CAN-DOSE Study: Cessation With Augmented Nicotine for Dual Use Of Smoking and E-cigarettes

Medical University of South Carolina (MUSC)

Status and phase: Completed; Phase 2

Conditions: Cigarette Smoking; Electronic Cigarette Use; Smoking Cessation

Treatments: Drug: Augmented Nicotine patch and lozenge dose; Drug: Regular Nicotine patch and lozenge dose

Study type: Interventional

Funder types: Other

Identifiers

NCT06087328

Pro00130184

IRG-19-137-20 (Other Grant/Funding Number)

Details and patient eligibility

About

Many people smoke cigarettes and use e-cigarettes, and have a hard time stopping. Nicotine replacement therapy medications, such as nicotine patches and lozenges, have been shown to help people quit e-cigarette use. The purpose of the present study is to see how well nicotine patches and lozenges help people quit both smoking and vaping, and to determine if higher doses of the medication work best.

Full description

Tobacco use is a leading cause of cancer death and disability in the US, thus tobacco control remains an important public health priority. Alternative tobacco products have grown popular in the past decade, including electronic cigarettes (e-cigarettes; vaping). E-cigarettes were initially marketed as an alternative to or means for smoking cessation and became popular amongst those currently smoking. Recent estimates suggest that 54% of those who vape are currently smoking (i.e., dual use). Despite this, there is a lack of empirically tested interventions for dual use cessation among the general adult population. In a prior pilot study, investigators found preliminary evidence that a standard dose of nicotine replacement therapy (NRT; 21mg patch+4mg lozenge) was sufficient at helping exclusive e-cigarette users quit vaping. However, dual users (individuals who smoke cigarettes and use e-cigarettes) did not respond similarly. The proposed project aims to compare three doses of NRT (21mg patch+4mg lozenge; 21+14mg patch + 4mg lozenges; 21+21mg patch + 4mg lozenges) with a sample of dual users who wish to quit smoking and vaping use in order to understand more about how NRT can help dual users quit tobacco.

Enrollment: 46 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18yrs +
• Daily nicotine-containing e-cigarette user (25+ days per previous month)
• E-cigarette use 5+ times/day
• E-cigarette use > 1year
• Smoking >1 cigarette on 5-7 days per week
• Interest in quitting smoking and e-cigarette within the next month (>7 on 10-point scale)
• Willingness to use NRT
• Able to receive text messages/email
• Mailing address in South Carolina.

Exclusion criteria

• Medical conditions contraindicated to NRT use (including pregnancy, past month myocardial infarction, current cardiac arrhythmia, current angina, uncontrolled vascular disease, or medical conditions in which consumption of phenylalanine is contraindicated)
• Individuals reporting current use of other nicotine-containing products and/or smoking cessation medications
• Those who vape non-nicotine substances
• Individuals unable to consent (e.g. significant cognitive deficit, non-English speaking).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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46 participants in 3 patient groups

Arm A

Active Comparator group

Description:

21mg patch, qd + 4mg lozenge prn \[minimum of 5 \& up to 20 per day\]

Treatment:

Drug: Regular Nicotine patch and lozenge dose

Arm B

Active Comparator group

Description:

21mg patch + 14mg patch qd + 4mg lozenge prn minimum of 5 \& \[up to 30 per day\]

Treatment:

Drug: Augmented Nicotine patch and lozenge dose

Arm C

Active Comparator group

Description:

2 x 21mg patches qd + 4mg lozenges prn \[minimum of 5 \& up to 40 per day\]

Treatment:

Drug: Augmented Nicotine patch and lozenge dose