ENDS-Switch: The Role of Nicotine Dose and Route of Delivery in Affecting Adoption of E-cigarettes and Reducing Exposure to Toxic Combustion Products

Sponsor
Duke University (Other)
Overall Status
Completed
CT.gov ID
NCT03492463
Collaborator
National Institute on Drug Abuse (NIDA) (NIH)
94
1
4
33.8
2.8

Study Details

Study Description

Brief Summary

This study plans to investigate whether using electronic cigarettes (e-cigarettes) or skin patches containing nicotine affects switching from smoking conventional combustible (burning) cigarettes.

Condition or Disease Intervention/Treatment Phase
  • Drug: Nicotine patch
  • Other: Placebo patch
  • Other: E-cigarettes
  • Other: Non-nicotine e-cigarettes
Phase 2

Detailed Description

This study proposes to assess the relative role of nicotine dose and route of delivery in affecting successful switching from combustible cigarettes to e-cigarettes, as well as concomitant reductions in ad libitum cigarette smoking and exposure to harmful and potentially harmful constituents of combustion. The strategy will be to assess adoption of e-cigarette use and concomitant reduction in ad libitum smoking of subjects' usual brands of cigarettes over an 8-week period, during which they will receive nicotine or non-nicotine e-cigarettes, and nicotine skin patches. The nicotine patches will not be used as a therapeutic treatment in this study, but rather as a way to manipulate the nicotine dose, while varying the rate and route of nicotine delivery. Behavioral or "habit" aspects of e-cigarette use will be controlled for by the groups receiving non-nicotine e-cigarettes. Initially the study design included placebo patch control conditions, but due to limitations in budget and period of support, enrollment in these these arms was discontinued. All participants currently receive active nicotine patches.

Study Design

Study Type:
Interventional
Actual Enrollment :
94 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Participant, Care Provider)
Primary Purpose:
Basic Science
Official Title:
The Role of Nicotine Dose and Route of Delivery in Affecting Adoption of E-cigarettes and Reducing Exposure to Toxic Combustion Products
Actual Study Start Date :
Aug 6, 2018
Actual Primary Completion Date :
May 31, 2021
Actual Study Completion Date :
May 31, 2021

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Nicotine e-cigs + Nicotine patches

Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks.

Drug: Nicotine patch
Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks.
Other Names:
  • NicoDerm
  • Other: E-cigarettes
    Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Other Names:
  • Electronic Nicotine Delivery System (ENDS)
  • e-cigs
  • electronic cigarettes
  • Active Comparator: Non-nicotine e-cigs + Nicotine patches

    Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks.

    Drug: Nicotine patch
    Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks.
    Other Names:
  • NicoDerm
  • Other: Non-nicotine e-cigarettes
    Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Other Names:
  • Electronic Nicotine Delivery System (ENDS)
  • e-cigs
  • electronic cigarettes
  • Active Comparator: Nicotine e-cigs + Placebo patches

    Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks.

    Other: Placebo patch
    Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks.

    Other: E-cigarettes
    Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Other Names:
  • Electronic Nicotine Delivery System (ENDS)
  • e-cigs
  • electronic cigarettes
  • Placebo Comparator: Non-nicotine e-cigs + Placebo patches

    Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks.

    Other: Placebo patch
    Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks.

    Other: Non-nicotine e-cigarettes
    Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Other Names:
  • Electronic Nicotine Delivery System (ENDS)
  • e-cigs
  • electronic cigarettes
  • Outcome Measures

    Primary Outcome Measures

    1. Expired Air Carbon Monoxide (CO) to Assess Recent Smoking [Week 8]

      The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of conventional cigarettes will be assessed by comparing the groups on the expired air carbon monoxide (CO) measured at the end of the exposure period (Week 8).

    Secondary Outcome Measures

    1. Cigarette Use, Assessed by Self-report in Daily Dairies [Week 8]

      The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of conventional cigarettes will be assessed by comparing the groups on self-report of cigarette consumption on daily diaries (for week 8 only, average cigarettes smoked per day).

