This project will examine the impact of very low nicotine content (VLNC) cigarettes in a complex tobacco and nicotine product marketplace. We will compare the number of cigarettes smoked and cigarette-free days in an experimental marketplace that contains VLNC cigarettes versus normal nicotine content (NNC) cigarettes.
This randomized, open label, controlled, multi-site study will simulate a "real world" tobacco environment by providing participants access to an experimental marketplace where they will be given vouchers for a specified number of points that can be exchanged for study cigarettes (varying in nicotine content described below) and non-combusted tobacco/nicotine products (smokeless tobacco, snus, electronic cigarette, medicinal nicotine replacement) and at the end of the study can exchange unspent points for money. Subjects (N=200 in each group) will be randomly assigned to: 1) very low nicotine content cigarettes (VLNC; 0.4 mg nicotine/g tobacco) along with non-combusted tobacco/nicotine products or 2) normal nicotine content cigarettes (NNC; 15.8 mg nicotine/g tobacco) along with non-combusted tobacco/nicotine products. Smokers will undergo an orientation visit for screening and then enter a three phase experimental trial: 1. Phase 1 - Baseline: Two week baseline assessment period during usual brand cigarette smoking. 2. Phase 2 - Marketplace Adaptation: Two week period where subjects have access to the marketplace that provides their preferred usual brand cigarettes and selected non-combusted tobacco products to allow the subject to adjust to the marketplace prior to randomization; 3. Phase 3 - Intervention: Randomization to a marketplace with access to either VLNC or NNC cigarettes plus non-combusted products for a 12 week period. Biomarker samples are collected at baseline, end of Phase 2 and end of week Phase 3 (week 12).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
799
0.4 mg nicotine/g tobacco; 9 mg tar
15.8 mg nicotine/g tobacco; 9 mg tar
Tobacco Research Center
San Francisco, California, United States
Tobacco Research Programs
Minneapolis, Minnesota, United States
The Center for Addiction Science and Technology
Durham, North Carolina, United States
Wake Forest Tobacco Control Center of Excellence
Winston-Salem, North Carolina, United States
Cigarettes Per Day (CPD)
The mean cigarettes (study and non-study cigarettes) smoked per day based on 7 days Daily Interactive Voice Response (IVR) data at the end of Phase 3 (experimental marketplace with study cigarettes) compared to Phase 2 (experimental marketplace with usual brand cigarettes).
Time frame: 7 days prior to week 12 visit
Number of Smoke-free Days
Rate of smoke-free days, defined as no cigarettes smoked in the past 24 hours calculated as the proportion of smoke-free days out of the total number of days in Phase 3. Number of smoke free days based on the interactive voice response (IVR)
Time frame: day 1 of study until day before week 12 visit
Percent Change in 2-cyanoethyl-mercapturic Acid (CEMA)
Change in CEMA (biomarker for the mercapturic acid acrylonitrile) from end of Phase 2 (experimental marketplace with usual brand cigarettes) to end of Phase 3 (experimental marketplace with study cigarettes).
Time frame: The last visit in Phase 2 is the end of the baseline
Study Cigarettes Per Day
The mean study cigarettes smoked per day based on 7 days Daily Interactive Voice Response (IVR) data at the end of Phase 3 (experimental marketplace with study cigarettes) compared to Phase 2 (experimental marketplace with usual brand cigarettes).
Time frame: 12 weeks (Phase 3) on study cigarettes
Seven Day Point-prevalence CO-verified Abstinence
Total cigarettes per day equal to 0 for all 7 days before the week 12 visit and carbon monoxide (CO) ≤ 6ppm at week 12.
Time frame: 7 days before week 12 visit
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Center for Interdisciplinary Research on Nicotine Addiction
Philadelphia, Pennsylvania, United States
Brown University Center for Alcohol and Addiction Studies School of Public Health
Providence, Rhode Island, United States