This is a randomized, controlled, six-way crossover clinical study to characterize the nicotine PK (pharmacokinetic) and subjective effects of HTPs (Heated Tobacco Products) comprised of 2 menthol varieties and 2 tobacco flavor varieties (Ploom® HTPs, Japan Tobacco Inc.) in adult menthol and non-menthol combustible cigarette smokers (males and females between the ages of 22 and 65). The study will include participants' UBCC (Usual Brand Combustible Cigarette) and a nicotine gum (Nicorette®) as high and low abuse liability reference products, respectively, to the HTP. Study participation is expected to last up to 34 days, including a 28-day screening period (that includes a 5-day at-home HTP product trial period), and a 6-day in-clinic confinement period (from Check-in \[Day -1\] through the end-of-study \[EOS\] visit on Day 6).
This is a randomized, controlled, six-way crossover clinical study to characterize the nicotine PK and subjective effects of HTPs (2 menthol varieties, Products A and B; 2 tobacco flavor varieties, Products C and D) in adult menthol and non-menthol combustible cigarette smokers. The study will include participants' UBCC (Product F) and a nicotine gum (Product E) as high and low abuse liability reference products, respectively, to the HTP. The study will include generally healthy adult males and females who smoke factory manufactured combustible cigarettes. This study will recruit approximately 60 participants (composed of approximately 30 menthol and 30 non-menthol adult smokers) in an attempt to obtain approximately 48 study completed participants (approximately 24 menthol and 24 non-menthol smokers). Adult participants will be between 22 and 65 years of age at screening, inclusive. Participants must have a history of smoking ≥ 10 to ≤ 30 menthol or non-menthol cigarettes daily for at least 12 months prior to screening. Enrolled participants will be randomized based on sex and their UBCC (menthol or non-menthol) to one of 6 product use sequences. Screening will occur within 28 days prior to Day 1 and includes administering the FTCD (Fagerstrom Test for Cigarette Dependence), standard safety procedures, collection of baseline information, and a 5-day at-home HTP product trial period. Enrollment visit (Day -6) will occur 5 days prior to Check-in (Day -1). Participants will receive the Ploom® HTP products for at-home product acclimation to become familiar with the product during the next 5 days. Training on how to use the Ploom® HTP device will be provided to each participant at the Enrollment visit. Participants will receive all four varieties of HTS on Day -6 and begin the at-home product trial. Participants are required to use each HTS variety at least once a day ad libitum for a minimum of 20 HTS uses over 5 days. Participants will check-in on the morning of Day -1. Product use sequence randomization and assignment will also occur on Day -1. Participants will be randomized based on sex and their UBCC (menthol or non-menthol) to one of six product use sequences. Once participants are randomized to a product use sequence, product use sessions in confinement will start. Participants will remain in confinement at the clinic until completion of all study activities on Day 6. Starting on Day -1 (following Check-in) through Day 5, depending on the randomized product use sequence, participants will use their assigned product (HTP, UBCC, or nicotine gum) during an afternoon product use session. Participants will use the same assigned product to be tested during the next day's morning ad libitum product use PK test session (e.g., if a participant is assigned to Product A \[HTP\] as the product to be used in the morning ad libitum product use PK test session on Day 1, the participant will use Product A \[HTP\] during the afternoon product use session on Day -1). The afternoon product use session should be no more than approximately 6 hours long. Participants will be required to use the assigned study product at least once, but no more than six HTS, UBCC, or nicotine gum ad libitum per daily afternoon product use sessions. Participants will then be required to abstain from any tobacco- or nicotine-containing products for at least 12 hours prior to the start of the following morning's ad libitum product use PK test session. Morning ad libitum product use PK test sessions will occur on the mornings