    2. E-cigarette Use, Assessed by Self-report in Daily Dairies [Week 8]

      The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of e-cigarettes will be assessed by comparing the groups on self-report of e-cigarette use on daily diaries (for week 8 only).

    3. Total Urinary 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) [Week 8]

      The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of conventional cigarettes will be assessed by comparing the groups on total urinary NNAL, a metabolite of the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), at the end of week 8.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 65 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Smoke an average of at least 10 cigarettes per day;

    • Have smoked at least one cumulative year;

    • Have an expired air CO reading of at least 10ppm;

    • Have a body weight of > 110 lbs. (50 kg) and ≤ 300 lbs. (136 kg);

    • Are able to read and understand English;

    Potential subjects of child bearing potential must agree to use acceptable contraception during their participation in this study. Potential subjects must agree to avoid the following during their participation in this study:

    • Participation in any other nicotine-related modification strategy outside of this protocol;

    • Use of tobacco products other than cigarettes, including pipe tobacco, cigars, snuff, and chewing tobacco;

    • Use of e-cigarettes other than the ones provided during the study;

    • Use of experimental (investigational) drugs or devices;

    • Use of illegal drugs;

    • Use of exclusionary medications.

    Exclusion Criteria:
    • Seeking treatment for nicotine dependence.

    • Hypertension - systolic BP > 160 mm Hg, diastolic BP > 100 mm Hg. Individuals with a history of hypertension may be allowed to participate in the study if the study physician or medical provider determines that the condition is stable and will not jeopardize the individual's safety.

    • Hypotension (with symptoms) - systolic BP < 90 mm Hg, diastolic BP < 60 mm Hg.

    • Coronary heart disease with symptoms (e.g., chest pain)

    • Heart attack in the past year

    • Cardiac rhythm disorder (irregular heart rhythm with symptoms)

    • Chest pain in the last month (unless history indicates a non-cardiac source)

    • Symptomatic heart disorder such as heart failure

    • Advanced liver or kidney disease that requires medication or dialysis, paracentesis

    • Major gastrointestinal illness (e.g. Celiac disease, Crohn's dx Ulcerative Colitis)

    • Bleeding stomach ulcers in the past 30 days

    • Lung disease that requires oxygen

    • Major brain disorder (including stroke with residual deficit, brain tumor, and seizure disorder)

    • Migraine headaches that occur more frequently than once per week

    • Recent, unexplained fainting spells

    • Problems giving blood samples

    • Diabetes with insulin use or with HbA1C over 7%

    • Current cancer or treatment for cancer in the past six months (except basal or squa-mous cell skin cancer)

    • HIV, Hepatitis B, or Hepatitis C

    • History of Tuberculosis or recent positive purified protein derivative (PPD)

    • Other major medical condition (as determined by study physician)

    • Currently symptomatic psychiatric disease (as determined by study physician)

    • Psychosis, bipolar disorder, or psychiatric hospitalization within the past 12 months

    • Suicidal ideation (thinking about ways to commit suicide) (within the past 12 months) or a lifetime occurrence of attempted suicide;

    • Current depression - The Patient Health Questionnaire PHQ-9 for Depression will be used to screen for current (within 2 weeks) depression. Potential subjects who score

    9 (or who score >0 on item #9 ("Thoughts that you would be better off dead, or of hurting yourself in some way") will be excluded from study participation, and, at the discretion of the study physician, referred to appropriate psychiatric treatment;

    • Pregnant or nursing mothers

    • Use (within the past 30 days) of:

    • Illegal drugs (or if the urine drug screen is positive for tetrahydrocannabinol (THC), Cocaine, Amphetamine, Opiates, Methamphetamines, phencyclidine (PCP), Benzodiazepines, or Barbiturates), unless recent use of prescription Opiates or Benzodiazepines were taken for management of acute symptoms (e.g., tooth extraction, recent surgery);

    • Experimental (investigational) drugs;

    • Psychiatric medications including antidepressants (selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressant (TCAs), monoamine oxidase inhibitors (MAOIs), St. John's Wort), lithium, anti-psychotics or any other medications that are known to affect smoking cessation (e.g. clonidine);

