Reduced Exposure to HPHC in Smokers Switching From Cigarettes to Different Versions of THS

Overview

This was a randomized, controlled, open-label, 4 parallel arm study with a stratified randomization by sex (a quota for each sex \[females and males\] of at least 40% overall). This study aimed to demonstrate the reduction of Biomarkers of Exposure (BoExp) to selected Harmful and Potentially Harmful Constituents (HPHC) in smokers switching from cigarettes (CIG) to each of the Tobacco Heating System (THS) variants with different heating technology (Blade device, Induction Mono device, or Induction Mid device, respectively), compared with smokers who continued to smoke CIG.

Study Title: Reduced Exposure to Harmful and Potentially Harmful Constituents (HPHC) in Smokers Switching From Cigarettes to Different Versions of the Tobacco Heating System (THS) Who carried out the research? This research was sponsored and funded by Philip Morris Products S.A. What public involvement there was in the study? Ninety-one healthy, currently smoking, adults participated in this study. Where and when the study took place? The study was conducted at a clinical trial facility managed by a contract research organization in Belfast, Northern Ireland, from November 4th 2022 to February 4th 2023. Who participated in the study? Ninety-one healthy male or female adults, aged between 21 and 65 years, participated in this study. All participants were currently smoking. The participants did not plan to quit using tobacco and/or nicotine products within the next 3 months and had smoked continuously for at least the last 3 years prior to joining the study. Each participant was given full and adequate oral and written information about the nature, purpose, possible risks, and benefits of the study. All participants received information on the risks of smoking, smoking cessation advice and a briefing on the Tobacco Heating System, for example, that its use is not risk-free. Once each participant had received all the necessary information, and if they agreed to participate, this was documented in an Informed Consent Form with the date, time, and signature of both the participant and the study doctor. Participants were informed that they were free to withdraw from the study at any time. What treatments or interventions did the participants take/receive? Eighty participants were randomly assigned to one of four study arms: THS Blade device, THS Induction Mono device, THS Induction Mid device, or Cigarette, for five days in a confinement setting. Participants assigned to one of the THS arms or the Cigarette arm could use their assigned product, as often as they wished, from 6:30 AM to 11:00 PM during the five-day confinement period. Urine was collected from each participant for analysis, for each 24 hours, from Day -1 (the start of the confinement period) to Day 5 (until discharge at the morning of Day 6). Participants were also asked to evaluate their experience of using their assigned products, using a product experience questionnaire. The questionnaire assessed the perceived effects experienced by Cigarette smokers switching to the THS Blade device, THS Induction Mono device, or THS Induction Mid device compared to the experience of subjects continuing Cigarette smoking. What happened during the study? A presentation of THS (without product use) was made to the participants during the Screening visit. All participants received information on the risks of smoking, smoking cessation advice, and a briefing that the use of THS is not risk-free. Eligible participants, fulfilling all criteria for participation, returned to the investigational site for confirmation of eligibility at the Admission visit (Day -2). On Day -2 (Admission), after eligibility criteria had been verified, subjects had a product test of the THS Blade device and Induction Mono device (with use of up to three THS tobacco sticks per device). All eligible participants were then enrolled and participants willing to continue their participation in the study started their confinement period of seven days. On Day -1, participants were randomly assigned to one of four arms: THS Blade device, THS Induction Mono device, THS Induction Mid device, or Cigarette. Participants were informed about their randomization arm by the study site staff on Day 1 prior to the start of product use. The Exposure period in confinement began on Day 1 and consisted of 5 days of at will use of the assigned product in the THS and Cigarette arms. Use of any tobacco/nicotine containing product other than the assigned product was not allowed. Daily 24-hour urine was collected from Day -1 to Day 5 for HPHC analysis. On Day 1, use of THS or Cigarette smoking in the respective arms was not supposed to start before the end of 24-hour urine collection of Day -1. The 24-hour urine collection period for Day 5 ended in the morning of Day 6 prior to Discharge. On Day -1 and on Days 1 to 5, participants completed questionnaires to assess the perceived effects experienced after switching to THS, compared to the experience of participants who continued Cigarette smoking. During the confinement period, adherence to investigational product arm allocation (exclusive use of the assigned THS devices with designated sticks, or Cigarette smoking, respectively) was ensured by strict distribution of the devices, and of each stick/cigarette upon demand of the subject to the study site staff. Any participant who wanted to attempt to quit using any tobacco or nicotine-containing product at any time during the study (that is, to quit THS use or Cigarette smoking) was encouraged to do so and was to be referred to appropriate medical services. This decision would not affect the participant's financial compensation, and the participant was to be considered as remaining in the study. The Exposure period to the assigned investigational product (THS or Cigarette) ended at 11:00 PM on Day 5, followed by Discharge on Day 6 after completion of all study procedures. Participants were allowed to smoke Cigarettes or use other tobacco or nicotine-containing products, at their discretion, only after discharge from the study. After discharge at Day 6 or from the day of an early termination, subjects entered a 3-day Safety follow-up period during which any adverse reactions reported by the participants were collected. The follow-up of adverse reactions ongoing at discharge was conducted by the investigational site.