 no response.

Contact information

Jed Rose, jed.rose@duke.edu

Notes

"This is not a smoking cessation study; people who smoke will not be asked to quit smoking, and e-cigarettes will not be used as a medical device or therapy."

NCT03277495

Study name

Predictors and consequences of combustible cigarette smokers' switch to standardized research e-cigarettes

Methods

RCT. Randomized, parallel assignment

Setting: USA

Participants

Estimated enrolment 120 participants

Nicotine EC = 60; placebo EC = 60

Inclusion criteria: ≥ 21 years; ≥ 7 cpd ≥ 1 yr; breath CO ≥ 10 ppm; interested in reducing combustible cigarette use; willing to try EC; attend in-person assessments for 5 months; English-speaking; women who are of childbearing age cannot be pregnant and must agree to use an approved form of birth control during the study.

Exclusion criteria: current use of any smoking cessation medication or participation in a smoking cessation programme or study; daily EC use; pregnancy; no 2 members of the same household may participate in this study.

Interventions

EC: Standardized Research E-Cigarette (SREC)

Participants will be stratified by sex and use of menthol cigarettes and randomly assigned with a 1:1 allocation ratio to one of two conditions:

  1. Active comparator: nicotine SREC. The liquid in the e-cigarette refills contains nicotine and comes in the following flavours: tobacco, menthol, blueberry, and watermelon.
  2. Placebo comparator: placebo SREC

The liquid in the e-cigarette refills does not contain nicotine and comes in the following flavours: tobacco, menthol, blueberry, and watermelon.

Outcomes

3, 4, 5 to 13, 14, 18 weeks

Combustible cigarette use

Abstinence from combustible cigarettes (defined as no cigarette smoking in the past 7 days)

The total number of cigarettes smoked in the 7 days prior to the last assessment

CO level. BP. Heart rate. Weight. Self-report of respiratory symptoms. Fagerstrom Test for Nicotine Dependence

Starting date

Estimated starting date June 2022. Estimated completion date: August 2024

Contact information

Kathleen Diviak, PhD 312-996-2327 kdiviak@uic.edu

Notes

New to 2022 update

NCT03625986

Study name

Does switching to nicotine containing electronic cigarettes reduce health tisk markers

Methods

RCT. Prospective, parallel-group, randomized, double-blind, placebo-controlled study

Setting: Penn State Milton S. Hershey Medical Center, USA

Participants

Estimated enrolment: 240

Inclusion criteria: age 21 to 70 years; smoke regular, filtered cigarettes or machine-rolled cigarettes with a filter ≥ 5 cpd for ≥ 12 months (CO ≥ 6 ppm at baseline visit); no serious quit attempt in prior month; willing to stop cigarette consumption and switch to an EC and to attend regular visits over a 7-week period

Exclusion criteria: unstable or significant medical condition such as COPD, kidney disease, or liver disease in the past 12 months or severe immune system disorders, uncontrolled mental illness or substance abuse or use of illicit drug/prescription, history of a seizure or seizure medication. Use of any non-cigarette nicotine delivery product in the past 7 days (including EC); use of hand-rolled, roll-your-own cigarettes; allergy to propylene glycol or vegetable glycerin; pregnancy or breastfeeding

Interventions

EC: Pod

The electronic cigarette (e-cig) used in this study will be the Standardized Research Electronic Cigarette (SREC). The SREC product is a pod-based device and comprises a replaceable pre-filled liquid reservoir ("pod") and a rechargeable power supply unit.

Arm 1. Experimental: Nicotine-containing electronic cigarette

The experimental group will be provided with and encouraged to use a Standardized Research Electronic Cigarette (SREC) with liquid containing 58 mg/mL nicotine for the duration of 6 weeks.

Arm 2. Placebo comparator: Non-nicotine electronic cigarette

The placebo group will be provided with and encouraged to use a Standardized Research Electronic Cigarette (SREC) with liquid containing 0 mg/mL nicotine for the duration of 6 weeks.

Outcomes

3 weeks, 6 weeks, 10 weeks (phone)

3 weeks and 6 weeks after switching

NNAL, FEV1, CO, plasma cotinine concentration, Fagerstrom Test for Nicotine Dependence mean total score, cpd, abstinence from cigarettes and other tobacco (not including e-cigs) CO < 6 ppm, total score on Minnesota Nicotine Withdrawal Scale, EC use days, self-reported abstinence

Starting date

Actual start date 22 April 2022. Study completion date: 23 February 2024.

Contact information

Jessica Yingst, DrPH 7175314637, jyingst@phs.psu.edu

Nicolle Krebs, MS 7175315673, nkrebs@pennstatehealth.psu.edu

Notes

New to 2022 update

NCT03862924

Study name

Health effects of the standardized research e-cigarette in smokers with HIV (ProjectSREC)

Methods

RCT

12 week study. Randomization: computerized urn randomization

Setting: Brown University, USA

Participants

Target N = 72

HIV positive CC smokers, who are not ready or willing to quit smoking

Inclusion Criteria: diagnosed with and engaged in care for HIV (defined as at least one HIV clinic medical appointment within the past six month period. At least 18 years of age. Smoke at least 5 cigarettes per day for longer than one year. Exhaled CO greater than 5 at BL

Exclusion Criteria: intention to quit smoking in the next 30 days. Using pharmacotherapy for smoking cessation. Using electronic cigarettes more than 2 days/week. Unstable medical or psychiatric condition (defined as hospitalization). Medical contraindications to nicotine (unstable angina, uncontrolled hypertension, or recent cardiovascular event, including hospitalization). Psychotic symptoms. Substance use disorder other than nicotine dependence.Past-month suicidal ideation or past-year suicide attempt. Pregnant or nursing.

Specific population characteristic: HIV positive

Motivated to quit smoking: No.

EC use at baseline: No.

Interventions

1) EC arm. Standardized Research Electronic Cigarette. 6-weeks of free EC (a standardized form developed by the NIH) and encouraged to use them whenever they would smoke a regular cigarette.

2) Control arm. Continue to smoke their usual brand of CC.

At week 6, all participants receive advice to stop smoking and referral to the RI Department of Health Quitline (a state-funded smoking cessation resource/program), if desired.

Outcomes

Baseline, weekly for 6 weeks, 12 weeks

Change, weekly to week 6: CC use, heart and lung function (e.g. BP).

Change from baseline to 6 weeks: CO, serum biomarkers, toxicant levels (e.g.NNAL), pulmonary function (Forced expiratory volume in 1 sec (FEV1)).

Study aims to assess: 1) the feasibility and acceptability of EC distribution in people with HIV; 2) the effect of EC use on smoking behaviors; and 3) the change in cardiopulmonary symptoms and biomarkers in smokers who transition from CC to EC use.

Starting date

Start date March 2022. Estimated completion date: December 2024.

Contact information

Patricia Cioe PhD, patricia_cioe@brown.edu

Jasminette Dilorenzo BA, jasminette_dilorenzo@brown.edu

Notes

Ongoing study added 2025

NCT03962660

Study name

Harm reduction for tobacco smoking with support of tobacco-replacing electronic nicotine delivery systems (HaRTS-TRENDS)

Methods

Parallel, randomized controlled trial

Setting: USA

Recruitment: from prominent Housing First programmes serving chronically homeless people who are often affected by multiple psychiatric, medical and substance-use disorders. The proposed sample will be recruited from a highly vulnerable and marginalized population in a tight-knit urban community.

Participants

Estimated enrolment: 94

Inclusion criteria:

  • Having a history of chronic homelessness according to the widely-accepted federal definition
  • Being a current DESC client living in 1 of DESC's participating permanent supportive housing projects
  • Being between 21 and 65 years of age
  • Being a daily smoker (> 4 cigarettes/day in the past year with a breath CO ≥ 6 ppm or salivary cotinine test at level 1 if CO < 6 ppm)
  • Having adequate English language skills to understand verbal information and communicate in the study

Exclusion criteria:

  • Use of other tobacco products besides cigarettes ≥ 9 days in the past month
  • Refusal or inability to consent to participation in research
  • Constituting a risk to the safety and security of other clients or staff

Interventions

  • Intervention: HaRTS-TRENDS: 4 individual sessions delivered in the context of the interventionist's pragmatic harm-reduction mind set paired with a compassionate, advocacy-oriented 'heart-set' or style. It comprises the delivery of 4 manualized components, including:
    • a) participant-led tracking of preferred smoking outcomes,
    • b) elicitation of participants' harm-reduction goals and their progress toward achieving them,
    • c) discussion of the relative risks of various nicotine delivery systems,
    • d) instruction in using ENDS. Additionally, HaRTS-TRENDS entails provision of commercially available ENDS.
  • Standard care: The 4-session, individual standard care control condition entails the well-documented and evidence-based 5 As intervention (i.e. Ask about nicotine use, Assess use, Advice to quit smoking, Assist with exploring current smoking/planning smoking cessation, Arrange follow-up). Part of arranging follow-up is the recommendation to call the smoking quitline, which can supply additional counselling and nicotine replacement therapy.

Outcomes

Primary outcomes, measured across the 12-month follow-up:

  • Biologically-verified nonsmoking (i.e. self-reported nonsmoking if corresponding CO measure is < 8) in the past 7 days
  • Urinary concentration of a tobacco-specific nitrosamine

Secondary outcomes, measured across the 12-month follow-up:

  • Self-reported smoking intensity is the mean number of cigarettes participants report smoking per day in the 7 days prior to the assessment.
  • Self-reported smoking frequency is the number of days participants report smoking in the 7 days prior to the assessment
  • CO level
  • Urinary cotinine
  • FEV1%
  • 10-item Clinical COPD Questionnaire
  • EQ-5D-5L

Other outcomes:

  • Smoking craving
  • Side effects of ENDS

Starting date

9 May 2019

Contact information

Tatiana M Ubay, tatiubay@uw.edu

NCT04003805

Study name

Biomarkers of exposure and effect in standardized research e-cigarette (SREC) users

Methods

Design: RCT

Setting: USA

Participants

Estimated enrolment: 125

Inclusion criteria:

  • 18 to 65 smokers willing to stop smoking and completely switch to EC or medicinal nicotine
  • ≥ 5 cigarettes daily and not using any other nicotine or tobacco product; biochemically confirmed
  • Smoking daily for at least 1 year and no serious quit attempts

Exclusion criteria:

  • Regular tobacco or nicotine product use other than cigarettes
  • Currently using NRT or other tobacco cessation products
  • Significant immune system disorders, respiratory diseases, kidney or liver diseases or any other medical disorders that may affect biomarker data; taking anti-inflammatory medications; unstable health conditions; unstable mental health; excessive drinking; positive toxicology screen for illicit any drugs: pregnant or breastfeeding

For a full list see NCT record.

Interventions

EC: Standardized Research E-cigarette (SREC)

Arm 1: Experimental: Switching from Smoking Cigarettes to E (SREC)

The device operates at a single output voltage (3.30 ± 0.05 V) and uses sealed disposable 3 mL cartridges with tobacco-flavoured e-liquid (~350 puffs/cartridge). The concentration of nicotine in e-liquid is 15 mg/mL, and the vehicle composition is 50:50 propylene glycol and glycerin. The device uses a battery that can be recharged via a micro USB port.

Arm 2: Experimental: Switching from smoking cigarettes to nicotine mini-lozenge

We will use commercially available nicotine mini-lozenges containing 2 or 4 mg nicotine/lozenge (Nicorette, manufactured by GlaxoSmithKline). Dose will be determined per instructions on the package (e.g. if smoking within 30 minutes upon awakening, then 4 mg dose will be prescribed).

Outcomes

1 year

4 and 8 weeks for formaldehyde-DNA adducts and oxidative DNA adduct 8-oxo-dG in DNA

Biomarkers: TNE, NNAL, NNN, PneT, mercapturic acids HMPMA, 2-HPMA, 3-HPMA, formaldehyde-DNA adducts, oxidative DNA adduct 8-oxo-dG in DNA, NNN and nornicotine, HPB-releasing DNA adducts

cpd, product use (EC and nicotine lozenges), CC avoidance

Starting date

Actual start date: 11 May 2022. Estimated study completion date: January 2025

Contact information

Hanna Vanderloo, RN, MSN 612.624.4983, hannav@umn.edu

Notes

New to 2022 update

NCT04058717

Study name

Low nicotine cigarettes plus electronic cigarettes

Methods

RCT: randomized, parallel-group assignment, 2 x 2 factorial design

Setting: USA

Participants

Actual enrollment: 88. Estimated enrolment 240 participants

Inclusion criteria:

  • Meet lifetime diagnostic criteria for a current or lifetime unipolar or bipolar mood disorder
  • Smoke > 5 cigarettes per day for at least the prior 12 months
  • No serious cigarette smoking quit attempt or use of any FDA-approved smoking cessation medication in the prior 30 days; no plans to quit smoking within the next 3 weeks
  • Willing to both switch to a different type of cigarette that may contain a different amount of nicotine and to try an EC to substitute for some of their cigarettes

Exclusion criteria:

  • Unstable or significant medical condition in the past 3 months
  • Uncontrolled mental illness or substance abuse, or inpatient treatment for these in the past 6 months or current suicide risk
  • Use of any non-cigarette nicotine delivery product or EC
  • Use illegal drugs/prescription drugs
  • Pregnancy or breastfeeding

For a full list see NCT record.

Interventions

EC: type of EC not reported

Arm 1 Experimental: NNC cigarettes + high nicotine-containing e-cigarette. Participants are provided with normal nicotine content (NNC) cigarettes (11.6 mg nicotine/cigarette) plus e-cigarette with high nicotine e-liquid.

Arm 2 Experimental: NNC cigarettes + zero nicotine containing e-cigarette. Participants are provided with normal nicotine content (NNC) cigarettes (11.6 mg nicotine/cigarette) plus e-cigarette with zero nicotine e-liquid.

Arm 3 Experimental: VLNC cigarettes + high nicotine-containing e-cigarette. Participants are provided with very low nicotine content (VLNC) cigarettes (0.2 mg nicotine/cigarette) plus e-cigarette with high nicotine e-liquid.

Arm 4 Experimental: VLNC cigarettes + zero nicotine-containing e-cigarette. Participants are provided with very low nicotine content (VLNC) cigarettes (0.2 mg nicotine/cigarette) plus e-cigarette with zero nicotine e-liquid.

Outcomes

4, 8, 12 and 16 weeks

Urinary NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol)

Exhaled carbon monoxide

Kessler-6 score measure of serious psychological distress

Penn State Cigarette Dependence Index

Penn State Electronic Cigarette Dependence Index

Cigarette abstinence. No cigarette use in the past 7 days and exhaled carbon monoxide < 6 ppm

Starting date

Actual start date: 1 June 2021. Estimated completion date: Aug 2024.

Contact information

Nicolle Krebs, MS 717-531-5673, nkrebs@pennstatehealth.psu.edu

Jonathan Foulds, PhD 717-531-3504, jfoulds@psu.edu

Notes

New to 2022 update

NCT04063267

Study name

Electronic cigarettes as a harm reduction strategy in individuals with substance use disorder

Methods

Parallel-group, randomized trial

Recruitment/setting: Not specified

Participants

Actual enrollment: 48. Estimated enrolment: 240

Inclusion criteria:

  • Smokes at least 10 cpd
  • Meet DSM-V AUD and/or OUD within the past year, interested in reducing cpd
  • Able to provide consent
  • Use a cell phone, are willing/able to receive and respond to daily text messages about their cigarette use and e-cigarette use on their cell phone
  • Provide 1 additional contact, and are willing to use an e-cigarette for 3 weeks

Exclusion criteria:

  • Pregnant and/or breastfeeding (self-reported)
  • Currently using smoking cessation medications (including other forms of NRT, bupropion, or varenicline)
  • Enrolled in a smoking cessation programme or another cessation trial
  • Have used an e-cigarette in the past 14 days
  • Have used any other tobacco products (pipe, cigar, cigarillos, snuff, chewing tobacco, rolling tobacco, or hookah/shisha) in the past 30 days
  • Report having a history of asthma, other airways diseases, or heart disease

Interventions

E-cigarettes arm:

Participants will be encouraged to substitute e-cigarettes for combustible cigarettes in order to reduce nicotine withdrawal symptoms.

Nicotine Replacement Therapy arm:

Nicotine patches and gum to last them the first week based on their baseline recorded smoking. Participants will be advised to use both a 21 mg nicotine patch and 4 mg nicotine for cravings.

Outcomes

Baseline, 3 weeks.

AEs/SAEs.

Starting date

Start date: October 2020

Estimated completion date 30 June 2024

Contact information

NYU Langone Health, Scott.Sherman@nyulangone.org

Notes

In SRNT abstract no eligible data. To confirm that the SRNT abstract is linked to this study.