    • Phentermine, triptans, tryptophan, linezolid, dextromethorphan, opiates (unless taken for management of acute symptoms), tramadol, or dopamine agonists;

    • Any agents that have documented correlation with increased incidence of valvulopathy and/or pulmonary hypertension (e.g., cyproheptadine, trazodone, nefazodone, amoxapine, tricyclic antidepressants, mirtazapine, pergolide, ergotamine, methysergide) (or anticipated use during the study);

    • Wellbutrin, bupropion, Zyban, Chantix, varenicline, nicotine patch, nicotine replacement therapy or any other smoking cessation aid;

    • Use of cigars, cigarillos, pipes, Hookah, dissolvable nicotine, snuff, chewing tobacco, or e-cigarettes

    • Concurrent use of a serotonergic agent/combination associated with severe serotonin syndrome (within the past 30 days)

    • Use of cigars, cigarillos, pipes, Hookah, dissolvable nicotine, snuff, chewing tobacco, or e-cigarettes within the past 30 days

    • Self-report of consuming more than 6 alcoholic drinks on 1 or more days per week

    • Significant adverse reaction to nicotine patch in the past

    • Current participation or recent participation (in the past 30 days) in another smoking study at our Center or another research facility

    • Current participation in another research study

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Duke Center for Smoking Cessation Durham North Carolina United States 27705

    Sponsors and Collaborators

    • Duke University
    • National Institute on Drug Abuse (NIDA)

    Investigators

    • Principal Investigator: Jed E. Rose, Ph.D., Duke University

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Duke University
    ClinicalTrials.gov Identifier:
    NCT03492463
    Other Study ID Numbers:
    • Pro00084132
    • P50DA027840-07
    First Posted:
    Apr 10, 2018
    Last Update Posted:
    Jun 28, 2022
    Last Verified:
    May 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Product Manufactured in and Exported from the U.S.:
    No
    Keywords provided by Duke University
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Arm/Group Description Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Period Title: Overall Study
    STARTED 37 33 11 13
    COMPLETED 26 19 7 10
    NOT COMPLETED 11 14 4 3

    Baseline Characteristics

    Arm/Group Title Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches Total
    Arm/Group Description Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Total of all reporting groups
    Overall Participants 37 33 11 13 94
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    49.1
    (9.4)
    46.0
    (8.7)
    46.3
    (12.5)
    45.4
    (8.7)
    47.2
    (10.3)
    Sex: Female, Male (Count of Participants)
    Female
    25
    67.6%
    17
    51.5%
    6
    54.5%
    8
    61.5%
    56
    59.6%
    Male
    12
    32.4%
    16
    48.5%
    5
    45.5%
    5
    38.5%
    38
    40.4%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Not Hispanic or Latino
    37
    100%
    33
    100%
    11
    100%
    13
    100%
    94
    100%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    1
    3%
    0
    0%
    0
    0%
    1
    1.1%
    Asian
    1
    2.7%
    0
    0%
    0
    0%
    0
    0%
    1
    1.1%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    9
    24.3%
    7
    21.2%
    5
    45.5%
    7
    53.8%
    28
    29.8%
    White
    25
    67.6%
    23
    69.7%
    6
    54.5%
    6
    46.2%
    60
    63.8%
    More than one race
    1
    2.7%
    1
    3%
    0
    0%
    0
    0%
    2
    2.1%
    Unknown or Not Reported
    1
    2.7%
    1
    3%
    0
    0%
    0
    0%
    2
    2.1%
    Region of Enrollment (Count of Participants)
    United States
    37
    100%
    33
    100%
    11
    100%
    13
    100%
    94
    100%
    Baseline expired air carbon monoxide level (Parts per million (ppm)) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [Parts per million (ppm)]
    30.2
    (14.3)
    27.7
    (14.0)
    27.2
    (13.4)
    28.5
    (10.7)
    28.7
    (13.5)

    Outcome Measures

    1. Primary Outcome
    Title Expired Air Carbon Monoxide (CO) to Assess Recent Smoking
    Description The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of conventional cigarettes will be assessed by comparing the groups on the expired air carbon monoxide (CO) measured at the end of the exposure period (Week 8).
    Time Frame Week 8