of Days 1, 2, 3, 4, 5, and 6 (for a total of 6 morning ad libitum product use PK test sessions). During the morning ad libitum product use PK test session, participants will use the assigned study product per their assigned product use sequence. Participants will use a single UBCC or HTP for 5 minutes ad libitum or use the nicotine gum for 30 minutes per product use instruction. Blood samples for PK will be collected prior to and for 3 hours following the start of each morning ad libitum product use PK test session. Heart rate measurements will be taken at specified time points during each morning ad libitum product use PK test session. In addition, participants will complete subjective effects questionnaires (Product Liking, Tobacco/Nicotine Withdrawal, Direct Effects of Product, Use Product Again, and mCEQ) at designated time points during each morning ad libitum product use PK test session. Participants will remain in confinement starting with Check-in on Day -1 until discharge after all study activities are completed on Day 6. Participants will not be forced to use the tobacco/nicotine products at any time during the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
170
Use of Test Product A in controlled use and ad libitum use sessions
Use of Test Product B in controlled use and ad libitum use sessions
Use of Test Product C in controlled use and ad libitum use sessions
Use of Test Product D in controlled use and ad libitum use sessions
Use of Reference Product E in controlled use and ad libitum use sessions
Use of Reference Product F in controlled use and ad libitum use sessions
Alliance for Multispecialty Research, LLC
Lexington, Kentucky, United States
QPS Bio-Kinetic
Springfield, Missouri, United States
Alliance for Multispecialty Research, LLC
Knoxville, Tennessee, United States
Plasma Nicotine Concentration Pharmacokinetic (PK) Measurement
Characterize PK parameters of nicotine in plasma during and after a single ad libitum use of HTP (two menthol and two tobacco flavor varieties) relative to UBCC and the nicotine gum. Plasma nicotine will be measured as ng/mL with baseline adjustment.
Time frame: Day 1 through Day 6
Product Liking of Heated Tobacco Products (HTP)
Characterize Product Liking of HTP (two menthol and two tobacco flavor varieties) during and after a single ad libitum use relative to UBCC and the nicotine gum by administering a Product Liking Questionnaire. This question is paired with a VAS (visual analog scale). The 100 mm VAS is anchored with 'Strongly Dislike' on the left, 'Neither Like nor Dislike' in the center and 'Strongly Like' on the right. Participants place a vertical line at a place along the VAS based on how he/she feels in the moment.
Time frame: Day 1 through Day 6
Tobacco Nicotine Withdrawal Questionnaire
Characterize subjective response to HTP (two menthol and two tobacco flavor varieties) during and after a single ad libitum use relative to UBCC and the nicotine gum through the administration of Tobacco Nicotine Withdrawal questionnaire adapted from Hughes and Hatsukami (1986). Each question will be paired with a 100 mm VAS. The VAS is anchored with "Not at All" on the left and "Extremely" on the right. Participants place a vertical line at a place along the VAS based on how he/she feels in the moment. Reference: Hughes JR, Hatsukami D (1986). Signs and symptoms of tobacco withdrawal. Archives of General Psychiatry. 43(3):289-94.
Time frame: Day 1 through Day 6
Direct Effects of Product Questionnaire
Direct Effects of Product Questionnaire contains items that were selected based on measures of product effects used in previous trials with conventional cigarettes and other tobacco products. Each question is paired with a 100 mm VAS. The VAS is anchored with "Not at ALL" on the left and "Extremely" on the right. Participants place a vertical line at a place along the VAS based on how he/she feels in the moment.
Time frame: Day 1 through Day 6
Use the Product Again Questionnaire
The Use the Product Again Questionnaire was adapted from abuse-deterrent drug formulation drug trials question "I would want to take this drug again." The question is paired with a 100 mm VAS. The VAS is anchored with "Definitely Would Not" on the left and "Definitely Would" on the right. Participants place a vertical line at a place along the VAS based on how he/she feels in the moment.