NCT04218708

Study name

Electronic cigarettes as a harm reduction strategy among people living with HIV/AIDS

Methods

RCT

Setting: NYU Langone Health, USA

Participants

Actual enrollment: 64. Estimated enrolment 120. [SRNT abstract N=43]

Inclusion criteria:

  • Current Combustible Cigarette (CC) smokers (more than 5 packs in a lifetime; smokes 4 or more days/week), at least 10 cigarettes per day on days they smoke CC
  • Motivated to quit smoking (at least a 5 on a 10-point Likert scale)
  • Be willing to use an e-cigarette or NRT for 12 weeks

Exclusion criteria:

  • Pregnancy or breastfeeding
  • Stated diagnosis of any medical condition (angina/heart disease) precluding use of nicotine patch or gum, or by self-report in screening questionnaire. Reporting a history of severe or untreated cardiopulmonary disease such as asthma or emphysema
  • Reporting using NRTs or e-cigarettes within the last 30 days
  • Have untreated/are undergoing current treatment for psychiatric illness or cognitive impairment

Interventions

EC: Pod. NIDA Standardized Research E-cigarettes (SREC) (15 mg/mL nicotine in tobacco flavour)

Arm 1: counselling + nicotine replacement therapies NRT

A research assistant (RA) trained in motivational interviewing and qualitative methods will support the PI to deliver counselling sessions and conduct interviews. Briefly, during each visit, with help of the RA, participants will provide exhaled CO and saliva cotinine test, and complete surveys in REDCAP using a tablet, allowing programmed logic checks and skip patterns to minimize burden. The RA will also deliver brief motivational counselling tailored to the participant's readiness to quit and arm in the study (NRT). Participants will also receive their NRT to last them to the following visit based on their baseline smoking.

Arm 2: Counselling + Standardized Research E-cigarettes (SREC)

Participants in the SREC arm to practice using the SREC and RA to give them instructions to return with their SREC and used refill tanks on every visit. A research assistant (RA) trained in motivational interviewing and qualitative methods will support the PI to deliver counselling sessions and conduct interviews. Briefly, during each visit, with help of the RA, participants will provide exhaled CO and saliva cotinine test, and complete surveys in REDCAP using a tablet, allowing programmed logic checks and skip patterns to minimize burden. The RA will also deliver brief motivational counselling tailored to the participant's readiness to quit and arm in the study (SREC). Participants will also receive their SREC to last them to the following visit based on their baseline smoking.

Outcomes

Week 1, 2, 4, 6, 8, 12

Change in cigarettes per day (cpd). Smoking reduction will be measured by a combination of self-report, text message data and changes in CO and saliva cotinine between baseline and end of treatment.

Assessing differences in nicotine withdrawal symptoms

Assessing differences in e-cigarette dependency

Assessing differences in nicotine use

Assessing differences in use of substance use

Assessing differences in side effects associated with e-cigarette use

Starting date

Study start date: 17 June 2021. Estimated study completion date: October 2024.

Contact information

Omar El Shahawy, MD 1-646-501-2587, omar.elshahawy@nyulangone.org

Notes

New to 2022 update

NCT04238832

Study name

Impact of non-cigarette tobacco product formulation on reinforcement value and use in current smokers

Short title: Salt-based e-cigarette

Methods

RCT

Setting: USA, South Carolina

Participants

Actual enrollment: 24. (Estimated enrollment: 30)

Inclusion criteria:

  • Daily cigarette smoker
  • Interested in using non-cigarette tobacco product
  • Have a smartphone that can receive text messages and has access to the internet or have an email account they check daily (necessary for daily diary completion)

Exclusion criteria:

  • Additional tobacco use criteria
  • Additional medical criteria

Interventions

Salt-base nicotine

Free-base nicotine

Outcomes

Most preferred product (time frame: Lab visit 2, occurring approximately 1 week after the initial screening/baseline visit)

Participants complete a preference assessment in which they choose between the salt liquid, free-base liquid, or a traditional cigarette in a series of trials. The outcome of this assessment is the product chosen most often by each participant.

Cigarettes per day (time frame: Week 2 of study)

The average number of cigarettes smoked per day during the 1-week sampling period

Biomarkers (i.e. expired CO, cotinine) will corroborate self-reported indices of use.

Starting date

23 June 2020. Estimated completion: August 2021

Contact information

Tracy Smith, smithtra@musc.edu

NCT04452175

Study name

Official title: Cigarette consumption after switchinG to high or low Nicotine strENght E-cigaretteS In Smokers with schizophrenia spectrum disorders: a 12-month randomized, double-blind multicentre trial

Brief title: Cigarette consumption after switchinG to high or low nicotine strENght E-cigaretteS In Smokers with schizophrenia (GENESIS)

NB: The GENESIS protocol (NCT04452175) now incorporates SCARIS protocol, NCT01979796. Antismoking effects of electronic cigarettes in subjects with schizophrenia and their potential influence on cognitive functioning: design of a randomized trial. Smoking Cessation And Reduction In Schizophrenia (The SCARIS Study). clinicaltrials.gov/show/NCT01979796

Methods

RCT

Multicentre: Italy, Russia, Ukraine, UK

Collaborators:

  • Juul Labs, Inc.
  • St. Petersburg State Pavlov Medical University
  • Bashkir State Medical University
  • Ukrainian Institute on Public Health Policy
  • University of Surrey
  • Eclat Srl

Participants

Estimated enrolment: 260

Inclusion criteria:

  • Adult (> 18 yrs)
  • Regular smoking (> 10 cigarettes a day; for at least 1 year)
  • Exhaled breath CO (eCO) level > 7 ppm
  • Not currently attempting to quit smoking or wishing to do so in the next 30 days; this will be verified at screening by the answer "NO" to the question "Do you intend to quit in the next 30 days?"
  • Schizophrenia spectrum disorder diagnosis (schizophrenia, delusional disorder, schizoaffective disorder, personality disorder, schizoid personality disorder, etc) by DSM-V criteria
  • Understand and provide informed consent
  • Able to comply with all study procedures

Exclusion criteria:

  • Institutionalized patients
  • Acute decompensation of schizophrenia spectrum disorder symptoms within the past month
  • Change in antipsychotic treatment within the past month
  • No recent history of hospitalization for any serious medical condition within 3 months prior to screening, as determined by the investigator
  • Myocardial infarction or angina pectoris within 3 months prior to screening, as determined by the investigator
  • Current poorly-controlled asthma or COPD
  • Pregnancy, planned pregnancy, or breastfeeding. Any female participant who becomes pregnant during this study will be withdrawn.
  • People who have a significant history of alcoholism or drug/chemical abuse within 12 months prior to screening, as determined by the investigator
  • Accepting to take part in a smoking cessation programme
  • People who regularly use any recreational nicotine (e.g. e-cigarettes) or tobacco product (e.g. tobacco heated products, oral smokeless) other than their own cigarettes within 30 days of screening
  • People who have used smoking cessation therapies (e.g. varenicline, bupropion, or NRT) within 30 days of screening
  • People who are still participating in another clinical study (e.g. attending follow-up visits) or who have recently participated in a clinical study involving administration of an investigational drug (new chemical entity) within the past 3 months
  • People who have, or who have a history of, any clinically significant neurological, gastrointestinal, renal, hepatic, cardiovascular, psychiatric, respiratory, metabolic, endocrine, haematological or other major disorder that, in the opinion of the investigator or their appropriately qualified designee, would jeopardize the safety of the participant or impact on the validity of the study results

Interventions

  • Experimental: high 5%. Intervention: JUUL e-cigarette
  • Active comparator: low 1.7%. Intervention: JUUL e-cigarette

Outcomes

Primary outcomes:

  • Rates of participants with continuous smoking abstinence at 6 months; time frame: 24 weeks
  • Self-reported continuous smoking abstinence at 6 months from the previous visit, biochemically verified by exhaled CO measurements of ≤ 7 ppm

Secondary outcomes

  • Rates of participants with continuous smoking abstinence at 12 months (time frame: 52 weeks)
  • Rates of participants with continuous smoking reduction at 6 months (time frame: 24 weeks)
  • Rates of participants with continuous smoking reduction at 12 months (time frame: 52 weeks)
  • Proportion of AEs (time frame: 24 weeks)
  • Absolute change in PANSS (time frame: 24 weeks)
  • Absolute change in mCEQ (time frame: 24 weeks)
  • Absolute change in Chester Step Test-derived values (time frame: 24 weeks)
  • Change in App-derived endpoints (self-rated mental health SRMH) (time frame: 24 weeks)

Starting date

Actual start date 30 October 2021. Estimated study completion: February 2023 (NCT record update posted on 23 May 2022)

Contact information

Pasquale Caponnetto, p.caponnetto@unict.it

NCT04521647

Study name

Effects of menthol in e-cigarettes on smoking behaviors

Methods

Randomized cross-over

Setting: Connecticut Mental Health Center, USA

Participants

Actual enrollment: 10. Estimated enrolment 85

Inclusion criteria: ≥ 21 years, use combustible cigarettes

Exclusion criteria: none

Interventions

EC: type not stated

Arm 1: menthol flavour. Participants will receive 5% nicotine in an EC. Participants will receive 2 nicotine concentrations via EC. Each exposure will be 10 3-sec puffs and ad libitum use.

Arm 2: tobacco flavour. Participants will receive 5% nicotine in an EC. Participants will receive 2 nicotine concentrations via EC. Each exposure will be 10 3-sec puffs and ad libitum use.

Outcomes

Baseline and 2, 5, 15, 30, 45, 60, 90, 120, and 180 minutes after nicotine exposure (plasma nicotine levels), 2 weeks (CO), 3 weeks, 5 weeks (BP and heart rate)

Primary outcomes: cigarette craving; plasma nicotine levels; carbon monoxide

Secondary outcomes: EC craving; irritation/harshness; liking of EC; coolness; nicotine withdrawal; stimulation; EC use; cigarette use. Other outcomes measured: heart rate, blood pressure, pulse oximetry

Starting date

Study start date: 1 November 2020. Completion date: 25 July 20253

Contact information

Asti Jackson, PhD 4752414904, asti.jackson@yale.edu

Notes

New to 2022 update

NCT04649645

Study name

International randomized controlled trial evaluating changes in oral health in smokers after switching to combustion-free nicotine delivery systems (SMILE)

Methods

RCT

Setting: multicentre: Italy, Moldova, Poland, UK, and Indonesia

Participants

Estimated enrolment 606 participants

Inclusion criteria:

  • Demonstrate understanding of the study and willingness to participate in the study by providing a signed written informed consent
  • Healthy, not taking regular medications for chronic medical conditions
  • Adults, age at least 18 years old
  • Presence of at least 10 natural anterior teeth in total (cuspid to cuspid, lower and upper jaw)
  • Presence of at least 18 'scorable' teeth with scorable facial and lingual surfaces. Teeth that are grossly carious, orthodontically banded, exhibiting general cervical abrasion and/or enamel abrasion, and third molars will not be included in the tooth count.
  • Willingness and ability to comply with the requirements of the study, including installing an APP on their digital device, e.g. smartphone or tablet

For Arms A and B, participants have to be:

  • Regular smokers, defined as: smoked for at least 5 consecutive years prior to screening. Smoked > 10 and < 30 cigarettes per day (cpd) with an exhaled breath carbon monoxide (CO) level ≥ 7 ppm at screening
  • Willing to regularly use any nicotine or tobacco product other than their own conventional cigarette brand within 14 days prior to screening
  • Willing to change to use of study products or, if randomized to Arm A, continuing to use their own brand of conventional cigarettes for the whole duration of the study

For Arm C, participants have to be:

  • Never-smokers, defined as: never smoked or who have smoked < 100 cigarettes in their lifetime and none in the 30 days prior to screening with an exhaled breath CO level < 7 ppm at screening
  • Willing to not smoke or use any form of tobacco or nicotine-containing products for the whole duration of the study

Exclusion criteria:

  • Pregnancy
  • Presence of extensive crown or bridge work, dental implants, and/or rampant decay (per investigator/examiner discretion)
  • Significant oral soft tissue pathology or any type of gingival overgrowth, other than plaque-induced gingivitis and mild periodontitis (Stage I)
  • Moderate-to-severe periodontitis (Stage II, III and IV) based on 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions, which require: Detectable interdental Clinical Attachment Loss (CAL) ≥ 3 mm at ≥ 2 non-adjacent teeth. Buccal or oral CAL ≥ 3 mm with pocketing ≥ 5 mm detectable at ≥ 2 teeth
  • Removable dentures or fixed and removable orthodontic appliance (except fixed lingual wires)
  • Significant history of alcoholism or drug abuse (other than tobacco/nicotine) within 24 months prior to screening, as determined by the investigator
  • A course of treatment with any medications or substances (other than tobacco/nicotine) which: interfere with the cyclo-oxygenase pathway (e.g. anti-inflammatory drugs including aspirin and ibuprofen) within 3 days prior to each visit or are known to have antibacterial activity (e.g. antibiotics) within 7 days prior to each visit

Interventions

Standard arm (Arm A): own tobacco cigarette brand

Intervention arm (Arm B): combustion-free nicotine delivery system (C-F NDS)

Control arm (Arm C): no smoking or use of any nicotine/tobacco products

Outcomes

Oral health parameters and teeth appearance, comparing short- and long-term impact on periodontal health between smokers continuing with conventional cigarette smoking, those switching to combustion-free nicotine delivery systems (C-F NDS), and never-smokers over 18 months

Starting date

Not yet recruiting (last updated February 2021)

Estimated study start date: Feb 2021. Estimated primary completion date: Feb 2023. Estimated completion April 2023.

Contact information

Principal investigator: Antonio Pacino, DDS, Addendo srl, Catania, Italy

info@addendo.net

NCT04708106

Study name

Characterization of product use in smokers switching from cigarettes to a RELX electronic nicotine delivery system

Setting: USA

Methods

Design: RCT, multicentre, open-label, parallel-cohort study

Participants

Estimated 200

Inclusion criteria:

  • Provides voluntary consent to participate in the study as documented on the signed informed consent form (ICF)
  • Is 22 to 65 years of age, inclusive, at the time of consent
  • Is willing to comply with the requirements of the study
  • Reports typically smoking 5 or more combustible cpd at screening
  • Has been a daily smoker for at least 12 months prior to screening. Brief periods of non-smoking (e.g. up to ~7 consecutive days due to illness, trying to quit, participation in a study where smoking was prohibited) ≥ 56 days prior to screening will be permitted at the discretion of the investigator.
  • Has a positive urine cotinine test (≥ 200 ng/mL) at screening and test visit 1
  • Has an eCO value > 10 ppm at screening and test visit 1
  • Has daily access to a cell phone for daily product use reporting
  • If female, meets one of the following criteria:
  • If of childbearing potential - agrees to use one of the accepted contraceptive regimens from at least 30 days prior to the first product use and during the study. An acceptable method of contraception includes one of the following:
  • Abstinence from heterosexual intercourse
  • Hormonal contraceptives (birth control pills, injectable/implant/insertable hormonal birth control products, transdermal patch)
  • Intrauterine device (with or without hormones) OR agrees to use a double barrier method (e.g. condom and spermicide) during the study
  • If a female of non-childbearing potential - should be surgically sterile (i.e. has undergone complete hysterectomy, bilateral oophorectomy, or tubal ligation) or in a menopausal state (at least 1 year without menses), as confirmed by follicle stimulating hormone (FSH) levels.