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Arm/Group Description Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Measure Participants 26 19 7 10
    Mean (Standard Deviation) [Parts per million (ppm)]
    18.3
    (16.2)
    22.9
    (12.6)
    21.3
    (25.7)
    25.6
    (16.6)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Nicotine E-cigs + Nicotine Patches, Non-nicotine E-cigs + Nicotine Patches
    Comments Due to time and budget constraints a blinded decision was made and approved by the funding agency to limit further enrollment to the two conditions that provided nicotine patches. The primary (one-tailed) test compared Nicotine e-cigs + Nicotine patches to Non-nicotine e-cigs + Nicotine patches.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.01
    Comments
    Method Regression, Linear
    Comments
    2. Secondary Outcome
    Title Cigarette Use, Assessed by Self-report in Daily Dairies
    Description The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of conventional cigarettes will be assessed by comparing the groups on self-report of cigarette consumption on daily diaries (for week 8 only, average cigarettes smoked per day).
    Time Frame Week 8

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Arm/Group Description Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Measure Participants 27 22 7 10
    Mean (Standard Deviation) [cigarettes smoked per day]
    9.2
    (7.7)
    9.9
    (9.0)
    10.3
    (12.3)
    9.3
    (6.9)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Nicotine E-cigs + Nicotine Patches, Non-nicotine E-cigs + Nicotine Patches
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.8
    Comments
    Method ANOVA
    Comments
    3. Secondary Outcome
    Title E-cigarette Use, Assessed by Self-report in Daily Dairies
    Description The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of e-cigarettes will be assessed by comparing the groups on self-report of e-cigarette use on daily diaries (for week 8 only).
    Time Frame Week 8

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Arm/Group Description Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Measure Participants 25 18 7 10
    Mean (Standard Deviation) [e-cigarette pods]
    2.5
    (2.6)
    2.0
    (2.5)
    3.5
    (3.6)
    2.4
    (2.1)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Nicotine E-cigs + Nicotine Patches, Non-nicotine E-cigs + Nicotine Patches
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.5
    Comments
    Method ANOVA
    Comments
    4. Secondary Outcome
    Title Total Urinary 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL)
    Description The effects of e-cigarette nicotine content and patch nicotine content on the concurrent use of conventional cigarettes will be assessed by comparing the groups on total urinary NNAL, a metabolite of the tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), at the end of week 8.
    Time Frame Week 8

    Outcome Measure Data

    Analysis Population Description
    Data not collected due to time and budgetary limitations.
    Arm/Group Title Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Arm/Group Description Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    Measure Participants 0 0 0 0

