Concentration Impact Nicotine Salt
- Conditions
- VapingSmoking Cessation
- Interventions
- Procedure: Smoking cessation counselingOther: Open system vape device and nicotine salt e-liquids
- Registration Number
- NCT04725656
- Lead Sponsor
- Insel Gruppe AG, University Hospital Bern
- Brief Summary
Double-blind (for the two active arms), randomized, three-arm (two active and one control) clinical trial investigating factors (e.g. nicotine concentration) influencing the success of smoking cessation strategies and possible health risks related to nicotine salt vaping.
- Detailed Description
At the clinic screening visit demographics, smoking (including the Fagerström Test for Cigarette Dependence (FTCD) Questionnaire) and medical history, concomitant medication, vital signs, body mass index (BMI) and exhaled carbon monoxide (CO) will be assessed, and a physical examination will be performed. Saliva samples will be collected for cotinine and nicotine metabolite ratio (NMR) measurement, urine samples for urinary anabasine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), nicotine metabolites, tobacco-specific nitrosamines (TSNA), and VOC, and blood samples for genotyping, steroid levels, blood lipids, creatinine, and glucose.
After randomization the open system vape device and the nicotine salt e-liquids will be distributed to the participants of the two active arms. Use of e-liquids in the active arms will be ad libitum during three months and will be monitored by returned empty e-liquid bottles.
All groups will receive smoking cessation counseling at baseline, week 1, and week 4. Visits at the center at baseline, week 4, and 3 months will include questionnaires regarding TC and EC use, respiratory symptoms, liking, and adverse events, measurement of heart rate, blood pressure, BMI, blood steroid levels, HDL, LDL, creatinine and glucose, and measurement of urinary TSNA, VOC and nicotine metabolites. For participants self-reporting TC abstinence, exhaled CO validation and urinary anabasine and NNAL will be collected to verify tobacco abstinence.
A follow-up visit also assessing TC abstinence will take place at 6 months.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 312
- 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
- Exhaled CO ≥ 10 ppm or saliva cotinine of > 30 ng/ml (in case of borderline CO measurement of 6-10 ppm) 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
- Known hypersensitivity/allergy to a content of the e-liquid
- Pregnancy or breast feeding
- Intention to become pregnant during the course of the study
- Current regular use of EC or tobacco heating systems
- Use of NRT, varenicline, or bupropion in the month prior to the screening visit
- People who 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
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Active arm, low concentration (18 mg/mL) nicotine salt e-liquids Smoking cessation counseling - Active arm, high concentration (59 mg/mL) nicotine salt e-liquids Open system vape device and nicotine salt e-liquids - Active arm, high concentration (59 mg/mL) nicotine salt e-liquids Smoking cessation counseling - Control group Smoking cessation counseling Receive only smoking cessation counseling Active arm, low concentration (18 mg/mL) nicotine salt e-liquids Open system vape device and nicotine salt e-liquids -
- Primary Outcome Measures
Name Time Method 7-day point prevalence tobacco abstinence (in terms of non-inferiority) 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) 1 month Volume of e-liquid used when using low vs. high nicotine salt concentration e-liquids.
- Secondary Outcome Measures
Name Time Method 7-day point prevalence tobacco cigarette abstinence 3 and 6 months Self-reported 7-day point prevalence abstinence at 3 and 6 months (confirmed by exhaled carbon monoxide and urinary anabasine) using the stricter, i.e. "not a puff" and the less strict, i.e. "no more than 5 cigarettes" definition
Adverse events Up to 6 months Checklist with specific questions regarding presence or absence of nausea, sleep disturbance, throat/mouth irritation or other
Time of dropping out Through study completion Urinary volatile organic compounds (VOC) 1 and 3 months Change of non-nicotine toxicants (VOC) from baseline to 1 month and 3 months of nicotine salt use
Respiratory symptoms Up to 6 months Checklist with specific questions regarding shortness of breath, wheezing, cough or phlegm
Total volume of e-liquid consumed 1 and 3 months Number of drop-outs Through study completion Liking/rating of trial product (active arms) 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.
Continuous tobacco cigarette abstinence 3 and 6 months Self-reported continuous abstinence at 3 and 6 months (confirmed by exhaled carbon monoxide and urinary anabasine) using the stricter, i.e. "not a puff" and the less strict, i.e. "no more than 5 cigarettes" definition, and when allowing a 2-week "grace period" from the target quit date
Tobacco-specific nitrosamines (TSNA) 1 and 3 months Change of non-nicotine toxicants (TSNA) from baseline to 1 month and 3 months of nicotine salt use
Steroid profiles Baseline, 1, 3 and 6 months Steroid profiles in saliva, blood and urine
Total nicotine amount vaped 1 and 3 months Number of cigarettes smoked per day among those who fail to quit Through study completion
Trial Locations
- Locations (1)
Inselspital
🇨🇭Bern, Switzerland