Use of Nicotine Pouches Among Daily Smokers

Phase

N/A

Condition

Tobacco Use Disorder

Treatment

Smooth nicotine pouch

Wintergreen nicotine pouch

0 mg nicotine pouch

Clinical Study ID

NCT06043362

STUDY00023056

1U54DA058271

Ages 21-70
All Genders
Accepts Healthy Volunteers

Study Summary

The purpose of this clinical trial is to understand the health effects of a new oral nicotine pouch, and also to understand if this product can help reduce traditional cigarette smoking. The main aims are:

Understand the impact of nicotine pouch use on toxicant exposure biomarkers, and indicators of potential harms to health.
Examine the influence of nicotine pouch use on conventional tobacco product use (cigarettes).

Participants will be randomized to one of six nicotine pouch groups (3 nicotine strengths, each with 2 potential flavors) to use over 16 weeks and asked to reduce their cigarette smoking over that time by at least 75% by substituting with the use of the nicotine pouches. Researchers will compare the outcomes of the different nicotine pouch strengths and flavors to each other. Participants will be asked to complete study questionnaires and provide urine, exhaled carbon monoxide, and mouth cell samples, and other health measurements.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Commonly smoke ≥ 5 cigarettes per day (at least 2 days/week) for at least the prior 12 months
Exhaled CO measurement of ≥ 6 parts per million at baseline
Must be interested in reducing cigarette consumption by at least 50% and willing totry nicotine pouches
Able to understand, read and write in English
Access to e-mail and a smartphone/computer that has reliable internet connection
Able to understand and give informed consent

Exclusion

Exclusion Criteria:

Plans to quit smoking within the next 30 days
Currently pregnant, breastfeeding, or planning to become pregnant in the next 6months
Recent (past 3 months) unstable illness that may increase risks of participation orability to participate fully (e.g. hospitalization for a mental health condition orsubstance use disorder in prior 6 months, stroke or myocardial infarction in thepast year)
Serious current respiratory diseases (e.g. exacerbations of asthma or chronicobstructive pulmonary disease [COPD], requiring oxygen or oral prednisone), kidneydisease (e.g. requiring dialysis), liver disease (e.g cirrhosis), or any medicaldisorder/medication that may affect participant safety or biomarker data
Use of a nicotine pouch or other non-cigarette nicotine product (e-cigarette, pipe,cigar, chew, snus, hookah, IQOS) for 5 or more days in the past 28 days
Use of illegal drugs daily or weekly in the past 3 months
Use of combustible (smoked) recreational or medical marijuana weekly in the past 3months (less frequent smoked medical marijuana or use of other forms of medicalmarijuana are ok)
Other member of the household currently participating in the study
Any other condition that in the opinion of the investigator would make it unlikelythat the participant could comply with the study protocol

Study Design

Smooth nicotine pouch

September 17, 2024

August 31, 2028

Study Description

Nicotine Pouches represent a rapidly growing category in the U.S. tobacco market, but little is known about their health effects (including addiction) or effects on cigarette smoking. The investigators propose to use a randomized controlled trial methodology to inform FDA on the effects of nicotine pouch use in smokers interested in reducing their smoking but not quitting smoking. The specific aim of this proposal is to recruit a cohort of 330 current daily smokers with an interest in reducing smoking, and to measure a comprehensive battery of behavioral and health indicators at baseline, and over 16 weeks after being randomized to use Nicotine Pouches containing either 0mg, 3mg or 6mg nicotine in "Smooth" or Wintergreen flavors in a randomized double-blind, placebo-controlled trial. The trial will be conducted at two sites: Penn State Hershey and M.D. Anderson in Texas in order to recruit a diverse sample of smokers. This trial therefore addresses the scientific domain of Product Composition and Design (specifically nicotine content and flavor additives). The central hypothesis is that key markers of toxicity and health effects (e.g. urine NNAL, exhaled carbon monoxide [CO], measures of cigarette addiction [e.g. Penn State Cigarette Dependence Index], oxidative stress and oral B(a)P DNA adducts) will be significantly reduced in smokers who are provided high nicotine (6mg) Nicotine Pouches, relative to 0mg pouches. The investigators will also assess the effects of Nicotine Pouch content on Nicotine Pouch addiction, and the effects of pouch nicotine dose on cigarette and other tobacco product consumption. Lastly, investigators will also compare the effects in those randomized to "Smooth" versus Wintergreen flavors. After the 16-week randomized phase, participants will be encouraged to quit smoking and connected to telephone cessation services and then followed-up 4 weeks later (week 20) in order to ascertain whether the nicotine content of the pouches influenced intention and ability to quit smoking. At the completion of this rigorous double-blind randomized trial investigators will have a better understanding of the effects of Nicotine Pouches (and their nicotine content and flavor characteristics) on cigarette consumption and the resulting changes to markers of health risks, oral health and nicotine addiction.

Connect with a study center

Penn State College of Medicine
Hershey, Pennsylvania 17033
United States
Site Not Available
Penn State College of Medicine
Hershey 5193342, Pennsylvania 6254927 17033
United States
Active - Recruiting
University of Texas MD Anderson Cancer Center
Houston, Texas 77030
United States
Site Not Available
University of Texas MD Anderson Cancer Center
Houston 4699066, Texas 4736286 77030
United States
Active - Recruiting

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