    Adverse Events

    Time Frame 8 weeks
    Adverse Event Reporting Description Adverse events were assessed through systematic approach. Solicited events were tabulated by asking participants to report side effects potentially common in e-cigarette use (e.g. throat irritation) and nicotine patch use (e.g. skin redness). Additionally, unsolicited events were tabulated by asking participants to report on any health concern that may have occurred during the study.
    Arm/Group Title Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Arm/Group Description Participants will receive e-cigarettes containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and nicotine patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Nicotine patch: Participants will wear the nicotine patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. E-cigarettes: Participants will use e-cigarettes containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks. Participants will receive e-cigarettes not containing nicotine and placebo patches (21mg/24hr) and will be asked to switch from cigarette use to use of the study e-cigarettes for eight weeks. Placebo patch: Participants will wear the placebo patch daily while switching from cigarette use to use of e-cigarettes for eight weeks. Non-nicotine e-cigarettes: Participants will use e-cigarettes not containing nicotine while switching from cigarette use to use of e-cigarettes for eight weeks.
    All Cause Mortality
    Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/37 (0%) 0/33 (0%) 0/11 (0%) 0/13 (0%)
    Serious Adverse Events
    Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 2/37 (5.4%) 3/33 (9.1%) 1/11 (9.1%) 0/13 (0%)
    Psychiatric disorders
    Auditory Hallucinations 0/37 (0%) 0 1/33 (3%) 1 0/11 (0%) 0 0/13 (0%) 0
    Renal and urinary disorders
    Infected renal stone 0/37 (0%) 0 0/33 (0%) 0 1/11 (9.1%) 1 0/13 (0%) 0
    Respiratory, thoracic and mediastinal disorders
    COPD Exacerbation 1/37 (2.7%) 1 0/33 (0%) 0 0/11 (0%) 0 0/13 (0%) 0
    Streptococcal Pneumonia 0/37 (0%) 0 1/33 (3%) 1 0/11 (0%) 0 0/13 (0%) 0
    Surgical and medical procedures
    Knee Surgery 1/37 (2.7%) 1 0/33 (0%) 0 0/11 (0%) 0 0/13 (0%) 0
    Vascular disorders
    Hypertensive Crisis 0/37 (0%) 0 1/33 (3%) 1 0/11 (0%) 0 0/13 (0%) 0
    Other (Not Including Serious) Adverse Events
    Nicotine E-cigs + Nicotine Patches Non-nicotine E-cigs + Nicotine Patches Nicotine E-cigs + Placebo Patches Non-nicotine E-cigs + Placebo Patches
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 21/37 (56.8%) 15/33 (45.5%) 4/11 (36.4%) 4/13 (30.8%)
    Cardiac disorders
    Rapid Heart Beat 0/37 (0%) 0/33 (0%) 2/11 (18.2%) 0/13 (0%)
    Gastrointestinal disorders
    Nausea 0/37 (0%) 0/33 (0%) 1/11 (9.1%) 1/13 (7.7%)
    Vomiting 0/37 (0%) 0/33 (0%) 1/11 (9.1%) 0/13 (0%)
    Constipation 0/37 (0%) 0/33 (0%) 2/11 (18.2%) 0/13 (0%)
    General disorders
    Fatigue 2/37 (5.4%) 0/33 (0%) 0/11 (0%) 0/13 (0%)
    Insomnia 0/37 (0%) 3/33 (9.1%) 0/11 (0%) 1/13 (7.7%)
    Vivid Dreams 7/37 (18.9%) 6/33 (18.2%) 3/11 (27.3%) 1/13 (7.7%)
    Dry Mouth 2/37 (5.4%) 0/33 (0%) 1/11 (9.1%) 0/13 (0%)
    Nervous system disorders
    Headache 2/37 (5.4%) 0/33 (0%) 1/11 (9.1%) 0/13 (0%)
    Psychiatric disorders
    Irritability 2/37 (5.4%) 2/33 (6.1%) 1/11 (9.1%) 0/13 (0%)
    Depression 0/37 (0%) 0/33 (0%) 1/11 (9.1%) 0/13 (0%)
    Respiratory, thoracic and mediastinal disorders
    Cough 2/37 (5.4%) 2/33 (6.1%) 0/11 (0%) 1/13 (7.7%)
    Sore throat 0/37 (0%) 0/33 (0%) 1/11 (9.1%) 0/13 (0%)
    Skin and subcutaneous tissue disorders
    Itchiness 8/37 (21.6%) 3/33 (9.1%) 1/11 (9.1%) 1/13 (7.7%)
    Local Rash 0/37 (0%) 2/33 (6.1%) 0/11 (0%) 0/13 (0%)
    Distant Rash 0/37 (0%) 3/33 (9.1%) 0/11 (0%) 0/13 (0%)
    Vascular disorders
    Dizziness 0/37 (0%) 0/33 (0%) 0/11 (0%) 1/13 (7.7%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    All Principal Investigators ARE employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Jed E. Rose, Ph.D.
    Organization Duke University
    Phone 919-668-5055
    Email jed.rose@duke.edu
    Responsible Party:
    Duke University
    ClinicalTrials.gov Identifier:
    NCT03492463
    Other Study ID Numbers:
    • Pro00084132
    • P50DA027840-07
    First Posted:
    Apr 10, 2018
    Last Update Posted:
    Jun 28, 2022
    Last Verified:
    May 1, 2022