Exclusion criteria:

  • Has a history or presence of clinically significant uncontrolled gastrointestinal, renal, hepatic, neurologic, haematologic, endocrine, oncologic, urologic, pulmonary, immunologic, psychiatric, or cardiovascular disease, or any other condition that, in the opinion of the investigator, would jeopardize the safety of the subject or impact the validity of the study results
  • Has a clinically significant abnormal finding on the physical examination, medical history, vital signs, electrocardiogram (ECG), or clinical laboratory results, in the opinion of the investigator
  • Has a positive test for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV) at screening
  • Has a positive COVID-19 test at screening or during the study
  • Has had an acute illness (e.g. upper respiratory infection, viral infection) within 14 days prior to test visit 1
  • Has a fever (> 100.5°F) at screening or test visit 1
  • Has a body mass index (BMI) greater than 40.0 kg/m2 or less than 18.0 kg/m2 at screening
  • Has a systolic blood pressure < 90 mmHg or > 150 mmHg, diastolic blood pressure < 40 mmHg or > 95 mmHg, or heart rate < 40 bpm or > 99 bpm at screening
  • Has a post-bronchodilator forced expiratory volume in 1 second:forced vital capacity (FEV1:FVC) ratio < 0.7 and FEV1 < 50% of predicted at screening
  • Has a post-bronchodilator FEV1 increase ≥ 12% and > 200 mL from pre- to post-bronchodilator at screening
  • Has used an ENDS product on > 7 days during each of the 3 months prior to screening or any use from screening to test visit 1 other than as may be required for this study
  • Reports use of a very-low-nicotine content cigarette (e.g. Moonlight, Spectrum, VLN) as usual brand
  • Has used nicotine-containing products other than manufactured cigarettes (e.g. ENDS products (e-cigarettes), roll-your-own cigarettes, bidis, snuff, nicotine inhaler, pipe, cigar, chewing tobacco, nicotine patch, nicotine spray, nicotine lozenge, or nicotine gum) within 14 days prior to test visit 1
  • Has used any products for the purpose of smoking cessation, including, but not limited to, nicotine replacement therapies, varenicline (Chantix), or bupropion (Zyban) from 30 days prior to screening through the duration of the study
  • Is a self-reported puffer (i.e. draws smoke from the cigarette into the mouth and throat but does not inhale)
  • Is postponing a planned smoking quit attempt in order to participate in the study
  • Has a history of drug or alcohol abuse within 12 months prior to screening, as determined by the investigator
  • Is allergic to PG or glycerin
  • Has a positive urine drug or alcohol breath test at screening or test visit 1. At the discretion of the investigator, a subject testing positive for tetrahydrocannabinol may be permitted to participate if the subject reports use by routes other than inhalation.
  • If female, the subject is pregnant, breastfeeding, or intends to become pregnant from screening through the duration of the study
  • Has been treated for depression, diabetes, asthma, emphysema, or chronic obstructive pulmonary disease within 12 months prior to test visit 1
  • Has previously been diagnosed with any form of cancer, except for basal cell or squamous epithelial carcinomas of the skin that have been resected at least 12 months prior to screening 1
  • Has a planned surgery that would occur during study participation
  • Has participated in a previous clinical study for an investigational drug, device, biologic, or tobacco product within 30 days prior to test visit 1
  • Is or has a first-degree relative (e.g. spouse, parent, sibling, or child) who is a current or former employee of a tobacco or ENDS manufacturer or is a named party or class representative in litigation with the tobacco or ENDS industry
  • Is or has a first-degree relative (e.g. spouse, parent, sibling, or child) who is a current employee of the clinic site
  • Is or has a first-degree relative (e.g. spouse, parent, sibling, or child) who is a current employee of the sponsor
  • Has previously taken part in (from completion of any baseline measurements), has been withdrawn from, or has completed this study
  • In the opinion of the investigator, the subject should not participate in this study.

Interventions

RELX ENDS tobacco flavour ad libitum use of the RELX ENDS tobacco flavour product

RELX ENDS menthol flavour ad libitum use of the RELX ENDS menthol product

Ad libitum use of the RELX ENDS tobacco and menthol flavour products

Outcomes

Primary outcomes:

Weekly RELX ENDS product use; time frame: 56 days. Self-reported number of RELX ENDS pods started each week

Daily number of cigarettes smoked; time frame: 56 days. Self-reported number of cigarettes smoked daily by study week

Number of puffs from the RELX ENDS each day; time frame: 56 days. Self-reported number of puffs from the RELX ENDS daily by study week (0, < 100, ≥ 100 per day)

Secondary outcomes:

Biomarkers of exposure measured in blood; time frame: baseline, day 28, and day 56; change in carbon monoxide concentration in the blood

Biomarkers of tobacco exposure measured in urine; time frame: baseline, day 28, and day 56; change in creatinine-adjusted NNAL, NNN, 3-HPMA, CEMA, HMPMA, S-PMA, HEMA, 1-OHP, o-toluidine, nicotine equivalents, and propylene glycol excreted in urine

Subjective effects as measured by the Penn State (Electronic) Cigarette Dependence Index (PS(E)CDI); time frame: baseline, day 14, day 28, day 42, and day 56. Change in product dependence as measured by the PSCDI/PS(E)CDI total score. Total scores may range for 0 to 20, with higher levels of dependence associated with higher scores.

Subjective effects as measured by the Cough Questionnaire; time frame: baseline, day 14, day 28, day 42, and day 56. Change in self-reported cough symptoms as measured by responses to the Cough Questionnaire

Subjective effects as measured by the Questionnaire of Smoking Urges-Brief (QSU-Brief); time frame: baseline, day 14, day 28, day 42, and day 56. Change in smoking urge as measured by the QSU-Brief factor 1 and factor 2 scores. Questionnaire responses are measured on a Likert scale range of 1 (not at all) to 7 (extremely).

Subjective effects as measured by the Minnesota Tobacco Withdrawal Scale-Revised (MTWS-R); time frame: baseline, day 14, day 28, day 42, and day 56. Change in withdrawal symptoms as measured by the MTWS-R total score, which includes the DSM-5 and craving items from the Minnesota Tobacco Withdrawal Scale. Questionnaire responses are measured on a Likert scale range of 0 (none) to 4 (severe)).

Subjective effects as measured by the Modified Product Evaluation Scale (mPES); time frame: baseline, day 14, day 28, day 42, and day 56. Change in product assessments as measured by mPES satisfaction, psychological reward, aversion, and relief subscale scores. Questionnaire responses are measured on a Likert scale range of 1 (not at all) to 7 (extremely).

Subjective effects as measured by the Future Intent to Use Questionnaire; time frame: baseline, day 14, day 28, day 42, and day 56. Change in future intent to use cigarettes and ENDS products as measured by responses to the Future Intent to Use Questionnaire Questionnaire responses are measured on a Likert scale range of 1 (extremely unlikely) to 7 (extremely likely)

Subjective Effects as measured by the Health Effects Perceptions Questionnaire; time frame: baseline and day 56. Harmful and addictiveness perceptions as measured by responses to the Health Effects Perceptions Questionnaire

Puff topography - number of puffs; time frame: baseline, day 28, and day 56. Change in the number of puffs during a 1-hour puff topography session

Puff topography - puff duration; time frame: baseline, day 28, and day 56. Change in puff duration during a 1-hour puff topography session

Puff topography - puff volume; time frame: baseline, day 28, and day 56. Change in puff volume during a 1-hour puff topography session

Puff topography - peak puff flow rate; time frame: baseline, day 28, and day 56; change in peak puff flow rate during a 1-hour puff topography session

Puff topography - average flow rate; time frame: baseline, day 28, and day 56. Change in average flow rate during a 1-hour puff topography session

Puff topography - inter-puff interval; time frame: baseline, day 28, and day 56. Change in inter-puff interval during a 1-hour puff topography session

RELX ENDS product use; time frame: day 28 and day 56; change in pod weight during a 1-hour topography session

Incidence of product-use emergent adverse events (safety and tolerability); time frame: 56 days

Incidence of product-use emergent adverse events

Starting date

Study start date: 15 October 2020. Estimated completion date: April 2021

Contact information

Study Director: Donald Graff. Principal Investigator: Mark Adams, MD

Cheerain HK Limited. AMR, USA. Pillar Clinical Research, USA. QPS, USA. No contact details provided.

NCT04709471

Study name

E-cigarette nicotine study

Methods

Design: RCT. Parallel-group assignment

Setting: USA

Start date: 20 January 2021. Estimated completion date: September 2021

Participants

Actual enrollment 77. Estimated: 75

Eligibility criteria include at least 21 years old, use e-cigarettes and tobacco cigarettes regularly, not planning to quit in the near future, and not pregnant, breastfeeding or planning to become pregnant or breastfeed in the next 2 months

Additional criteria will be evaluated to assess for eligibility.

Interventions

Experimental: Switch to low-nicotine e-cigarettes: switch to e-cigarettes containing 60% of baseline e-cigarette nicotine content. Device: Juul e-cigarette. Participants will switch to Juul pods containing less nicotine.

Experimental: Reduce number of e-cigarette pods: reduce e-cigarette use to 60% of baseline number of pods per week
Behavioural: Reduction: participants will reduce the number of Juul pods that they use

No Intervention: Use e-cigarettes as usual: continue using nicotine e-cigarettes as usual

Outcomes

Baseline, 4 week reduction period, 8 weeks.

All participants will complete a web-based follow-up survey and provide a breath CO sample 4 weeks after study completion (i.e., 8 weeks after randomization) to assess tobacco use, ENDS use, quit attempts, and behavioral economic measures.

Primary outcome measure:

Feasibility; time frame: Baseline and the 4-week reduction period. The investigators will assess compliance with study e-cigarettes and compare the percentage of non-study e-cigarette use between conditions to determine which behaviour-changing strategy is more feasible.

Combustible cigarette smoking; time frame: Baseline and the 4-week reduction period. The investigators will compare change in number of cigarettes per day between conditions.

Cigarette dependence; time frame: Baseline and the 4-week reduction period. The investigators will compare change in cigarette dependence between conditions using the PATH dependence measure.

E-cigarette dependence: time frame: Baseline and the 4-week reduction period. The investigators will compare change in e-cigarette dependence between conditions using the PATH dependence measure.

Secondary outcome measure:

Cigarette demand; time frame: Baseline and the 4-week reduction period. The investigators will compare change in cigarette demand using the Brief Assessment of Cigarette Demand task.

E-cigarette demand; time frame: Baseline and the 4-week reduction period. The investigators will compare change in e-cigarette demand using a version of the Brief Assessment of Cigarette Demand task adapted for e-cigarettes.

Starting date

20 January 2021. Study completion date: June 2022.

Contact information

Elias M Klemperer, PhD802-656-1641, elias.klemperer@med.uvm.edu

NCT04725656

Study name

Concentration Impact Nicotine Salt (CINS)

Methods

Design: RCT

Participants

Estimated enrolment: 312

Inclusion criteria:

  • Adult (≥ 18 years old) smokers (at least 5 TC per day for at least 12 months)
  • Motivated to quit smoking as evidenced by signing the informed consent form at trial enrolment specifying that a target quit date will be set
  • Saliva cotinine of > 50 ng/mL at screening
  • Willing to participate in the trial even if allocated to the control group
  • Ability to communicate well with the investigator and to understand and comply with the requirements of the study
  • Signed informed consent form

Exclusion criteria:

  • Known hypersensitivity/allergy to a content of the e-liquid
  • Pregnancy or breastfeeding
  • Intention to become pregnant during the course of the study
  • Regular use of EC or tobacco heating systems
  • Use of NRT, varenicline, or bupropion in the month prior to the screening visit
  • Smoke tobacco combined with marijuana and do not currently want to quit marijuana use
  • Participation in an interventional trial within 30 days prior to the screening visit
  • Legal incapacity or limited legal capacity at screening
  • Any circumstances or conditions which, in the opinion of the investigator, may affect full participation in the study or compliance with the protocol

Interventions

Active comparator: Active arm, low concentration (18 mg/mL) nicotine salt e-liquids. Procedure: Smoking cessation counselling: smoking cessation counselling at baseline, week 1, week 2 and week 4
Other: Open system vape device and nicotine salt e-liquids; ad libitum use of nicotine salt e-liquids during 3 months

Active comparator: Active arm, high concentration (59 mg/mL) nicotine salt e-liquids. Procedure: Smoking cessation counselling: smoking cessation counselling at baseline, week 1, week 2 and week 4
Other: Open system vape device and nicotine salt e-liquids; ad libitum use of nicotine salt e-liquids during 3 months

Control group: Receive only smoking cessation counselling. Procedure: Smoking cessation counselling: smoking cessation counselling at baseline, week 1, week 2 and week 4

Outcomes

Primary outcome:

7-day point prevalence tobacco abstinence (in terms of non-inferiority); time frame: 1 month. Defined as no smoking, i.e. "not a puff", self-reported and confirmed by exhaled carbon monoxide (< 10 ppm) and urinary anabasine levels (< 3 ng/mL) when using low vs. high nicotine salt concentration e-liquids

Volume of e-liquid used (in terms of superiority); time frame: 1 month; volume of e-liquid used when using low vs high nicotine salt concentration e-liquids

Secondary outcome:

7-day point prevalence tobacco abstinence (in terms of non-inferiority); time frame: 1 month. Defined as no smoking, i.e. "not a puff", self-reported and confirmed by exhaled carbon monoxide (< 10 ppm) and urinary anabasine levels (< 3 ng/mL) when using low vs. high nicotine salt concentration e-liquids

Volume of e-liquid used (in terms of superiority); time frame: 1 month; volume of e-liquid used when using low vs high nicotine salt concentration e-liquids

Liking/rating of trial product (active arms); time frame: 1 and 3 months. Questions regarding helpfulness in refraining from smoking, how satisfying and how good the e-cigarette tastes compared to the tobacco cigarettes, if they would recommend the assigned trial product to another smoker, and any potential practical problems they might have with the handling

Respiratory symptoms; time frame: up to 12 months; checklist with specific questions regarding shortness of breath, wheezing, cough or phlegm

Adverse events; time frame: up to 12 months; checklist with specific questions regarding presence or absence of nausea, sleep disturbance, throat/mouth irritation, or other

Total nicotine amount vaped; time frame: 1 and 3 months

Total volume of e-liquid consumed; time frame: 1 and 3 months

Starting date

Start date: Jan 2024. Estimated study completion date: 31 Dec 2024

Contact information

Evangelia Liakoni, MD0041316325461, evangelia.liakoni@insel.ch

NCT04946825

Study name

Quit smoking study for people who use e-cigarettes. A randomized controlled trial of smoking cessation treatment for young adult dual users of combustible and electronic cigarettes

Methods

RCT. Randomized factorial assignment

Setting: community; University of Vermont, USA

Participants

Estimated enrolment 390

Inclusion criteria: young adult; smokes tobacco cigarettes; uses EC; interested in quitting tobacco

Exclusion criteria: pregnancy or breastfeeding; ≥ 1 contraindications for NRT

Interventions

EC: type not stated

NRT: patch and lozenge

A) NRT plus text messages to quit CCs only

B) NRT plus text messages to quit CCs and ECs simultaneously

C) text messages alone to quit CCs only

D) text messages alone to quit CCs and ECs simultaneously

Outcomes

Baseline, 3 months, 6 months

CO confirmed 7-day point-prevalence abstinence at the end of treatment (i.e. 3 months after randomization)

CO biochemically confirmed prolonged 30-day abstinence, 3-month follow-up (i.e. end of treatment) and 6-month follow-up (3 months after the end of treatment)

Self-reported abstinence, 7 days, 30 days

Attempts to quit combustible cigarettes (CC), cpd, CC dependence

Starting date

Study start date: 27 June 2021. Estimated study completion: January 2024.

Contact information

Elias Klemperer, PhD 8026561641, elias.klemperer@med.uvm.edu

Shaun Meyers, BA 8026568681, shaun.meyers@uvm.edu

Notes

New to 2022 update

NCT05023096

Study name

Potential effects of electronic nicotine delivery system flavor regulations on African American menthol smokers (RVA Flavors)

Methods

RCT
Virginia Commonwealth University, USA

Participants

Actual enrollment 71. Estimated enrolment: 210

Inclusion criteria: 21+ years; identify as Black/African-American (single or multi-race); used ≥ 5 cigarettes per day for ≥ 1 year (biochemically confirmed); regular cigarette brand menthol or mint flavoured; EC use in the past 30 days; no intent to quit smoking in the next 6 months; previous quit attempt using evidence-based method; mobile phone, willing to receive calls/text

Exclusion criteria: unwilling to use EC; report other tobacco use > 10 days in past 30 other than combustible cigarettes; unstable or significant medical condition in the past 12 months; > 15 days of marijuana or other illegal drug use in the past 30 days; pregnancy/breastfeeding

Interventions

EC: type not stated

Arm 1: Menthol + tobacco. Both menthol and tobacco-flavoured liquids for EC are available to choose from.

Arm 2: Tobacco - only tobacco-flavoured liquid is available for EC.

Arm 3: Unflavoured - only unflavoured liquid is available for EC.

Participants are instructed to smoke their usual brand of menthol cigarettes normally for 7 days and avoid using any other tobacco products. After this baseline week, participants are randomized to 1 of 3 EC flavour conditions; all contain 5% nicotine (menthol + tobacco, tobacco, unflavoured) with equal probability and provided with a supply of their condition-specific EC and asked to use it in place of their usual menthol cigarettes for the next 6 weeks.

Outcomes

Week 1, week 6

Change in: average daily cigarette use; carbon monoxide exposure; urinary NNAL; urinary propylene glycol exposure; average daily ENDS use

Willingness to substitute from cigarettes to EC (ENDS); measure of substitution for condition-specific tobacco products will be assessed using drug purchase tasks. Choices made during this task are not reinforced.

Willingness to pay for ENDS (week 6); willingness to pay for condition-specific tobacco products will be assessed using drug purchase tasks. Choices made during this task are not reinforced.

