NCT02139930

Brief Summary

The main goal of this project is to compare two different approaches to reducing levels of nicotine in cigarettes: an immediate reduction in nicotine content in cigarettes to non-addictive levels or a gradual reduction in nicotine content in cigarettes to non-addictive levels. These two approaches will then be contrasted to a group that continues to smoke cigarettes with nicotine content similar to conventional cigarettes.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,250

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Sep 2014

Typical duration for not_applicable

Geographic Reach
1 country

10 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 12, 2014

Completed
4 days until next milestone

First Posted

Study publicly available on registry

May 16, 2014

Completed
4 months until next milestone

Study Start

First participant enrolled

September 1, 2014

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2017

Completed
13 days until next milestone

Study Completion

Last participant's last visit for all outcomes

March 14, 2017

Completed
Last Updated

August 15, 2018

Status Verified

August 1, 2018

Enrollment Period

2.5 years

First QC Date

May 12, 2014

Last Update Submit

August 13, 2018

Conditions

Keywords

smokingnicotine reduction

Outcome Measures

Primary Outcomes (3)

  • Toxicant exposure pattern: Expired air carbon monoxide

    Between group comparison of expired air carbon monoxide (CO) values at week 20 using baseline CO values as a covariate.

    20-week treatment period

  • Toxicant exposure pattern: Urinary phenanthrene tetroal (Phe)

    Between group comparison of urinary phenanthrene tetroal values at week 20 using baseline values as a covariate.

    20-week treatment period

  • Toxicant exposure pattern: Urinary mercapturic acids of acrolein

    Between group comparison of urinary mercapturic acid level at week 20 using baseline values as a covariate.

    20-week treatment period

Secondary Outcomes (8)

  • Nicotine exposure: Total nicotine equivalents (TNE)

    End of treatment (Week 20)

  • Other toxicant exposure: Tobacco specific nitrosamines-Total NNAL and NNN

    End of treatment (Week 20)

  • Effect biomarker: C-Reactive protein-high sensitivity as an inflammation biomarker

    End of treatment (Week 20)

  • Measure of acceptability: Retention in study

    End of treatment (Week 20)

  • Measure of acceptability: Non-compliance

    End of treatment (Week 20)

  • +3 more secondary outcomes

Study Arms (3)

Normal Nicotine Control Group

ACTIVE COMPARATOR

These subjects will smoke normal nicotine content Spectrum brand cigarettes for 20 weeks.

Behavioral: Normal Nicotine Control Group

Immediate Nicotine Reduction Group

EXPERIMENTAL

This group will immediately be switched to smoking very low nicotine content (VLNC) Spectrum brand cigarettes. They will smoke these cigarettes for 20 weeks.

Behavioral: Immediate Nicotine Reduction Group

Gradual Nicotine Reduction Group

EXPERIMENTAL

This group will smoke progressively lower nicotine content Spectrum brand cigarettes for a period of one month each until they end up smoking the same VLNC cigarettes as the immediate reduction group.

Behavioral: Gradual Nicotine Reduction Group

Interventions

Participants will smoke experimental cigarettes for a period of 20-weeks.

Normal Nicotine Control Group

Participants will smoke experimental cigarettes for a period of 20-weeks.

Immediate Nicotine Reduction Group

Participants will smoke experimental cigarettes for a period of 20-weeks.

Gradual Nicotine Reduction Group

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18+
  • Daily smokers who smoke an average of at least five cigarettes per day for at least 1 year
  • Breath CO levels \> 8 ppm (if ≤ 8 ppm, then NicAlert Strip level must indicate regular smoking)

You may not qualify if:

  • Planned quit date in the next 30 days
  • Currently seeking treatment for smoking cessation
  • Currently using nicotine replacement therapies or other pharmacotherapies as cessation aid (non-cessation intermittent use acceptable)
  • A quit attempt in the past 30 days resulting in greater than 3 days of abstinence
  • Using other tobacco products or e-cigarettes more than 9 days in the past 30 days
  • Significant unstable medical conditions (Any significant change in a serious medical condition occurring during the past 3 months including, cardiovascular disease, COPD, and cancer, as determined by the licensed medical professional at each site)
  • Unstable psychiatric conditions (Any significant change in psychiatric symptoms during the past 3 months as determined by the licensed medical professional at each site)
  • Schizophrenia and schizoaffective disorder
  • Psychiatric medication changes (e.g., new prescriptions, changes in dosages, or discontinuation of medications) in the past 3 months that was a result of negative changes in symptoms.
  • Positive toxicology screen for any of the following drugs: cocaine, opiates, methadone, benzodiazepines, barbiturates, amphetamines, methamphetamines, and PCP
  • Participants with valid prescriptions for opiates, benzodiazepines, barbiturates, amphetamines or methadone will not be excluded.
  • Participants failing the toxicology screen will be allowed to re-screen once.
  • Blood alcohol level \> 0.01
  • a. Participants failing the blood alcohol screen will be allowed to re-screen once.
  • Binge drinking alcohol (more than 9 days in the past 30 days, 4/5 drinks per day (female/male))
  • +38 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (10)

Mayo Clinic

Phoenix, Arizona, 85054, United States

Location

University of California San Francisco

San Francisco, California, 94143, United States

Location

Moffitt Cancer Center

Tampa, Florida, 33617, United States

Location

Johns Hopkins University

Baltimore, Maryland, 21224, United States

Location

University of Minnesota Medical School Duluth

Duluth, Minnesota, 55812, United States

Location

University of Minnesota

Minneapolis, Minnesota, 55455, United States

Location

Duke University

Durham, North Carolina, 27705, United States

Location

Oregon Research Institute

Eugene, Oregon, 97403, United States

Location

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

MDAnderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Publications (1)

  • Hatsukami DK, Luo X, Jensen JA, al'Absi M, Allen SS, Carmella SG, Chen M, Cinciripini PM, Denlinger-Apte R, Drobes DJ, Koopmeiners JS, Lane T, Le CT, Leischow S, Luo K, McClernon FJ, Murphy SE, Paiano V, Robinson JD, Severson H, Sipe C, Strasser AA, Strayer LG, Tang MK, Vandrey R, Hecht SS, Benowitz NL, Donny EC. Effect of Immediate vs Gradual Reduction in Nicotine Content of Cigarettes on Biomarkers of Smoke Exposure: A Randomized Clinical Trial. JAMA. 2018 Sep 4;320(9):880-891. doi: 10.1001/jama.2018.11473.

MeSH Terms

Conditions

Tobacco Use DisorderTobacco SmokingSmoking

Condition Hierarchy (Ancestors)

Substance-Related DisordersChemically-Induced DisordersMental DisordersBehaviorTobacco Use

Study Officials

  • Eric Donny, PhD

    University of Pittsburgh

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
BASIC SCIENCE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 12, 2014

First Posted

May 16, 2014

Study Start

September 1, 2014

Primary Completion

March 1, 2017

Study Completion

March 14, 2017

Last Updated

August 15, 2018

Record last verified: 2018-08

Locations