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This is a two-site, open-label, randomized, 5-way cross-over study designed to evaluate elements of abuse liability (AL) including subjective effects and physiological measures (pharmacodynamics [PD]) and plasma nicotine uptake (pharmacokinetics [PK]) during and following ad libitum use of the study investigational products (IPs) by generally healthy smokers.
Full description
Cigarette smokers and smokers also using smokeless tobacco products (ST) will be recruited into this AL study to evaluate elements of AL of three nicotine pouches compared to combustible cigarettes (CC) and nicotine polacrilex gum. At least one-third of the study population will include smokers who also use ST.
Potential subjects may complete a pre-screening telephone interview. Subjects will complete a Screening Visit to assess their eligibility within 45 days prior to check-in and enrollment.
Starting on Day 1, subjects will check-in at the clinical site to complete procedures to confirm eligibility. Eligible subjects will be enrolled and confined for 6 days. Subjects will be randomized to one of 10 product use sequences (using a Williams Design) in which the subjects will evaluate one IP in each of five separate Test Sessions, such that each subject will evaluate five IPs, including three IPs, and both a high-AL comparator (subject's usual brand [UB] cigarette) and a low-AL comparator (a commercially available nicotine replacement therapy [NRT] nicotine gum).
On Day 2 and continuing through Day 6, subjects will participate in Test Sessions that will last for approximately 4 hours. Each Test Session will include collection of both PD measures (subjective and physiological) and PK measures prior to, during, and following IP use.
On the half day prior to each respective Test Session, a Product Acclimation Period will allow subjects ad libitum use of the randomized IP (at least two trial uses) for product familiarization prior to use in the next day's Test Session. Subjects can also use their UB cigarettes ad libitum, until the 12-hour tobacco abstinence begins prior to each Test Session, as long as the minimum use requirement for randomized IP is met.
Enrollment
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Inclusion criteria
Generally healthy males or females, 21 to 60 years of age, inclusive, at the time of consent.
Smokes combustible, filtered, non-menthol or menthol cigarettes, 83 mm to 100 mm in length as primary source of tobacco.
Smokes an average of at least 10 cigarettes per day (CPD) and inhales the smoke, for at least 6 months prior to Screening. Brief periods of abstinence due to illness, quit attempt (prior to 30 days of Screening), or clinical study participation (prior to 30 days of Screening) will be allowed at the discretion of the PI.
Smokers who also use ST products (e.g., moist snuff, snus), and have used ST within 30 days prior to screening, will be enrolled.
Agrees to smoke the same UB cigarette throughout the study period. The UB cigarette is defined as the reported cigarette brand and style currently smoked most frequently by the subject.
Expired breath carbon monoxide (ECO) level is ≥ 10 ppm and ≤ 100 ppm at Screening and at check-in Day 1.
Positive urine cotinine test at Screening.
Response at Screening to the Fagerström Test for Nicotine Dependence (FTND) Question 1 ("How soon after you wake up do you smoke your first cigarette?") is either "Within 5 minutes" or "6-30 minutes" (Heatherton et al., 1991).
Willing to use the UB cigarette, IPs, and Nicorette® nicotine gum during the study period.
Willing to abstain from tobacco and nicotine use for at least 12 hours prior to the start of each of five Test Sessions.
Females must be willing to use a form of contraception acceptable to the PI from the time of signing the informed consent until End-of-Study.
Examples of acceptable means of birth control are, but not limited to:
Agrees to an in-clinic confinement of 6 days (5 nights).
Exclusion criteria
Primary purpose
Allocation
Interventional model
Masking
40 participants in 10 patient groups
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Central trial contact
Kristen Prevette
Data sourced from clinicaltrials.gov
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