Starting date

Study start date: 14 April 2022. Estimated primary completion date: June 2025

Contact information

Andrew J. Barnes, PhD 804-827-4361, abarnes3@vcu.edu

Caroline O. Cobb, PhD, cobbco@vcu.edu

Notes

New to 2022 update

NCT05144542

Study name

Risk and benefits of electronic cigarettes to older smokers at high risk for lung cancer

Methods

RCT

Setting: M. D. Anderson Cancer Center, Texas, USA

Participants

Estimated enrolment: 330

Inclusion criteria: meeting National Comprehensive Cancer Network (NCCN) guideline for lung cancer screening; daily or non-daily smoker; interested in trying ECs to change CC smoking behaviour; willing and able to complete two spirometry sessions

Exclusion criteria: used ECs on more than 2 days in the past 30 days; meet criteria for current major depressive disorder (MDD) or suicidality; report more than once weekly of tobacco products other than CCs during the past 30 days; ever diagnosis of lung cancer, have uncontrolled or unstable medical condition; spirometry forced expiratory volume in 1 second (FEV1) percentage reading < 50; pregnancy/breastfeeding

Interventions

EC: type not specified

GROUP A: Participants smoke their usual brand of cigarettes for 26 weeks. Participants use smartphone to answer questions about nicotine cravings and mood, and log daily smoking activity every day for up to 182 days. Participants complete questionnaires over 50 minutes and undergo collection of urine sample at 1, 6, 12, and 26 weeks, and collection of blood samples at 6, 12, and 26 weeks. Participants may also undergo measurement of CO levels at 1, 6, 12, and 26 weeks.

GROUP B: Participants vape EC for 26 weeks. Participants use smartphone to answer questions about nicotine cravings and mood, and log daily smoking activity every day for up to 182 days. Participants complete questionnaires over 50 mins and undergo collection of urine sample at 1, 6, 12, and 26 weeks, and collection of blood samples at 6, 12, and 26 weeks. Participants may also undergo measurement of CO levels at 1, 6, 12, and 26 weeks.

Outcomes

1, 6, 12, and 26 weeks, and collection of blood samples at 6, 12, and 26 weeks

Primary outcome measure: cigarettes per day, diary data of combustible cigarette use over last 24 hours

Secondary outcome measures: high-sensitivity C-reactive protein (hs-CRP); white blood cells (WBC); 8-epi prostaglandin F2 alpha (8-epi-PGF2a). All from blood draws at weeks 0, 6, 12, and 26

Starting date

Start date: 7 March 2022. Estimated completion date: 30 April 2025

Contact information

Jason Robinson, PHD 713-792-0919, jdrobinson@mdanderson.org

Notes

New to 2022 update

NCT05199480

Study name

Understanding the impact of cartridge-based electronic cigarettes and generated aerosols on cardiopulmonary health

Methods

Two groups recruited: EC users and demographically matched non-EC users.

NCT record: 'Randomised' 'parallel assignment'.

Virginia Commonwealth University, USA

Participants

Actual enrolment: 64

Inclusion criteria for EC group: ≥ 21 yrs; used EC (≥ 3 times/week for ≥ 3 months)

Inclusion criteria for the group not using EC (Non-e-cigarette group: ≥ 21 yrs

Exclusion criteria: use of cigarettes for 15 days or more in the past 60 days; use of other tobacco products (cigars, hookah, smokeless) weekly or more frequently in the past 60 days; use of marijuana or any illicit or prescription drugs for non-medical use weekly or more frequently in the past 60 days; allergy to propylene glycol or vegetable glycerin; evidence of cardiovascular, pulmonary, renal, hepatic, metabolic, or cerebral diseases; disorder or use of medication that affects cardiopulmonary health; pregnancy/breastfeeding

Interventions

EC: commercially available cartridge-based EC device

Arm 1: E-cigarette liquid type 1 (tobacco flavour)

A commercially available cartridge-based device with tobacco-flavoured liquid. Participants will be instructed to use at least one study product daily in place of their own EC during the intervention period.

Arm 2: E-cigarettes liquid type 2 (tobacco flavour)

A commercially available cartridge-based device with tobacco-flavoured liquid. Participants will be instructed to use at least one study product daily in place of their own EC during the intervention period.

Arm 3: No e-cigarettes. No e-cigarette use

Outcomes

Baseline, 2 weeks

Change in peak oxygen consumption (VO2 peak)

Change in expiratory volume

Change in skeletal muscle O2 utilization

Change in maximal microvascular dilation

Starting date

Study start date: 10 January 2022. Study completion 30 July 2024.

Contact information

Paula Rodriguez Miguelez, PhD804-396-4498, prodriguezmig@vcu.edu

Notes

New to 2022 update

NCT05205811

Study name

A randomized controlled trial to determine the effects of combination zonisamide and bupropion on switching to an electronic cigarette

Methods

RCT

Rose Research Center, USA

Participants

Estimated enrolment: 180

Inclusion criteria: 21 to 65 yrs; ≥ 10 commercially available cigarettes per day, for the last 12 months (CO reading ≥ 10 ppm); interested in switching to an EC; smartphone with text message and data capabilities

Exclusion criteria: unhealthy or cannot participate in the study for any reason; PHQ-9 score greater than 9, or a score greater than 0 on item #9; plans to use an FDA-approved smoking cessation product; high blood pressure, coronary heart disease, structural cardiac disease; BMI ≤ 15.0 kg/m2 or > 40.0 kg/m2; depression, anxiety, or nicotine withdrawal within 30 days of screening, or during the study, taking antidepressants, psychoactive medications or medications that prolong QTc

For full list see NCT record

Interventions

EC: JUUL

Zonisamide

Bupropion

Arm 1: Combination zonisamide and bupropion with EC

After the first week of EC use (JUUL), participants will be given bupropion (150 mg each morning for days 1 to 3, then 300 mg daily) with zonisamide (100 mg daily). The combination of zonisamide and bupropion use will continue for 7 weeks of treatment, and EC use will continue until the end of the study (an additional 4 weeks). EC for ad libitum use for 2 weeks prior to complete switch day and for an additional 10 weeks

Arm 2: Bupropion with EC

After the first week of EC use (JUUL), participants will be given bupropion (150 mg each morning for days 1 to 3, then 300 mg daily) with placebo zonisamide. The combination of placebo and bupropion use will continue for 7 weeks of treatment, and e-cigarette use will continue until the end of the study (an additional 4 weeks). EC for ad libitum use for 2 weeks prior to complete switch day and for an additional 10 weeks

Arm 3: Placebo with EC

After the first week of EC use (JUUL), participants will be given placebo bupropion with placebo zonisamide. The combination of these placebos will continue for 7 weeks of treatment, and EC use will continue until the end of the study (an additional 4 weeks). EC for ad libitum use for 2 weeks prior to complete switch day and for an additional 10 weeks

Outcomes

Baseline, week 8, week 12, 6 months

Complete switching from combustible cigarettes to JUUL EC as measured by: exhaled carbon monoxide (CO); change in total urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL); change in self-report of daily cigarette and EC use

Seven-day point abstinence at 6 months post-switch, assessed by self-report and confirmed by exhaled CO < 5 ppm. Change in smoking withdrawal symptoms. Change in rewarding and aversive effects of smoking and EC use

AEs; SAEs

Starting date

Start date: 14 December 2021. Estimated completion date: 30 June 2024

Contact information

Derek Mercedes 704-350-2999, derek.mercedes@roseresearchcenter.com

Notes

New to 2022 update

NCT05206435

Study name

Methadone-maintained smokers switching to e-cigarettes (SHINE)

Methods

RCT

Butler Hospital, Providence, Rhode Island, United States, 02906

Participants

Estimated enrolment: 240

Inclusion criteria:

  • Moderate to heavy cigarette smokers (10 cigarettes/day for > 1 yr; breath CO > 10 ppm)
  • Receiving methadone for ≥ 3 months and attend at least weekly to receive methadone dose
  • Interested in switching to EC or NRT

Exclusion criteria:

  • Using ECs on > 2 of the past 30 days
  • Currently use medications that may reduce smoking (e.g. bupropion, varenicline, NRT)
  • Unstable psychiatric conditions
  • Near-daily or daily use of marijuana
  • Pregnancy
  • Cardiovascular event in the last month, daily medication for asthma or COPD

Interventions

EC: type not stated

Arm 1: Electronic cigarettes. Participants in this arm are randomized to receive electronic cigarettes for the 6-week study period. Electronic cigarettes are provided to replace tobacco cigarettes.

Arm 2: Nicotine lozenges. Participants in this arm are randomized to receive nicotine lozenges for the 6-week study period. Nicotine lozenges are provided to replace tobacco cigarettes.

Outcomes

Baseline, 6 weeks

Nicotine exposure (urine)

Lung functioning: FVC (changes in Forced Vital Capacity, spirometry); FEV1 (changes in Forced Expiratory Volume (FEV - during the first second), spirometry)

Smoking behaviour and experiences (self-report)

For complete switchers: nicotine exposure; lung functioning (FVC, FEV1, FEV1/FVC); smoking behaviour and experiences

Starting date

Study start date: 31 March 2022. Estimated study completion date: 30 June 2024.

Contact information

Michael Stein, MD 401-455-6200, michael_stein@brown.edu

Ana Abrantes, PhD 401-455-6200, ana_abrantes@brown.edu

Notes

New to 2022 update

NCT05257629

Study name

Aggressive smoking cessation therapy post-acute coronary syndrome (ASAP) trial

Methods

RCT

Setting: hospital

Jewish General Hospital, USA

Participants

Estimated enrolment: 798

Inclusion criteria:

Currently hospitalized (or at time of discharge) for ACS. Defined as follows: MI, defined by positive troponin T, troponin I, or CK-MB levels (as defined by institution-specific cut-offs). For definition, see NCT record. CC user; motivated to quit smoking according to the Motivation To Stop Scale (MTSS) (≥ level 5); ≥ 18 years

Exclusion criteria:

Use of any of the following in the 30 days prior to ACS admission: i. Pharmacotherapy (e.g. NRTs, bupropion, or varenicline) for smoking cessation; ii. Nicotine or non-nicotine e-cigarettes; iii. Psychotropic medications (e.g. mood stabilizers, antipsychotics, prescribed opiates and sedatives); iv. Other anti-craving medication (e.g. naltrexone, acamprosate) with the potential to alter substance-seeking behaviours

Pregnancy/breastfeeding

For a full list, see NCT record.

Interventions

EC: participant's choice

Arm 1: Combination therapy arm (varenicline and nicotine EC plus counselling)

Patients in the combination therapy arm will be supplied funds and instructions for the purchase of EC and cartridges/pods upon hospital discharge and at the week 4 and 12 clinic visits. As with standard NRTs such as the gum, inhaler, and lozenge, we expect smokers will self-regulate administration according to their withdrawal symptoms. Use will be monitored via self-report for telephone follow-ups. At clinic visits, patients will be asked to bring their EC, used and unused cartridges/pods, and purchasing receipts. Patients will be advised regarding the signs and symptoms of nicotine toxicity and of an allergic reaction.

Arm 2: Varenicline plus counselling

All patients will begin varenicline in-hospital upon randomization. For the first 3 days, patients will take a 0.5 mg tablet once a day. They will then take a 0.5 mg tablet twice a day for the following 4 days, and one 1 mg tablet twice a day from day 8 onward for the remainder of the 12-week treatment. Use will be monitored via self-report for telephone follow-ups and return of all unused tablets at the end of the treatment period. Should a patient experience severe side effects (such as headache, nausea, vomiting, dizziness, dyspepsia, fatigue, insomnia, abnormal dreams, constipation, or flatulence) on day 8 onward, the varenicline dose should be reduced from 1 mg twice daily to 0.5 mg twice daily prior to study medication discontinuation.

Outcomes

1, 2, 8, 18, 24 weeks

Week 4, week 12, and week 52

Number of participants with: 7-day point prevalence smoking abstinence (biochemically-validated); continuous smoking abstinence; prolonged smoking abstinence; change in daily cigarette consumption; ≥ 50% reduction in daily cigarette consumption; point prevalent abstinence or ≥ 50% reduction in daily cigarette consumption at 24 weeks

Frequency of adverse events (AEs) or SAEs

Spirometry measurements (subset) at all other clinic visits (FVC, FEV1, and FEV1/FVC)

O2 cost diagram and COPD Assessment Test (subset) at all other clinic visits

Number of patients averaging ≥ 1 pill of varenicline/day

Starting date

Estimated start date: 1 June 2022. Estimated completion date: 7 March 2027

Contact information

Carole Bohbot 514-340-8222 ext 22790

ASAP.Trial@ladydavis.ca, carole.bohbot@ladydavis.ca

Notes

New to 2022 update

NCT05278065

Study name

Complimentary electronic cigarettes for harm reduction among adult smokers with asthma (SWAP)

Methods

RCT

Setting and recruitment: Participants will be adults from the local community with persistent asthma symptoms who are regular combustible cigarette smokers and do not also regularly use ENDS. The study will recruit 30 non-treatment-seeking participants using flyers, advertisements, a website triaging visitors to the Center for Alcohol and Addiction Studies, and through targeted recruitment at community immunology clinic partners at Rhode Island Hospital, USA.

Participants

Actual enrollment: 17. Estimated enrolment: 30

Inclusion criteria: 21 to 65 years; Persistent asthma symptoms (i.e. episodic symptoms of airflow obstruction/airway hyper-responsiveness (AHR) as documented in review of medical history); Currently prescribed SABA medication; Past-year smoking of ≥ 5 cigarettes/day (CO ≥ 6 ppm at baseline); Zero breath alcohol during informed consent for participation

Exclusion criteria: Intention to quit smoking during the next 30 days or current engagement in any smoking cessation treatment; Regular EC/ENDS user or using ENDS > 2 days/week; Medical contraindication to nicotine; Pregnancy (due to toxicity of nicotine and tobacco products); Current alcohol dependence (AUDIT > 15); Urine-screened or past-month self-reported use of illicit substances (amphetamine, cocaine, methamphetamine, opioids, benzodiazepines); Current psychosis, mania, or suicidal ideation.

EC use at baseline: No

Motivated to quit smoking: No

Specific population characteristic: people with asthma

Interventions

EC: 4th generation and disposable cartridges

Arm 1: Electronic cigarette

Participants in this experimental condition will be provided with a 4th generation EC device and disposable cartridges. Participants will be provided with EC and 5% nicotine e-liquid cartridges for 8 weeks and encouraged at weekly assessments to use the EC any time they would normally smoke. Participants will be able to choose commercially available e-liquid flavours (tobacco) at each weekly assessment.

Arm 2: Smoking-as-usual

Participants in this assessment-only condition will continue smoking-as-usual.

Outcomes

Baseline, week 8, week 16. Eight weekly visits to complete follow-up assessments

cpd

EC use

Asthma symptoms

Pulmonary functioning, FEV, FVC, FEF25-75, PEF

CO. Level of exhaled CO assessed with Smokerlyzer

NNAL

Cotinine

Interleukin-6 (IL-6)

Tumour necrosis factor alpha (TNF-a)

Chemokine ligand 9 (CXCL9)

Matrix metallopeptidase 9 (MMP9)

Starting date

Start date: 1 May 2022. Study completion date: September 2024

Contact information

Alexander W Sokolovsky, PhD 4018636629, alexander_sokolovsky@brown.edu

Mary Ellen Fernandez, BA 4018635521, mary_fernandez@brown.edu

Notes

New to 2022 update

NCT05510154

Study name

Impact of e-cigarette training on puff patterns, cigarette smoking, and health outcomes among smokers with COPD; COPD e-cigarette topography training

Methods

Design: RCT. An open-label, randomized clinical trial of e-cigarette training and training dose amongst smokers with COPD

Smokers with COPD (n = 45) stratified by e-cigarette use history (naïve vs current use) will be randomized (1:1:1) to receive 1) brief advice to switch to e-cigarettes, 2) single-session e-cigarette training, or 3) enhanced e-cigarette training.

Setting: University of Kansas Medical Center (KUMC) campus in Kansas City, Kansas (KS), USA

Study start date March 2022. Study end June 2023.

Participants

N = 45

Smokers with COPD (n = 45) stratified by e-cigarette use history (naïve vs current use) will be randomized (1:1:1) to receive 1) brief advice to switch to e-cigarettes, 2) single-session e-cigarette training, or 3) enhanced e-cigarette training.

Inclusion criteria: smokers or dual users diagnosed with COPD; ≥ 21 years old; speak and understand English; smoke on > 25 of the last 30 days for the past 3 months; willing to switch from cigarettes to the study e-cigarette for the duration of the study; have tried but failed to quit smoking in the last year; unwilling to make a pharmacotherapy-assisted quit attempt in the next 30 days

Exclusion criteria: smokers or dual users; use of tobacco products other than cigarettes, including e-cigarettes in the past 30 days; current use of cessation medications; pregnant, planning to become pregnant, or breastfeeding; recent history of cardiovascular or pulmonary events in the past 3 months; household member current or previously enrolled in the study

Interventions

EC. The study product is an e-cigarette device and is available for sale in the US.