Time frame: Day 1 through Day 6
Modified Cigarette Evaluation Questionnaire (mCEQ) - Cigarette
The instructions for subjects are: Please mark the number that best represents how using the product made you feel (1 - not at all, 2 - very little, 3-a little, 4-moderately, 5-a lot, 6-quite a lot, 7-extremely)
Time frame: Day 1 through Day 6
Modified Cigarette Evaluation Questionnaire - HTP
Modified Cigarette Evaluation Questionnaire is further modified for heated tobacco product (mCEQ-HTP). The instructions to subjects for completion of the questionnaire are: Thinking about the study product that you used today, please mark the number that best represents how using the heated tobacco product made you feel (1- not at all, 2- very little, 3-a little, 4-moderately, 5-a lot, 6-quite a lot, 7-extremely).
Time frame: Day 1 through Day 6
Modified Cigarette Evaluation Questionnaire-NRT
Modified Cigarette Evaluation Questionnaire was further modified for oral tobacco derived nicotine products. The instructions for subjects are: Please mark the number that best represents how using the product made you feel (1-not at all, 2-very little, 3-a little, 4-moderately, 5-a lot, 6-quite a lot, 7-extremely).
Time frame: Day 1 through Day 6
Product Use for HTP-Units Dispensed
For the HTP use the number of units dispensed will be manually documented for the 5-minute ad libitum product use period during the morning ad libitum product use PK test session. During the afternoon product use session (6 hours max ad libitum product use) the number of units used will be manually documented for the 5-minute ad libitum product use.
Time frame: Day 1 through Day 6
Product Use for UBCC-Units Dispensed
For the UBCC use the number of units dispensed will be manually documented for the 5-minute ad libitum product use period during the morning ad libitum product use PK test session. During the afternoon product use session (6 hours max ad libitum product use) the number of units used will be manually documented for the 5-minute ad libitum product use.
Time frame: Day 1 through Day 6
Product Use for Nicotine Gum-Units Dispensed
For nicotine gum, the number of units dispensed will be manually documented for the 30-minute ad libitum product use during the morning ad libitum product use PK test session. During the afternoon product use sessions (6 hours max ad libitum product use), the number of units of nicotine gum dispensed will be documented manually.
Time frame: Day 1 through Day 6
Product Use for HTP-Puff Count
For HTP use the puff count will be the number of puffs per unit manually documented for the 5-minute ad libitum product use period during the morning ad libitum product use PK test session. During the afternoon product use session (6 hours max ad libitum product use) the puff count for each unit used will be manually documented for the 5-minute ad libitum product use.
Time frame: Day 1 through Day 6
Product Use for UBCC-Puff Count
For UBCC use the puff count measured as the number of puffs per unit will be manually documented for the 5-minute ad libitum product use period during the morning ad libitum product use PK test session. During the afternoon product use session (6 hours max ad libitum product use) the number of puffs per each unit used will be manually documented for the 5-minute ad libitum product use.
Time frame: Day 1 through Day 6
Physiological Heart Rate (HR) Assessment-HTP
Physiological HR assessments will be assessed at designated time points during the morning ad libitum HTP product use PK test sessions. The scheduled time points are to include -5, 5, 15, 30, 60 and 180 minutes during PK session. Heart rate measurements as beats per minute (BPM) will be performed prior to the blood draw (approximately 1 minute prior to the scheduled blood draw time point) when scheduled at the same time.
Time frame: Day 1 through Day 6
Physiological Heart Rate (HR) Assessment-UBCC
Physiological HR assessments will be assessed at designated time points during the morning ad libitum UBCC product use PK test sessions. The scheduled time points are to include -5, 5, 15, 30, 60 and 180 minutes during PK session. Heart rate measurements as beats per minute (BPM) will be performed prior to the blood draw (approximately 1 minute prior to the scheduled blood draw time point) when scheduled at the same time.
Time frame: Day 1 through Day 6
Physiological Heart Rate (HR) Assessment-Nicotine Gum
Physiological HR assessments will be assessed at designated time points during the morning ad libitum nicotine gum product use PK test sessions. The scheduled time points are to include -5, 5, 15, 30, 60 and 180 minutes during PK session. Heart rate measurements as beats per minute (BPM) will be performed prior to the blood draw (approximately 1 minute prior to the scheduled blood draw time point) when scheduled at the same time.
Time frame: Day 1 through Day 6
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