  1. Brief advice to switch to e-cigarettes
  2. Single-session e-cigarette training
  3. Enhanced e-cigarette training (3 real-time training sessions rather than 1)

Outcomes

12 weeks

Changes in puff duration in seconds from pre- to post-e-cigarette training (time frame: 12 weeks)

Complete switch to e-cigarette (time frame: 12 weeks)

Change in spirometry FVC, FEV1, FEV1/FVC ratio, systolic blood pressure, change in diastolic blood pressure, change in COPD Assessment Test (CAT) score, respiratory symptoms score, change in 6-minute walk test distance

Starting date

Study start date March 2022

Contact information

Eleanor Leavens, Assistant Professor, University of Kansas Medical Center

Notes

New to 2023 update

NCT05555069

Study name

The impact of menthol flavoring on switching in adult menthol smokers

Methods

Design: Randomized parallel assignment

Setting. USA; University of Kansas Medical Center

Participants

Estimated enrolment: 800 participants

Inclusion criteria: ≥ 21 years of age; smoke ≥ 5 cigarettes per day (CPD); smoke menthol cigarettes for ≥ 6 months; verified smoker (CO > 5ppm); functioning telephone; interested in switching to e-cigarettes

Exclusion criteria: interested in quitting smoking; use of other tobacco products in past 30 days (i.e. cigarillos, cigars, hookah, smokeless tobacco, pipes); e-cigarette use on ≥ 4 of the past 30 days; uncontrolled hypertension: BP ≥ 180 (systolic) or ≥ 105 (diastolic); use of smoking cessation pharmacotherapy in the month prior to enrolment; pregnant, contemplating getting pregnant, or breastfeeding

Motivated to quit: no

Interventions

EC: 4th generation nicotine salt-based pod-system e-cigarette in menthol versus tobacco-flavoured e-liquid

Arm 1. Menthol flavour electronic cigarette. 400 adult cigarette smokers will receive 12 weeks of menthol-flavoured electronic cigarettes.

Arm 2. Tobacco flavour electronic cigarette. 400 adult cigarette smokers will receive 12 weeks of tobacco-flavoured electronic cigarettes.

Participants will receive 12 weeks of menthol OR tobacco-flavoured electronic cigarettes to aid in switching from combustible cigarettes. Participants will be instructed on proper use of electronic cigarettes, educated about electronic cigarettes and participate in motivation enhancement and substituting electronic cigarettes for cigarettes.

Outcomes

Baseline, 12 weeks. Follow-up will continue to 26 weeks.

Outcomes at 12 weeks

1. Number of participants who switch from cigarettes to electronic cigarettes at week 12

Complete switching is defined as exclusive use of e-cigarettes, confirmed with CO < 6 ppm and predominant switching; defined as use of the e-cigarette with > 50% reduction in CPD. This will compare the effectiveness of menthol versus tobacco e-cigarettes in facilitating switching at week 12.

2. Assessment of respiratory symptoms using spirometry

Spirometry summarizing forced expiratory flow (FEF) 25-75% and the American Thoracic Society Questionnaire will assess acute respiratory symptoms experienced by cigarette and electronic cigarette smokers. This will help assess the tobacco harm reduction of electronic cigarettes.

3. Amount of e-liquid consumed

Starting date

8 November 2022. Estimated primary completion date 30 June 2025

Contact information

Tricia Snow, 816-398-8960 psnow@kumc.edu

PI Nicole Nollen, PhD, University of Kanas Medical Center

Notes

New to 2023 update

NCT05610514

Study name

Pulmonary and cardiac effects of e-cigarette use in pulmonary patients who smoke cigarettes

Methods

Design: Randomized, cross-over, open-label

Setting: Greater Burlington, VT, USA

Participants

Actual enrollment: 21. (Estimated enrolment: 25)

Inclusion criteria: men and women 40 years of age or older; current, every-day smoker (5 or more cigarettes per day for one year or longer) confirmed with intake CO of 8 ppm or greater; established pulmonary disease (chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, or asthma-COPD overlap syndrome) confirmed by physician diagnosis and/or current prescription of medication for treatment (i.e. LABA, LAMA, ± ICS, or combination); no intention to quit smoking within the next month

Exclusion criteria: patients who are medically unstable (unstable symptoms, changes in medications or hospitalizations within last 3 months); inability to conduct in-home measurements

Motivated to quit: no

Interventions

EC: JUUL/Vuse Alto and pods

Experimental: e-cigarette. Participants in this arm will smoke electronic cigarettes for 2 weeks. E-cigarettes (either JUUL or Vuse Alto) and pods (JUUL: Virginia tobacco flavour at 3% or 5% nicotine concentration; Vuse Alto: golden tobacco flavour at 1.8%, 2.4%, or 5% nicotine concentration) will be provided. In the EC arm, availability of e-cigarettes and altering the availability of financial incentives for abstaining from combustible cigarettes will be investigated.

No intervention: combustible cigarette. Participants in this arm will smoke their usual brand of combustible cigarettes for 2 weeks.

Outcomes

Baseline, 2 weeks, 4 weeks

Baseline and change from baseline: FEV1/FVC; lung reactance; oxygen saturation (SpO2); exhaled nitric oxide (FeNO); COPD; blood pressure; heart rate; tobacco use; Fagerstrom Test of Nicotine Dependence (FTND); Wisconsin Inventory of Smoking Dependence Motives-Brief (WISDM-Brief); Minnesota Tobacco Withdrawal Scale (MNWS); Questionnaire on Smoking Urges-Brief (QSU-Brief); health changes

Starting date

Starting date 28 April 2022; completion date December 2023

Contact information

Brian R Katz, PhD, 8025511798, Brian.Katz@uvm.edu

Shannon O'connor, 8025511798, shannon.oconnor@uvm.edu

Notes

New to 2023 update

NCT05703672

Study name

4th generation e-cigarettes in African American smokers: reducing harm and quitting combustible cigarettes in dual users

Brief title: Switching to e-cigarettes in African-American smokers

Methods

Design: Randomized, parallel-assessment interventional study

Setting: Missouri, USA. Swope Health Central, Kansas City, Missouri, United States, 64130. University of Kansas Medical Center, Kansas City, Missouri, United States, 64130

Participants

Estimated N = 500

Inclusion criteria: African-American; ≥ 21 years of age; smoke > 5 cigarettes per day; smoked cigarettes for > 6 months; verified smoker (CO > 5 ppm); interested in switching to EC

Exclusion criteria: interested in quitting smoking; use of smoking cessation pharmacotherapy in the month prior to enrolment; use of other tobacco products in past 30 days (i.e. cigarillos, cigars, hookah, smokeless tobacco, pipes); EC use on > 4 of the past 30 days; uncontrolled hypertension: BP > 180 (systolic) or > 105 (diastolic); heart-related event in the past 30 days; medical contraindications to VAR: unstable cardiac condition (e.g. unstable angina or AMI) cardiac event, or stroke in the past 4 weeks; renal impairment; history of clinically significant allergic reactions; history of epilepsy or seizure disorder; hospitalized for psychiatric issue in past 30 days; active suicidal ideation; pregnant, contemplating getting pregnant, or breastfeeding

Motivated to quit: no

Interventions

EC: Nicotine salt pod-based e-cigarette in 5% nicotine

Arm 1: Experimental: varenicline and electronic cigarette

At the end of the 6-week open-label phase, dual users of cigarettes and e-cigarettes will receive 1 mg varenicline to take twice daily for 12 weeks. They will also receive an additional 12 weeks of the nicotine salt-based pod system e-cigarette. Drug: Varenicline Tartrate, 0.5 mg once daily for days 1 to 3, 0.5 mg twice daily for days 4 to 7 and 1.0 mg twice daily from day 8 through week 12. Electronic cigarette: nicotine salt pod-based e-cigarette in 5% nicotine

Arm 2: Placebo comparator: placebo and electronic cigarette

At the end of the 6-week open-label phase, dual users of cigarettes and e-cigarettes will receive placebo pills to take twice daily for 12 weeks. They will also receive an additional 12 weeks of the nicotine salt-based pod system e-cigarette.

Drug: placebo 1 pill (white) once daily for days 1 to 3, one pill (white) twice daily for days 4 to 7 and 1 pill (blue) twice daily from day 8 through week 12. Electronic cigarette: nicotine salt pod-based e-cigarette in 5% nicotine

Arm 3: Open-label electronic cigarette

All participants will receive an initial 6-week supply of the study electronic cigarette. Nicotine salt pod-based e-cigarette in 5% nicotine

Outcomes

Baseline, 6 weeks, 12 weeks. FU to 52 weeks

Reduction in toxicant exposure as measured by NNAL excretion from baseline to week 6

CO verified 7-day point prevalence abstinence from cigarettes at week 12 post-randomization

Starting date

Estimated study start date 30 June 2023. Estimated completion date 30 November 2024.

Contact information

Tricia Snow, MPH, 816-398-8960, psnow@kumc.edu

Notes

New to 2023 update

NCT05815199

Study name

Effectiveness and impact of counseling enhanced using electronic cigarettes for harm reduction in people with serious mental illness

Brief title: E-cigarettes for harm reduction among smokers with serious mental illness

Methods

Design: randomized, parallel-assignment. RCT

Setting: NYU Langone Health, USA

Participants

Estimated enrolment: 60

Inclusion criteria: currently smokes 5 or more CPD; age of at least 21 years; has SMI diagnosis (such as schizophrenia, schizoaffective disorders, bipolar disorder, depressive disorders, trauma and stressor-related disorders etc.) as determined using the MINI tool; interested in reducing CC smoking but not necessarily trying to quit

Exclusion criteria: pregnant /breastfeeding; used tobacco other than CC in the past 2 weeks (e.g. EC, cigarillo); currently engaged in an attempt to quit CC; change in dose of their psychotropic medication(s) in the last 30 days; meeting DSM-V criteria for current alcohol or substance use disorder except for nicotine use disorder and active mild alcohol or substance use disorders; past month suicidal ideation/suicide attempt and/or psychiatric hospitalization in the last 30 days

Population: people with serious mental illness (SMI)

Motivated to quit: interested in reducing but not interested in quitting

Interventions

EC: NJOY Ace Electronic Cigarette

Intervention period: 8 weeks

Arm 1. Experimental: e-cigarettes (EC)

Interventions: E-cigarette (EC) NJOY Ace; behavioural: harm-reduction counselling; behavioural: Ecological Momentary Intervention (EMI) text messaging

Arm 2. Active comparator: nicotine replacement therapy (NRT)

Interventions: Other: nicotine replacement therapy (NRT) (patches, lozenges and gum); behavioural: harm-reduction counselling; Behavioural: Ecological Momentary Intervention (EMI) text messaging

Description of behavioural intervention for both groups

Behavioural: harm-reduction counselling. At baseline, after randomization, participants will receive their first telehealth session (20 to 25 minutes) from a counsellor trained in motivational interviewing, harm reduction, and smoking cessation. Up to 5 additional sessions will be delivered, 15 to 20 minutes each.

Behavioural: Ecological Momentary Intervention (EMI) text messaging. EMI can be defined as delivering tailored interventions via electronic messages (i.e. regular text messages) that include personalized feedback based on real-time assessment responses and other contextual factors. EMI will take place throughout the intervention period.

Outcomes

Baseline, wk 4, wk 8, wk 12

Abstinence from CC (wk 4, wk 8, wk 12). Self-report (daily diary about smoking behaviour) and verified by exhaled carbon-monoxide (eCO) level (< 6 ppm)

Self-reported percent change in CPD (baseline to wk 8, baseline to wk 12)

Change in American Thoracic Questionnaire Score from baseline to wk 12. 8-item questionnaire assessing general thoracic pain

Change in Symptom Check Questionnaire Score from baseline to wk 12. 9-item assessment of chronic obstructive pulmonary disease (COPD) symptoms

Starting date

Estimated start date: July 2023. Estimated completion date: March 2024.

Contact information

Omar El-Shahawy, 646-501-3587, Omar.ElShahawy@nyulangone.org

Adetayo Fawole, 646-501-3568, Adetayo.fawole@nyulangone.org

Notes

New to 2023 update

NCT05825924

Study name

Randomized, two arm parallel, clinical trial to compare effectiveness of different tobacco harm reduction products in general adult population in low middle income countries

Methods

Design: randomized, parallel-assignment, 2-arm trial

Setting: low-middle-income countries

Participants

Estimated enrolment: 258

Inclusion criteria: at least of legal age allowed for smoking in the country, of either gender, regular smokers (minimum 10 cigarettes/day for at least a year) and interested in stopping smoking

Exclusion criteria: pregnant/breastfeeding; using other smoking cessation medications (including other forms of NRT other than patch, bupropion, clonidine, nortriptyline or varenicline); any contraindications to products such as cardiovascular history; major illness with prognosis of less than 1 year

Motivated to quit: yes

Interventions

EC: EC 18 mg/mL designed to resemble tobacco cigarettes, aerosol generator, sensor, battery and storage area for liquid. Disposable or rechargeable

Study Arm 1: 18 mg nicotine EC (ad libitum use) for 12 weeks after the nominated quit date

Free EC and sufficient nicotine cartridges (18 mg/mL) supply to last till next in-person visit. Participants will be instructed to use the device ad libitum 1 week before their quit day to familiarize themselves with its operation and on their designated quit day will stop smoking tobacco cigarettes and instead use the EC exclusively for the next 12 weeks. CC users often take 10 to 15 puffs over the course of 5 to 8 minutes, repeating this pattern with each cigarette. EC users may periodically use it throughout the day, and they may or may not take their puffs like those of traditional CCs.

Study Arm 2: 21 mg nicotine patches (one daily) for 12 weeks after the nominated quit date

21 mg nicotine patches supply to last until the next-person visit. Participants will use the nicotine patch daily for 1 week before their quit day to familiarize themselves with its use. On their designated quit day, they will stop smoking and use nicotine patches daily for the next 12 weeks. Usually, a full-strength patch (15 to 22 mg of nicotine) daily for 4 weeks is suggested for use in the majority of smokers, followed by a lower-strength patch (5 to 14 mg of nicotine) for an additional 4 weeks, depending on their body size and smoking habits.

The nicotine patches are applied on the skin and nicotine is delivered at a steady rate. After administration, the peak blood levels are achieved within 6 to 10 hours. The levels remain constant, reducing by 25% to 40% with use of patches once daily. The patch is typically administered every 24 hours for no longer than 12 weeks. The dose of the patches is often determined by daily cigarette consumption and level of addiction.

The duration of counselling will be at least 30 minutes on site. The duration of counselling through telephone will be at least 10 minutes. Participants will be scheduled for a screening visit and a baseline (BL) visit at the trial site. The participants will be scheduled for 8 study visits in total, including 5 treatment sessions and 3 follow-up visits, using both face-to-face interaction at the trial site as well as follow-up on telephone.

Outcomes

Weeks 1, 2, 4, 8, 12, 18, 24, and 52

7 day PP. Self-report having smoked no cigarettes in the past 7 days

Number of cigarettes smoked per day assessed using self-reported diaries

AEs (time frame 12 weeks). AEs evaluated using Naranjo Adverse Drug Reaction Probability Scale

Physical signs and symptoms of withdrawal using Fagerstrom test for nicotine dependence

Perception of the product

Starting date

Estimated study start date: September 2023. Estimated primary completion date: March 2025

Contact information

Ather Mehmood, FCPS +92518314299, athermehmood70@gmail.com

Notes

New to 2023 update

Funded by: Foundation for a Smoke Free World INC

NCT05881304

Study name

Switching individuals in treatment for opioid use disorder who smoke cigarettes to the SREC

Methods

Design: waiting-list controlled RCT

Setting: Massachusetts General Hospital, USA

Participants

Estimated enrolment: 40

Inclusion criteria: 18 +; report daily cigarette smoking (≥ 10 cigarettes per day in the past week); not ready to quit smoking (not planning to quit in the next 30 days); willing to try EC; in stable buprenorphine (BUP) treatment for opioid use disorder at a Massachusetts General Hospital-affiliated primary care clinic (in treatment for ≥ 3 months without changes in BUP dose in the past 2 wks and planning to remain on current BUP treatment for ≥ 3 months)

Exclusion criteria: pregnant/breastfeeding; using non-cigarette nicotine or tobacco products (e.g. EC, cigarillos) recently (> 3 days in past 30 days); report past 30-day use of behavioural or pharmacologic smoking cessation aids; have an unstable psychiatric or medical condition

Motivated to quit: no

EC use at baseline: no

Interventions

EC: NIDA standardized research e-cigarette (SREC)

Arm 1. Experimental: Immediate standardized research EC (SREC) provision (iSREC)

Those randomized to the iSREC group will be provided a free 8-week supply of standardized research e-cigarettes (SRECs) and asked to try to switch completely to the SREC.

Arm 2. Active Comparator: Delayed SREC provision waiting-list control (WLC)

Those in the WLC condition will receive SREC provision after an 8-week delay.

Outcomes

Baseline, 2 wks, 8 wks

SREC for 8 weeks, either immediately (iSREC), or after an 8-week delay (waiting-list control [WLC]). They will be followed for an additional 4 weeks after SREC provision ends (to 12 weeks in iSREC and 20 weeks in WLC).

1) tobacco use behaviour (CPD, SREC use), 2) biomarkers (e.g. carbon monoxide, anabasine), 3) cigarette dependence and withdrawal, and 4) short-term health effects and tolerability (e.g. respiratory symptoms, substance use)

Change in cigarettes smoked per day (CPD) between randomized groups. Change in mean number of CPD in the past 7 days from baseline 2 to week 8 comparing between randomized groups (iSREC group vs WLC)

EC use during EC provision during the 8 wks of EC provision

Change in expired air carbon monoxide (CO) during EC provision. Change in expired air CO (ppm) from baseline to week 8 between randomized groups

Change in anabasine - during EC provision. Change in urine anabasine level (ng/mL)from baseline 1 to week 8 between randomized groups

Starting date

Estimated study start date: August 2023. Estimated completion date: December 2024

Contact information

Joanna M Streck, PhD, 617-643-9977, jstreck@mgh.harvard.edu

Notes

New to 2023 update

NCT05887947

Study name

Impact of e-cigarette nicotine concentration on compensation, cigarette smoking, and biomarkers of exposure and harm in diverse smokers

Methods

Design: randomized cross-over

Setting: University of Kansas Medical Center, USA

Participants

Estimated enrolment: 48

Inclusion criteria: identify as non-Hispanic white or non-Hispanic African-American/black; willing to switch from CC to EC for 6 wks; smoke greater than or equal to 25 of the last 30 days for the past 3 months; not previously used an EC for > 30 days; exhaled CO of ≥ 6ppm at screener visit; willing to abstain from marijuana for 12 hours prior to in-person lab visits; willing to abstain from smoking and vaping for 12 hours prior to 3 in-person lab visits

Exclusion criteria: weekly use of EC over the last 6 months; use of tobacco products other than CC on ≥ 10 days in the past 30 days; use of EC on > 5 of the past 30 days; current use of cessation medications; pregnant/breastfeeding; past 30-day hospitalization/ER visit for psychiatric issue, seizure, stroke, or new heart problem; recent history of cardiovascular or pulmonary events in the past 3 months; treatment for alcohol or drug dependence in the past yr; current enrolment in a programme aimed at changing smoking patterns

Motivated to quit: not clear but excluded if using current cessation medication

EC use at baseline: no

Interventions

EC: Pod. Electronic cigarette nicotine concentrations 1.8% and 5%

Participants will complete 2 standardized, 10-puff vaping bouts over 5 mins followed by a 60-minute ad libitum vaping session, using 2 e-liquids that differ only by nicotine concentration (5% vs 1.8%) to examine the effect of nicotine concentration on in-lab compensatory puffing, nicotine exposure, and e-liquid consumption. In Phase 2, the same participants will be randomized to 5% or 1.8% nicotine e-liquid and instructed to switch completely for 6 weeks.

African-American

EC Nicotine Concentration Order: 1.8%, 5%, 1.8%

EC Nicotine Concentration Order: 1.8%, 5%, 5%

EC Nicotine Concentration Order: 5%, 1.8%, 1.8%

EC Nicotine Concentration Order: 5%, 1.8%, 5%

White

EC Nicotine Concentration Order: 1.8%, 5%, 1.8%

EC Nicotine Concentration Order: 1.8%, 5%, 5%

EC Nicotine Concentration Order: 5%, 1.8%, 1.8%

EC Nicotine Concentration Order: 5%, 1.8%, 5%

Outcomes

Baseline lab visit 1, lab visit 2. Phase 2: 6 weeks home use

Total inhaled volume. Time frame: 2 to 10 days between visits. Differences within participants in total inhaled volume in electronic cigarette puff topography during the pharmacokinetic portions of lab visit 1 and 2

Examine the impact of nicotine concentration on short-term, real-world EC use patterns and related biomarkers of exposure (e.g. exhaled carbon monoxide, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), lung inflammatory markers)

Starting date

Starting date: 20 February 2023. Estimated primary completion date: 20 February 2025

Contact information

Leah Lambart, MPH, 913-945-7862, llambart@kumc.edu

Eleanor Leavens, PhD, 913-588-3763, eleavens@kumc.edu

Notes

New to 2023 update

NCT05960305

Study name

A multi-site randomized actual use study of electronic nicotine delivery system (P12) products among current U.S. adult smokers to assess the relative impact of availability and use of different e-liquid flavors on changes in cigarette consumption

Brief title: CSD201204 An actual use study of P12 electronic nicotine delivery system among U.S. adult amokers

Methods

Multi-site, open-label, randomized, 3-arm, 8-week, prospective observational study

Setting USA

Participants

1845 participants enrolled

Inclusion criteria: 21 to 60 years of age, inclusive, who are regular smokers (≥ 5 cigarettes/day on at least 20 of the past 30 days), indicate "an intention to use" (6 or higher on a 10-point Likert scale) for at least one Study IP flavour per arm across all 3 study arms.

Exclusion criteria: currently quitting or intending to quit within the next 3 months all tobacco or nicotine product use ("currently" is defined as within [≤] 30 days prior to pre-screening); regular ENDS user (using ENDS > 3 days per week, in the past 30 days), based on self-report; pregnant or breastfeeding; "poor" physical health; "poor" mental health; employees of a company that manufactures tobacco or ENDS products.

Interventions

Active comparator:

1. Tobacco flavour

2. Menthol flavour

3. NTNM flavour

For all can choose between 2 different flavour variants at 2 different nicotine levels (1.5% and 5%). 4 options per arm.

Real-life/naturalistic environments. Subjects will be able to choose freely among the Study IP available in 1 of the 3 study arms to which they are randomly assigned. The 3 study arms are organized by Study IP flavour categories: tobacco, menthol, and non-tobacco-non-menthol (NTNM). Subjects will self-report their ad libitum use of the Study IP as well as use of combustible cigarettes (CC) and any other tobacco- and nicotine-containing product (TNP) on a daily basis using an electronic diary (eDiary).

Outcomes

Baseline to 6 weeks

Number and proportion of subjects who reduce their cigarettes per day (CPD) (over 6 weeks). Number and proportion of subjects who reduce their cigarettes per day (CPD) consumption by at least 50% at Week 6 compared to baseline among all subjects who complete the study.

CPD mean per cent reduction over 6 weeks. CPD mean per cent reduction at Week 6 compared to baseline among all subjects who complete the study.

Starting date

Study start date: September 2023

Study completion 2024

Contact information

RAI Services Company. Reynolds American. Tobacco Industry.

Study Director: Kristen Jordan, PhD

Contact information not provided in NCR record.

Notes

New to 2024 update

NCT06063421

Study name

Comparison of nicotine replacement therapy and electronic cigarettes for smoking cessation in Pakistan

Methods

RCT

Pragmatic, open-label, parallel design RCT

Setting: Pakistan

Participants

Inclusion criteria: 18 years or older; current smokers presenting to a cessation clinic expressing a desire to quit smoking; capacity to consent; can read and understand the instructions in Urdu and/or English and follow the study instructions and procedures.

Exclusion criteria: pregnant or breastfeeding ; using EC or NRT products; enrolled in another similar study; not willing to quit; have had a recent cardiovascular event like unstable angina, stroke or myocardial infarction in the past 2 weeks.

Motivated to quit

Interventions

EC vs NRT

EC: The intervention consists of the use of an EC device, Vaporesso Gen Air 40 Vape Kit (includes EC device, integrated battery, refillable tank, charging cable, coil replacements and user manual). Three e-liquid flavours will be provided; tobacco, menthol, and fruit flavour. All e-liquids will have a nicotine concentration of 18 to 20 mg/mL. EC will be provided for a total of 12 weeks.

NRT: NRT combination therapy with a transdermal nicotine patch (7, 14, or 21 mg) and an oral product: either gum or lozenge in 1, 2, or 4 mg strength. Usage will be in the form of a daily nicotine patch and ad libitum use of the faster-acting lozenge to curb nicotine cravings. Participants will be provided with a 12-week supply of NRT.

Outcomes

Baseline, 1, 4, 8, 24, and 52 weeks

Carbon monoxide (CO) validated sustained abstinence at 24, 52 weeks

Self-reported 7-day point prevalence abstinence at 4, 24, and 52 weeks

AEs, CPD, and product satisfaction rating, 1, 4, 8, 24, and 52 weeks post TQD

Intervention cost per participant (12 wks from TQD)

Starting date

Study posted October 2023. Updated March 2024.

Contact information

Fouad Aslam, MPH, 00447494700290, projectdirector@strategichealthresearch.org.uk

Aftab Ahmad, MA

Notes

New to 2024

Funding: Foundation for a Smoke Free World INC

NCT06077240

Study name

Effects of e-cigs vs pouches on cigarette smoking and addiction

Official title: Evaluating the effects of e-cigarettes versus oral nicotine pouches and product constituents (menthol flavor, nicotine concentration) on adult cigarette smoking and addiction

Methods

Randomised parallel assignment

Triple-masked (participant, investigator, outcomes assessor)

Setting: USA

Participants

Aim to recruit 256 adults who currently smoke CC and willing to switch

Inclusion criteria: 21+ years old; English literate; currently smoking cigarettes, biochemically confirmed; not planning a smoking cessation attempt or to use smoking cessation pharmacotherapies (NRT, bupropion, varenicline) in the next month

Exclusion criteria: currently using any smoking cessation services and/or pharmacotherapies; pregnant or breastfeeding; significant current medical or psychiatric condition; known hypersensitivity to propylene glycol

Interventions

EC 2.4% nicotine, menthol and tobacco flavours

EC 2.4% nicotine with tobacco flavour only

EC 5% nicotine with menthol and tobacco flavours

EC 5% nicotine with tobacco flavour only

Tobacco pouches 3 mg nicotine with menthol and tobacco flavours

Tobacco pouches with 3 mg nicotine with tobacco flavour only

Tobacco pouches with 6 mg nicotine with menthol and tobacco flavours

Tobacco pouches with 6 mg nicotine with tobacco flavour only

Outcomes

Baseline, 4, 6 weeks; 5 visits

Plan to share IPD

Abstinence, biochemically verified 7-day point-prevalent abstinence from cigarettes (to week 4)

CPD

Cigarette dependence measured using the 4-item PROMIS® Short Form v1.0 - Smoking Nicotine Dependence for All Smokers 4a. Each item is scored from 1 to 5 with the range of scores from 4 to 20 with higher scores representing greater cigarette dependence.

Use of non-combustible product.

Continued use of study product (to 6 weeks).

Starting date

First posted Oct 2023. Last update posted February 2024.

Starting date not stated.

Contact information

Lisa M. Fucito, lisa.fucito@yale.edu

Krysten W Bold, krysten.bold@yale.edu

Notes

New to 2024

Funding: National Institute on Drug Abuse (NIDA)

NCT06111053

Study name

Trial for harm reduction with incentives and vaping e-cigarettes

Official title: Harm reduction in smokers with obesity: impact of contingent incentives and e-cigarettes

Methods

Randomised, 2x2 factorial design

Setting: USA

Participants

Actual enrollment: 39. Estimated enrolment 36

Inclusion criteria: BMI ≥ 25 kg/m2; smoked ≥ 5 cigarettes/day during the past year; 21 or older; exhaled CO of > 6 ppm at baseline; willing to use ENDs for 6 weeks; daily access to a Bluetooth-enabled smartphone/tablet

Exclusion criteria: planning to set a smoking quit date in the next 30 days; receiving smoking cessation treatment of any kind in the past 30 days; using EC/ ENDS > 4 days per month; hospitalized for mental illness in past 30 days; heart-related event (e.g. heart attack, severe angina) in past 30 days; resides with another person enrolled in the study; pregnant, nursing, or planning to become pregnant in the next 6 months

Interventions

Interventions:

EC/ENDS: participants in active comparator groups that include ENDS will receive 6 weeks' worth of ENDS supplies.

Contingent incentives: participants in active comparator groups will receive incentives that vary based on participant abstinence from smoking, measured by a carbon monoxide breath sample.

No EC /ENDS: participants in active comparator groups labelled No ENDS will only receive information about the comparative risk of ENDS relative to combustible cigarettes.

Non-contingent incentives. Participants in active comparator groups labelled Non-Contingent Incentives will receive compensation for each breath sample provided throughout the study, with no variation.

Study arms:

1. Experimental: EC and Contingent Incentives

Participants in this arm will receive information about the comparative risk of EC relative to smoking as well as 6 weeks' worth of provisions of EC and will receive 4 weeks of monetary incentives for complete abstinence from smoking (after a controlled ramp down of smoking).

2. Experimental: No EC and Contingent Incentives

Participants in this arm will receive information about the comparative risk of EC relative to smoking and will receive 4 weeks of monetary incentives for complete abstinence from smoking (after a controlled ramp down of smoking).

3. Experimental: EC and Non-Contingent Incentives

Participants in this arm will receive information about the comparative risk of EC relative to smoking as well as 6 weeks' worth of provisions of EC and will receive monetary incentives for providing breath samples only (non-contingent on smoking status).

3. Experimental: No EC and Non-Contingent Incentives

Participants in this arm will receive information about the comparative risk of EC relative to smoking and will receive monetary incentives for providing breath samples only (non-contingent on smoking status).

Outcomes

Baseline 4, 6, and 12 weeks

At 4, 6, and 12 weeks

Use of EC and CC; abstinence; CO; CC and EC dependence; questionnaire comparing CC and EC; weight assessed; motivation to change; attitudes to EC using Comparing E-Cigarette and Cigarettes (CEAC) Questionnaire.

IPD: plan to share data

Starting date

October 2023

Estimated completion date: December 2024

Contact information

Cara M Murphy, 1 (401) 203-5339, THRIVE@brown.edu

Notes

New to 2024

NCT06118502

Study name

A clinical trial of adaptive treatment for early smoking cessation relapse (ADAPT)

Methods

Randomised sequential assignment, open-label

Setting: Alabama and South Carolina, USA.

Participants

Estimated enrolment 544

Treatment-seeking people who smoke

Interventions

NRT (patches and lozenges); varenicline. At 8 weeks some non-responders will be offered EC.

Treatments free for 12 weeks

Switching to a different medication: 4 weeks of the other FDA-approved option, either varenicline or combination NRT, with instructions to try to quit again at week 4.

Continued use of the same medication: 4 additional weeks of the same medication (varenicline or NRT) with instructions to try to quit again at week 4.

Switching to a harm-reduction tobacco product: 4 weeks of e-cigarette products with instructions to switch completely at Week 8.

Study arms

1. Adaptive Randomization 1 (switching to another medication): people who did not respond to 4 weeks of pharmacotherapy (either varenicline or combination NRT). After a 4-week course of pharmacotherapy, participants that are not responding to medication will receive 4 weeks of the other FDA-approved option, either varenicline or combination NRT, with instructions to try to quit again.

2. Non-Adaptive Randomization 1 (continued use of the same medication) : people who did not respond to 4 weeks of pharmacotherapy (either varenicline or combination NRT). After a 4-week course of pharmacotherapy, participants that are not responding to the medication will receive 4 additional weeks of the same medication with instructions to try to quit again.

3. Harm Reduction Randomization 2 (switching to a harm-reduction tobacco product): people who did not respond to two 4-week courses of pharmacotherapy (either varenicline or combination NRT or both). After two 4-week courses of pharmacotherapy, participants who are not responding to medication will be randomly assigned to a harm-reduction group (e-cigarettes). Participants assigned to the harm-reduction group will receive 4 weeks of e-cigarette product with instructions to switch completely.

4. Non-Adaptive Randomization 2 (continued use of the same medication): people who did not respond to two 4-week courses of pharmacotherapy (either varenicline or combination NRT or both sequentially). After two 4-week courses of pharmacotherapy, participants that are not responding to the medication will receive 4 additional weeks of the same medication with instructions to try to quit again.

Outcomes

Baseline, 4, 8, 12, 24 weeks. 8 surveys, all assessments remote.

Abstinence from CC. 7-day point prevalence abstinence.

Starting date

Posted November 2023

Contact information

Tracy T Smith, 8438725164, smithtra@musc.edu

Matthew J Carpenter, 8438762436, carpente@musc.edu

Notes

New to 2024

NCT06169813

Study name

E-cigarette harm reduction among PLWHA in South Africa

Methods

RCT

Open-label, parallel assignment

Setting: South Africa

Participants

Estimated N = 90

Inclusion criteria: adult PLWHA CC smokers; speaks Afrikaans, or Xhosa, or English; daily CC smoking (≥ 5 CPD); mobile phone; interested in reducing CC smoking but not necessarily trying to quit; receives HIV/AIDS care in one of the 8 selected clinics follow-up rates

Exclusion criteria: pregnant or breastfeeding; unable to provide consent; used tobacco products other than CC in the past 2 weeks (e.g. EC, cigarillo); currently engaged in an attempt to quit CC smoking; current major depressive or manic episode, current psychotic disorder, past-year suicide attempt, or current suicidal ideation with plan or intent

Interventions

EC: EC VUSE "Solo" single-use pods. Nicotine - 48 mg/mL (4.8% nicotine) concentration + phone counselling + EMI texting

NRT: NRT (daily patches and lozenges). NRT strength will be according to the established dosing guidelines for tobacco treatment. NRT is the standard of care in tobacco treatment and helped reduce CPD in prior trials + phone counselling + ecological momentary intervention (EMI) texting

Quit Line: participants will receive referral to the existing South African Quitline. Participants will receive information to contact the Quitline if participants so choose.

All groups receive counselling. Each participant will receive up to 5 motivational counselling sessions. The first session will also include orientation of EMA/EMI texting.

Outcomes

Baseline, 8 weeks, 3 months, 6 months

7-day point prevalence abstinence at 3 months. Abstinence will be verified by exhaled carbon monoxide and defined as no combustible cigarette use in the last 7 days

50% reduction in cigarettes per day (CPD), compared with baseline at 6 months, CPD will be self-reported

Change in American Thoracic Society Questionnaire score

Client Satisfaction Questionnaire (CSQ-8) score at 8 weeks and 3 months

Percent of patients who enrol in counselling at 6 months

FU rate at 3 and 6 months

Starting date

Estimated start date: Feb 2024

Estimated completion date: June 2024

Contact information

Omar ElShahawy

Omar.ElShahawy@nyulangone.org

NYU Langone Health

Notes

New to 2024

NCT06260683

Study name

A comprehensive evaluation of tobacco-flavored vs. non-tobacco flavored e-cigarettes on smoking behavior

Methods

RCT

Setting: Ohio State University Comprehensive Cancer Center, USA.

Participants

Estimated N = 1500

Inclusion Criteria: >= 21 years old; Smoke >= 5 cigarettes per day for the past year; Willing to use EC /NRT; fluent English; smartphone.

Exclusion Criteria: using smoking cessation medications/NRT/seeking treatment for smoking cessation; use EC > 4 days a month; lung disease, asthma, cystic fibrosis, heart disease or chronic obstructive pulmonary disease (COPD); unmanaged schizophrenia; past 3 month cardiac event or distress or stroke; pregnant/breastfeeding; uncontrolled high BP; serious angina pectoris or chest pain; allergy to propylene glycol or vegetable glycerin; serious underlying arrhythmias, irregular heartbeat or abnormal heart rhythm.

EC use at baseline: No (exclusion criteria: use EC > 4 days a month)

Motivated to quit smoking: willing to use EC/NRT although not currently seeking help to stop smoking.

Interventions

ARM I: preferred flavoured EC

ARM II: tobacco flavoured EC

ARM III: NRT (nicotine patches and lozenges)

All receive for 14 weeks, including a 2-week pre-switch period to become familiar with usage. All given questionnaire. Participants in all arms participate in discussions throughout the trial.

Outcomes

Baseline, 2, 6, 14 and 26 weeks

Intervention for 14 weeks. Participants in all arms are followed for 12-weeks after completion of study procedures.

CO week 14; CPD baseline to 26 weeks; Continued use of EC (14 weeks and 26 weeks). [Abstinence to week 14.]

Starting date

Start date: 10 April 2024. Estimated completion date: 12 April 2028.

Contact information

Theodore Wagener, Ohio State University Comprehensive Cancer Center. Theodore.Wagener@osumc.edu

Notes

Ongoing study new to 2025 update.

NCT06264154

Study name

The role of flavor in the substitutability of e-cigarettes for combustible cigarettes among persistent smokers

Methods

RCT

Between-subjects study

Setting: University of Pennsylvania, Philadelphia, USA

Participants

Estimated N 210

Inclusion: > 21 years of age and self-report smoking at least 5 cigarettes (menthol and/or non-menthol) per day for at least the last 12 months; 5 or more failed quit attempts and the use of smoking cessation medication on at least one prior attempt; Ever use of an e-cigarette; CO > 10 ppm; Not using any forms of nicotine regularly other than CC; willing to switch to EC for 6 weeks and use the assigned flavors.

Exclusion: Regular use of nicotine-containing products other than CC (e.g., chewing tobacco, snuff, snus, cigars, EC, etc.); enrollment in a smoking cessation program over the duration of the study; current use of smoking cessation medication; history of substance abuse (other than nicotine dependence) in the past 12 months; pregnant/breastfeeding; serious or unstable disease within the past year (e.g. cancer, heart disease); lifetime history of schizophrenia or psychosis.

EC use at baseline: no

Motivated to quit: yes (have tried to quit on > 5 occasions (inclusion criteria).)

Interventions

All participants are instructed to switch from smoking combustible cigarettes to using e-cigarettes for 6 weeks. Participants will receive an e-cigarette device and flavored nicotine pods according to their randomly assigned flavor.

1) EC fruit flavour (blueberry or watermelon-flavored pods)

2) EC tobacco flavour

3) EC menthol flavoured

All participants provided with EC and instructed to switch from smoking CC to using only the study provided nicotine EC pods. Participants will receive their supply of nicotine pods in 7-day increments, based on baseline smoking behaviour.

Outcomes

Time Frame: 42 days (days 8 - 49). 6 months

Starting date

Start date 26 August 2024. Estimated study completion date December 2027.

Contact information

Janet Audrain-McGovern, audrain@pennmedicine.upenn.edu

Notes

New ongoing study added to 2025 update.

NCT06372899

Study name

Noncombustible nicotine delivery systems as potential harm reduction tools for persistent cigarette smokers. Official title: Alternative nicotine delivery systems as potential harm reduction tools for persistent cigarette smokers

Methods

RCT

Setting: University of Pennsylvania, Philadelphia, USA

Participants

Estimated N: 200

Inclusion: 21+; 5 or more failed quit attempts and the use of smoking cessation medication on at least one prior attempts; CO) greater than 10 ppm; not using any forms of nicotine regularly other than cigarettes; willing to switch to e-cigarettes or nicotine pouches for 6 weeks.

Exclusion: history of substance abuse (other than nicotine dependence) in the past 12 months; pregnant/breastfeeding; serious or unstable disease within the past year (e.g. cancer, heart disease); lifetime history of schizophrenia or psychosis.

EC use at baseline: no

Motivated to quit: yes, have tried to quit on > 5 occasions (inclusion criteria).

Interventions

1) EC. Tobacco, menthol, watermelon, and blueberry flavored nicotine pods.

2) Oral nicotine pouches. Original, mint, berry, and citrus flavored nicotine pouches.

Instructed to use study product for 6 weeks. Receive supply of study product in 7-day increments, based on baseline smoking behavior.

Outcomes

Baseline, 49 days, 6 months.

CPD baseline to the end of the six-week switch period and 6 months.

Changes in biomarkers of potential harm, assessed at baseline and the end of the six-week switch phase. CO, FEF, NNAL, 1-HOP.

Starting date

Starting date 2 October 2024. Estimated study completion date 31 March 2028.

Contact information

Janet Audrain-McGovern, Professor, University of Pennsylvania. audrain@pennmedicine.upenn.edu

Collaborator: National Cancer Institute.

Notes

New ongoing study added to 2025 update.

NCT06373679

Study name

Switch or quit R01. Official title: Non-cigarette tobacco products as harm reduction tools in smokers who failed to quit with traditional methods

Methods

RCT

Setting: Medical University of South Carolina

Participants

Estimated N 225

Inclusion Criteria: adults 21+ who previously had a quit attempt using FDA-approved pharmacotherapy.; interest in reducing harms from tobacco use or quitting smoking

Exclusion Criteria: pregnant / breastfeeding.

Motivated to quit: yes, all have previously tried to quit.

Interventions

1) EC. Participants will choose between two different brands of EC and choose up to two different flavors. Participants will receive 11 weeks of EC products with instructions to switch completely at switch date.

2) Medication. Participants will choose between 1) combo NRT and 2) varenicline. The NRT will consist of transdermal NRT and nicotine lozenge. Participants will receive 11 weeks of FDA approved medication with instructions to quit smoking cigarettes at quit date.

Outcomes

Baseline, 11 weeks

Abstinence: Self-reported zero cigarettes in the past 7 days on timeline followback at Week 11 + expired CO < 6 ppm. CO for all? > 50% reduction in cigarette smoking.

Starting date

Starting date: 10 July 2024. Estimated completion date 1 May 2027.

Contact information

Tracy Smith, smithtra@musc.edu. Merritt McDonald mcdoname@musc.edu

Notes

New ongoing study added to 2025 update.

NCT06534905

Study name

Pilot randomized controlled trial of e-cigarette switching among older adults with opioid use disorder. Short title: E-cigarette switching older adults.

Methods

RCT

Setting: University of Maryland Addiction Treatment Center, Baltimore, Maryland, USA

Participants

Esimated N: 40

Inclusion Criteria: 50 years or older; currently in treatment for opioid use disorder for at least 3 months; currently use CC; expired air CO 8ppm; does not regularly use EC (regular use defined as use in the past month for 2 or more consecutive days); not pregnant or breastfeeding.

Exclusion Criteria: trying to stop smoking or have a plan to quit smoking; age 49 or younger; not currently using CC.

Not motivated to quit smoking.

Not regularly using EC.

Inclusion based specific population characteristic: 50 years + and in treatment for opioid use disorder .

Interventions

1) EC (NJOY Ace, menthol or tobacco flavour depending on patient preference) + education on tobacco harms

2) Control standard advice. Brief advice to quit smoking (in alignment with recommendations by the American Society of Addiction Medicine). Inclusdes linking to a smoking cessation quitline.

Outcomes

Baseline, 2, 6, 8 weeks

CPD (self-report), intention to quit, assessments of tobacco and other substance use, health status, mood, and functioning.

Starting date

Start date 25 November 2024. Estimated completion December 2025.

Contact information

Bethea A Kleykamp, University of Maryland, Baltimore

Notes

New to 2025 update.

NCT06543407

Study name

Harm reduction for smokers with mental illness: RCT of e-cigarette provision with or without behavioral support to boost switching

Methods

RCT

Setting: 2 locations: Louisville, Kentucky USA , and Kalamazoo, Michigan USA

Sponsor: Dartmouth-Hitchcock Medical Center, New Hampshire, USA

Participants

Estimated N: 250

Inclusion: Diagnostic Criteria (must have one to be eligible): Schizophrenia; Bipolar disorder; Major Depressive Disorders; Posttraumatic disorder; Other anxiety disorders. Additional Inclusion Criteria:21 years +; CC user (at least 10 cigarettes/day); At least one quit attempt in the past 5 years using evidence- based pharmacotherapy or behavioral cessation support;Not currently interested in quitting.

Exclusion: Currently residing in a nursing home; Asthma; Cognitive impairment (score <26 on the Telephone Interview for Cognitive Status (TICS); current EC use (>once a week); Psychiatric instability (hospitalized in the past month); Current AND moderate to severe substance use disorder; Pregnant; Use of any smoked products other than cigarettes; Current unstable medical illness making EC unsafe (e.g., recent heart attack, cancer);

Motivated to quit: NR but have tried to quit at least once in past 5 years.

No EC use at baseline.

Inclusion based on specific population characteristics: people with mental illness

Interventions

1) EC NJOY for the first 8 weeks

2) EC NJOY + behavioral support and coaching, protocolized intervention, SWITCH IT, for the first 8 weeks of the study.

Behavioral support for switching, 7-10 sessions with SWITCH IT coach delivered during the first 8 weeks of the study. SWITCH IT participants will also have the opportunity to receive supported "field trips" to explore EC options based on availability, cost, and preferences during week 4 and week 6.

Outcomes

Baseline to 8 weeks, 8 weeks to 26 weeeks

NNAL, CO,

Baseline to 8 weeks 8 weeks to 16 weeks

CC use (self-reported).

Starting date

Start date 1 October 2024. Estiated completion date 31 March 2028.

Contact information

Meghan M. Santos, MSW, meghan.m.santos@hitchcock.org

Gail Williams, MS, MFT, gail.williams@dartmouth.edu

Sarah Pratt, Dartmouth-Hitchcock Medical Center

Notes

New to 2025 update.

NCT06554873

Study name

Adaptive use of nicotine substitution to maintain smoking reduction/abstinence in nicotine responders

Methods

RCT

Setting: 2 locations: Charlotte, North Carolina, USA and Raleigh, North Carolina, USA.

Rose Research Center, LLC

Participants

Estimated N: 150

Inclusion Criteria: Healthy, adult CC user for ≥12 months ; CC at least 10 cpd; Screening eCO ≥ 10 ppm; aged 22 to 65 years.

Exclusion Criteria: unable to understand English; history or presence of clinically significant medical or psychiatric disease; Has used nicotine EC or any NRT (nicotine patch, nicotine gum, nicotine spray, nicotine inhaler, nicotine lozenge) or prescription smoking cessation medications, including, varenicline (Chantix*) or bupropion (Zyban®) within the past 30 days; Pregnant/nursing; Participated in smoking cessation study in past year; Smokes or vapes cannabis >once a week; Cannabis Use Disorder Identification Test-Revised (CUDIT-R) score of 8 or greater.

No EC use at baseline.

Motivated to quit: NR

Interventions

To determine whether smokers who initially respond (within 2 weeks) to nicotine products (including NRT, EC, nicotine pouches) by reducing their smoking by ≥50% can be successfully maintained on use of these noncombustible nicotine alternatives to cigarettes for 6 months, and whether this results in sustained smoking reduction/abstinence.

Interventions: All groups offered: Nicoderm; Nicorette 4Mg Chewing Gum; Nicorette Lozenge Product; EC NJOY; on!

1) Nicotine Non-Responders

Participants that were not successful in reducing their expired carbon monoxide by the end of week 2 will not continue in the study.

2) Nicotine Responders - Group 1

Participants that were successful in reducing their expired carbon monoxide by the end of week 2 will be randomized to continued use of their choice of nicotine products for an additional 10 weeks (12-week total treatment period).

3) Nicotine Responders - Group 2

Participants that were successful in reducing their expired carbon monoxide by the end of week 2 will be randomized to continued use of their choice of nicotine products for an additional 22 weeks (24-week total treatment period).

Outcomes

Baseline, week 12, 24 , 36.

CC abstinence (CO confirmed) to week 24.

CO to week 24.

Study product use (to week 36). Cotinine to week 36.

Starting date

Start date 29 August 2024. Estimated completion date 31 December 2025

Contact information

Derek Mercedes, derek.mercedes@roseresearchcenter.com

Sponsor: Rose Research Center, LLC. Collaborator: Global Action to End Smoking

Notes

New to 2025 update.

NCT06614504

Study name

Nicotine regulation for dual users of e-cigarettes and cigarettes (RDEC)

Methods

2x2 factorial randomized controlled trial

Setting: 2 sites. Providence Rhode Island USA. Burlington, Vermont, USA.

Participants

Estimated N 308

Inclusion: regular use of tobacco; 21 year of age or older.

Exclusion: Pregnant / nursing; health conditions that could undermine ability to complete the study.

Inclusion based on specific population characteristics: dual users of CC and EC

Interventions

Varying the nicotine content of CC and varying the nicotine content of EC.

1) CC #1 plus EC #1 (Normal nicotine CC plus high nicotine content EC)

2) CC #1 plus EC #2 (Normal nicotine CC plus low nicotine content EC)

3) CC #2 plus EC #1 (Very low nicotine content CC plus high nicotine content EC)

4) CC #2 + EC #2 (Very low nicotine content CC plus low nicotine content EC)

Outcomes

Baseline, 12 weeks.

CPD.

Starting date

Start date 1 November 2024. Estimated completion date 30 September 2028

Contact information

Emily Booth, emily.booth@med.uvm.edu. PI Elias Klemperer.

Notes

New ongoing study added to 2025 update.

Polosa 2024

Study name

Magnitude of cigarette substitution after initiation of e-cigarettes and its impact on biomarkers of exposure and potential harm in dual users: MAGNIFICAT trial

Methods

Two parallel study groups. Not randomised.

Setting: ambulatory (outpatient) setting. University of Catania, Italy

Recruitment: from the clinical study site subject pool and public advertisements.

Participants

Estimated N 300

EC group (express interest inquitting) 250. CC group (not interested in quitting) 50

Inclusion criteria: ≥ 19 years of age b. Solus smokers of CC (≥ 15 cigarettes/day); History of regular smoking for at least 12 consecutive months; Verified smoking status (eCO ≥ 7 ppm); Willingness to switch to a vaping product and to try reducing CCconsumption (Study Group A only)

Exclusion criteria: Intention to quit smoking within the next 30 days ; Known clinically significant cardiovascular, respiratory, psychiatric, or other major disorder ; Regular use of any medication; A significant history of alcohol or drug abuse; Use of any nicotine (e.g., EC, nicotine pouches) or tobacco product (e.g., heated tobacco products - HTPs, oral smokeless) other than their own CC within 3 months of screening; Use of nicotine replacement therapy or other smoking cessation therapies within 3 months of screening g. Pregnant / breast feeding; Active participation in another clinical trial.

Motivated to quit smoking: no (exclusion criteria intending to quit within next 30 dats).

EC use at baseline: no.

Interventions

1) EC

2) Continued CC use

Outcomes

Baseline, 1 month, 3 months, 6 months.

Day −7 to Day −1: Screening Visit . Day 0: Baseline Visit (Visit 1). Day 30: Visit 2. Day 90: Visit 3. Day 180: Visit 4.

SAEs; AEs; CC use; CO; weight; BP; lung function.

Biomarkers: Acrolein (3-HPMA) • 1,3-Butadiene (MHBMA) • Propylene Oxide (2-HPMA) • Crotonaldehyde (HMPMA) • Benzene (SPMA) • Styrene (PHEMA) • Glycidol (DHPMA) • Isoprene (IPMA) • Toluene (SBMA) • Ethylene Oxide (HEMA) • Acrylonitrile (CEMA/CeVal) • Acrylamide (AAMA/GAMA/GlyVal) • Metabolites of polyaromatic hydrocarbons (benzo[a]pyrene, pyrene, phenanthrene, naphthalene) • Aromatic amines (3−/4-aminobiphenyl, 2-aminonaphthalene, ortho-toluidine) • total nicotine equivalents • (Methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) • N-nitrosonornicotine (NNN) • Propylene glycol; Eicosanoids in urine, • soluble intercellular adhesion molecule 1 (sICAM-1) in plasma, • growth differentiation factor 15 (GDF-15) in plasma.

Cardio-respiratory endpoints: VO2 max/Chester step test; Spirometry; Respiratory Symptoms Questionnaire (RSQ).

Non-targeted methods for the screening of the urinary exposome, the hemoglobin adductome and the breathome (exhaled breath )

Correlation of use behavior with exposure via BoE and BoPH in urine, plasma and exhaled breathin compliant subjects (biochemically verified with biomarkers of compliance)

Urinary creatinine for normalization of urinary biomarker concentrations.

EC (study product) use at all time points. Level of dual use (EC and CC)

Starting date

Start date February 2024. Estimated completion date early 2025.

Contact information

Riccardo Polosa polosa@unict.it Jakub Weglarz jakub.weglarz@eclatrbc.it

Notes

New ongoing study added to 2025 update.

Study funded through grant from the Foundation for a Smoke-Free World.

Schiek 2024

Study name

Combining app-based behavioral therapy with electronic cigarettes for smoking cessation: A study protocol for a single-arm mixed-methods pilot trial

Methods

Single arm

Setting: Faculty of Health/School of Medicine, Witten/Herdecke University, Germany

Recruitment: via web-based advertisements, flyers, and a study website.

Participants

Estimated N 70

Inclusion criteria: aged 18–65 years, report having smoked at least 5 cigarettes per day (CPD) for at least 12 months, are motivated to stop smoking (Motivation To Stop Scale (MTSS; [51]) > 4 points), have daily access to their own smartphone (iOS 15/Android 11 or more recent).

Exclusion criteria include self-reported current or planned pregnancy, breastfeeding, a self-reported allergy to vegetable glycerin or propylene glycol, drug and/or alcohol dependence, severe psychiatric or physical illness, a disease or medication associated with a contraindication to the use of EC, and medication that could affect the outcomes of the study (bupropion/ nortriptyline/ varenicline/ cytisine/ clonidine/ antidepressants). Surgery (with anesthesia) in the last 6 weeks, participation in any other smoking cessation program, current use of EC/tobacco heaters/alternative tobacco products/NRT for more than 5 days during the last 30 days, and the inability to consent.

Motivated to quit smoking: yes.

Not using EC at baseline.

Interventions

Nicotine EC pods + access to mHealth intervention nuumi app for at least 3 months. EC coupled with the app via Bluetooth, allowing for tracking of patterns of use. The behavioral therapy leverages evidence-based content informed by cognitive behavioral therapy and mindfulness-informed principles.

Nuumi is a self-guided digital therapeutic intervention comprising an app-based behavioral therapy and an EC connected to the app via Bluetooth. Initially, participants are asked to use the EC whenever they crave a cigarette (replacing CC with EC). Prompted to use the app-based behavioral therapy providing information on transitioning to the EC, and smoking cessation. App also contains information on gradual EC cessation, supporting abstinence of both CC and EC.

Participants are not required to quit smoking immediately after baseline; advised to switch from CC to EC either by choosing a quit date, or by gradually switching from CC to EC over a 2-week period.

EC closed system device, pods must be replaced with prefilled pods obtained through the manufacturer which can only be used after activation via the app. Participants will receive a kit including the EC, a charger, a power bank, pods, and manuals for the EC and the pods via mail. The amount of pods is equivalent to their respective CC consumption at study entry. EC two tobacco flavors. EC powered by a 450 mAh battery, nicotine strength 20 mg/ml to 0 mg/ml, decreasing in steps of two mg/ml. Prompted to start with 20 mg/ml pods and gradually use pods containing lower nicotine strength.

Participants will receive 10€ for each completed survey (t1- t4). For participation in the semi-structured interviews, participants can earn another 10€ for each interview for a total incentive of 60€ once the study has ended.

Outcomes

Baseline, 4, 8 , 12 weeks, and 24 weeks

Abstinence (7 day pp) at 12 and 24 weeks. AEs. Other smoking cessation-related outcomes, psychological outcomes, and acceptability of the nuumi intervention

Starting date

Study start October 2023.

Contact information

Helen Schiek, Institute for Integrative Health Care and Health Promotion (IGVF), Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany. helen.schiek@uni-wh.de

Notes

New ongoing study added to 2025 update. The EC has been developed and manufactured by the funder of this study.

Funding statement: "Open Access funding enabled and organized by Projekt DEAL. IGVF at Witten/Herdecke University received funding to perform this trial from Sanos Group GmbH, the manufacturer of the nuumi program consisting of the electronic cigarette device, the pods including the liquid solution, and the smoking cessation app. Sanos Group GmbH is financially supported by the European Union’s Fund for Regional Development and Investitionsbank Berlin for its technological innovation and social impact by the funding programs "Pro FIT – Early Stage Financing" and “Pro FIT – Project Financing”. The funder’s responsibilities included initiating contact with interested participants and approval of the final study design. The institute’s research team’s responsibilities included participant screening, data collection, data management, data analyses, interpretation of results, and writing manuscripts. The study funder has no role in data collection, management, analysis, or interpretation of the data, and in writing, submitting, and publishing of any and all resulting scientific manuscripts. These responsibilities were approved by the IRB. Contact information of the funder: Sanos Group GmbH. Luetzowstrasse 102 10785 Berlin, Germany."

Walker 2023

Study name

Cytisine and e-cigarettes with supportive text-messaging for smoking cessation (Cess@Tion)

Methods

RCT

Setting: community

University of Auckland, New Zealand

Participants

Estimated enrolment: 800

Inclusion criteria: daily smokers who live in New Zealand; motivated to quit smoking within the next 2 weeks and willing to use cytisine or an EC or both products; ≥ 18 years

Exclusion criteria: another person in their household currently enrolled in the study; pregnancy/breastfeeding; using smoking cessation medication (including EC daily for the last month); hypersensitivity to cytisine or nicotine EC; health condition e.g. renal impairment; tuberculosis; myocardial infarction, stroke, or severe angina, high BP, seizures; strong preference to use or not to use cytisine and/or EC in their quit attempt

For a full list, see NCT record.

Interventions

EC: pod device. Nicotine strength: 30 mg/mL (3%). Flavour: tobacco. Brand name: UpOx

Cytisine

Arm 1: Monotherapy (cytisine only)

12 weeks of cytisine: Participants allocated cytisine will be instructed to follow the manufacturer's 25-day dosing regimen, then follow a maintenance dose of cytisine from day 26 to week 12. Participants will also receive 6 months of text-based smoking cessation support.

Cytisine. Brand name: Tabex. Standard dosing of:

  • Days 1 to 3: 1 tablet (1.5 mg) every 2 hours through the waking day (6 tablets/day)
  • Days 4 to 12: 1 tablet every 2.5 hours (5 tablets/day). Quit smoking date is day 5
  • Days 13 to 16: 1 tablet every three hours (4 tablets/day)
  • Days 17 to 20: 1 tablet every 4 to 5 hours (3 tablets/day)
  • Days 21 to 25: 1 tablet every six hours (2 tablets/day)

Followed by a maintenance dose of cystine from day 26 to week 12 (1 tablet every 6 hours: 2 tablets/day)

Arm 2: Monotherapy (nicotine EC only)

12 weeks of a nicotine EC. Participants will also receive 6 months of text-based smoking cessation support.

Arm 3: Combination therapy (cytisine plus a nicotine EC)

12 weeks of cytisine (as above) and 12 weeks of a nicotine EC. Participants will also receive 6 months of text-based smoking cessation support.

Outcomes

Baseline, 3, 6, and 12 months post-quit date

Primary outcome: proportion of participants with verified continuous smoking abstinence CO confirmed

Self-reported continuous smoking abstinence; self-reported 7-day point prevalence smoking abstinence; change from baseline in the number of cigarettes smoked per day; health-related quality of life; cystine compliance; use of allocated treatment by participants; frequency of EC use, number of pods used; treatment switching; dual use; AEs; number of text-based behavioural support messages received by participants; marginal cost per quitter

Starting date

Study start date: 6 May 2022. Estimated primary completion date: February 2024

Contact information

Natalie Walker, PhD 64-9-923-9884, n.walker@auckland.ac.nz

Chris Bullen, PhD MBChB 64-9-923-4730, c.bullen@auckland.ac.nz

Notes

New to 2022 update

Footnotes

LC:8-iso-PGF2a: an isoprostane
1-OHP: 1-hydroxypyrene
ACS: acute coronary syndrome
AE: adverse event
AHR: airway hyperresponsiveness
AMI: acute myocardial infarction
AUD: alcohol use disorder
AUDIT: AUDIT-C checklist terminology for alcohol dependence
BMI: body mass index
BP: blood pressure
BUP: buprenorphine
CAL: clinical attachment loss
CAR: continuous abstinence rate
CAT: Computerized Adaptive Testing OR Computer-Aided Tomography
CC: combustible cigarette
CCQ: Clinical COPD Questionnaire
CEMA: 2‐cyanoethylmercapturic acid
C-F NDS: combustion-free nicotine delivery systems
CK-MB: creatine kinase, heart specific isoenzyme
CMHT: Community Mental Health Team
CO: carbon monoxide
COPD: chronic obstructive pulmonary disease
COVID: COVID-19, disease caused by SARS-CoV-2
cpd/CPD: cigarettes per day
CRF: cardiovascular risk factors
CT: computed tomography
CVD: cardiovascular disease
CXCL9: CSCL9 (chemokine ligand 9)
DESC: DESC refers to a supportive housing project (see NCT03962660)
DNA: deoxyribonucleic acid
DSM-IV/5: Diagnostic and Statistical Manual of Mental Disorders-IV/5
EC: electronic cigarette
eCO: expired carbon monoxide
ECG: electrocardiogram
ECwN: electronic cigarette with nicotine
ECwoN: electronic cigarette without nicotine
EMI: ecological momentary intervention
ENDS: electronic nicotine delivery system
EQ-5D-5L: EuroQol 5 Dimension 5 Level
ER: emergency room
FDA: Food and Drug Administration
FEF: forced expiratory flow
FeNO: fractional exhaled nitric oxide
FEV1: forced expiratory volume
FPL: federal poverty level
FSH: follicle-stimulating hormone
FTND: Fagerström Test for Nicotine Dependence
FU: follow-up
FVC: forced vital capacity
GIF: graphics interchange format
GP: General Practitioner (Dr)
HaRTS-TRENDS: (trial name) Harm reduction for tobacco smoking with
HbA1c: haemoglobin A1C, glycosylated haemoglobin
HBsAg: hepatitis B surface antigen
HCV: hepatitis C
HDL: high-density lipoprotein
HEMA: 2-hydroxyethylmercapturic acid
HIV: human immunodeficiency virus
HMPMA: 3‐hydroxy‐1‐methyl propylmercapturic acid
HPB: Health Promotion Board
HPMA: hydroxypropylmercapturic acid
hs-CRP: high-sensitivity C-reactive protein
HTP: hydroxytryptophan
ICD-10: International Classification of Diseases, Tenth Edition
ICF: International Classification of Functioning
IL-6: Interleukin 6
iSREC: immediate standardized research e-cigarette
LDCT: low-dose computed tomography
LHC: lung health check
mCEQ: modified Cigarette Evaluation Questionnaire
MDD: major depressive disorder
MetS: metabolic syndrome
MHRA: Medicines and Healthcare products Regulatory Agency
MI: myocardial infarction
MINI: mini International Neuropsychiatric Interview
MMP9: matrix metallopeptidase 9
mMRC: modified Medical Research Council
MNWS: Minnesota Nicotine Withdrawal scale
mPES: multi-Parameter Evidence Synthesis
MPSS: mood and physical symptoms scale
MTSS: Motivation To Stop Scale
MTWS-R: Minnesota Tobacco Withdrawal Scale-R (15 items)
NHS: National Health Service
NIDA: National Institute on Drug Abuse
NNC: non-nicotine cigarette
NCCN: National Comprehensive Cancer Network
NNAL: carcinogen found in tobacco smoke (4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol)
NNN: N'-nitrosonornicotine
NRT: nicotine replacement therapy
OHQoL-UK: Oral Health Quality of Life assessment United Kingdom
OUD: opioid use disorder
PANSS: Mean Positive and Negative Syndrome Scale
PATH: Population Assessment of Tobacco and Health
PEF: peak expiratory flow
PG: propylene glycol
PGEM: a stable metabolite of prostaglandin E2 (biomarker of inflammation)
PHQ-9: Patient Health Questionnaire 9
PI: principal investigator
PK: pharmacokinetic
PneT: PheT phenanthrene tetraol
PP(A): point prevalence (abstinence)
PPD: pocket probing depths
PROMPT: Community-Based Participatory Tobacco Dependence Strategy (PROMPT Project)
PS[E]CDI: Penn State Electronic Cigarette Dependence Index (e-cigarette dependence measure)
QN: NHS quit now programme
QoL: quality of life
q-PADDA: primer anchored DNA damage detection assay
QSU-Brief: Questionnaire of Smoking Urges
QTC: QT interval (time it takes for the electrical system to fire an impulse through the ventricles and then recharge)
RA: research assistant
RC: research cigarettes
RCT: randomised controlled trial
REDCAP: Research Electronic Data Capture (web application for surveys)
SABA: short-acting β2-agonists
SAE: serious adverse event
SC: e-salivary cotinine
SCP: smoking cessation programme
SES: socioeconomic status
SMI: serious mental illness
S-PMA: S-phenylmercapturic acid
SpO2: oxygen saturation
SREC: standardized research e-cigarette
SRMH: self-rated mental health
SSS: stop-smoking services
T2DM: type 2 diabetes
TC: tobacco cigarette
THP: tobacco heating products
TLFB: timeline follow back
TMS: transcranial magnetic stimulation
TNE: total nicotine equivalents
TNF-a: tumour necrosis factor alpha
TQD: target quit date
UC: usual care
USB: universal serial bus
V: volts
VAR: varenicline
VBA: very brief advice
VLNC: very low nicotine content
VNP: vaporized nicotine products
VO2: oxygen consumption
WBC: white blood cell
WISDM-Brief: Wisconsin Inventory of Smoking Dependence Motives-Brief
wk: week
WLC: waiting-list control
YLST: Yorkshire Lung Screening Trial
yr: year

References to studies

ACTRN12619001787178 {published data only}

ACTRN12621000148875 {published data only}

ACTRN12625000179437 {published data only}

Berlin 2019 {published data only}

Cox 2022 {published data only}

El-Khoury 2021 {published data only}

Hameed 2024 {published data only}

Holliday 2022 {published data only}

Howard 2022 {published data only}

ISRCTN14068059 {published data only}

ISRCTN61193406 {published data only}

ISRCTN82413824 {published data only}

Lin 2024 {published data only}

Malik 2023 {published data only}

Murray 2020 {published data only}

NCT01842828 {published data only}

NCT02398487 {published data only}

NCT02590393 {published data only}

NCT03277495 {published data only}

NCT03625986 {published data only}

NCT03862924 {published data only}

NCT03962660 {published data only}

NCT04003805 {published data only}

NCT04058717 {published data only}

NCT04063267 {published data only}

NCT04218708 {published data only}

NCT04238832 {published data only}

NCT04452175 {published data only}

NCT04521647 {published data only}

NCT04649645 {published data only}

NCT04708106 {published data only}

NCT04709471 {published data only}

NCT04725656 {published data only}

NCT04946825 {published data only}

NCT05023096 {published data only}

NCT05144542 {published data only}

NCT05199480 {published data only}

NCT05205811 {published data only}

NCT05206435 {published data only}

NCT05257629 {published data only}

NCT05278065 {published data only}

NCT05510154 {published data only}

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