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Smoking CessationPulmENDSNCT03938298

The ESTxENDS Trial: Pulmonary Function Substudy

A study testing ENDS (vaporizer/e-cig) and smoking cessation counseling and Smoking cessation counseling in people with Smoking Cessation and Pulmonary Disease, run by University of Bern at 2 sites in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

--> This is a substudy of the main ESTxENDS trial (NCT03589989). Pulmonary function outcomes should be considered secondary outcomes of the main smoking cessation outcome formulated in NCT03589989. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Smoking Cessation, Pulmonary Disease
What is being tested?
ENDS (vaporizer/e-cig) and smoking cessation counseling and Smoking cessation counseling
Could I receive a placebo?
No, everyone receives an active treatment
How many people
130 participants
Where
2 sitesSwitzerland
Study dates
10 Apr 2019to 28 Feb 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Informed Consent as documented by signature
  • Persons aged 18 or older
  • Currently smoking 5 or more cigarettes a day for at least 12 months
  • Willing to try to quit smoking within the next 3 months
  • Persons providing a valid phone number, a valid email address and/or a valid postal address.

Who cannot join

  • Known hypersensitivity or allergy to contents of the e-liquid
  • Participation in another study with investigational drug within the 30 days preceding the baseline visit and during the present study where interactions are to be expected
  • Women who are pregnant or breast feeding
  • Intention to become pregnant during the course of the scheduled study intervention, i.e. within the first 6-months of the study
  • Persons having used ENDS or tobacco heating systems regularly in the 3 months preceding the baseline visit
  • Persons having used nicotine replacement therapy (NRT) or other medications with demonstrated efficacy as an aid for smoking cessation such as varenicline or bupropion within the 3 months preceding the baseline visit
  • Persons who cannot attend the 6-month follow-up visit for any reason
  • Cannot understand instructions delivered in person or by phone, or otherwise unable to participate in study procedures

Trial locations and contacts

2 sites in 1 country.

Switzerland2 sites
  • University Clinic for General Internal Medicine, Bern University Hospital

    Bern, 3010

  • Department of Pneumology

    Bern

Other trials in Switzerland

About this study

Official title: Substudy of Efficacy, Safety and Toxicology of Electronic Nicotine Delivery Systems as an Aid for Smoking Cessation (ESTxENDS): Pulmonary Function Substudy (PulmENDS)

--> This is a substudy of the main ESTxENDS trial (NCT03589989). Pulmonary function outcomes should be considered secondary outcomes of the main smoking cessation outcome formulated in NCT03589989.

Cigarette smoking is the leading cause of preventable death in Switzerland and still more than a quarter of the Swiss population smokes cigarettes. Recently, electronic nicotine delivery systems (ENDS; also called vaporizer, e-cigarette or electronic cigarette) have become popular with smokers who want to stop smoking or reduce their exposure to inhaled chemicals since ENDS use appears to be safer than tobacco smoking. The inhaled ENDS aerosol appears safe in laboratory conditions, its long-term effects on pulmonary function remains unknown. This study will therefore investigate the impact of ENDS on lung function in smokers, who attempt to quit using ENDS compared with smokers, receiving only smoking cessation counseling with nicotine replacement therapy (NRT).

Read more

Multiple breath washout (MBW) is an established technique for assessment of peripheral airway function in pediatrics and its use is emerging in adult medicine, as it offers a better sensitivity to assess small airway disease before large airway involvement can be detected using conventional pulmonary function tests (PFT - spirometry, body plethysmography and diffusing capacity test). Preliminary evidence from limited studies suggest MBW parameters (LCI, Scond, Sacin) can be impaired in smokers with normal lung function and improve after smoking abstinence.

Primary objective of this substudy is to assess changes in LCI from baseline to 6 months post target quit date (TQD) in cigarette smokers randomized to the intervention group compared to the control group.

For the main ESTxENDS trial (NCT03589989), cigarette smokers motivated to quit smoking cigarettes will be included. Participants in the intervention group will receive an ENDS and nicotine-containing e-liquids, which they will be allowed to use ad libitum. Additionally, they will receive standard of care, i.e. smoking cessation counseling and encouragement to use NRT. Smoking cessation counseling will be provided in person at the first clinical visit and then over the phone at the target quit date and again at week 1, 2, 4 and 8 after the target quit date. Participants in the control group will receive only standard of care. All participants will be followed over a 6-month period. After 6 months, participants will be asked to come to a final clinical visit.

Being tested
ENDS (vaporizer/e-cig) and smoking cessation counseling, Smoking cessation counseling
Medical subject headings
Smoking Cessation, Lung Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ENDS (vaporizer/e-cig) and smoking cessation counselingOther

    Participants in the intervention group will receive an ENDS and nicotine-containing e-liquids, which they will be allowed to use ad libitum. Additionally, they will receive standards of care, i.e. smoking cessation counseling and encouragement to use NRT. Smoking cessation counseling will be provided in person at the first clinical visit and then over the phone at the target quit date and again at week 1, 2, 4 and 8 after the target quit date. All participants will be followed over a 6-month period. After 6 months, participants will be asked to come to a final clinical visit.

    PFT and MBW will be performed at baseline and after the 6 months follow-up period in all participants of the substudy.

  • Smoking cessation counselingOther

    Participants in the control group will receive standard of care only, i.e. i.e. smoking cessation counseling and encouragement to use NRT. Smoking cessation counseling will be provided in person at the first clinical visit and then over the phone at the target quit date and again at week 1, 2, 4 and 8 after the target quit date. All participants will be followed over a 6-month period. After 6 months, participants will be asked to come to a final clinical visit.

    PFT and MBW will be performed at baseline and after the 6 months follow-up period in all participants of the substudy.

Study groups in NCT03938298
Study groupRoleWhat they receive
Intervention groupExperimentalNot described
Receives: Other: ENDS (vaporizer/e-cig) and smoking cessation counseling
Control groupActive comparatorNot described
Receives: Other: Smoking cessation counseling

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in Lung Clearance Index (LCI)

    Measured by multiple breath washout (MBW) of a tracer gas (N2). LCI is defined as the cumulative expired volume/functional residual capacity (CEV/FRC) at 5% and 2.5% tracer gas concentration in the exhaled breath. An LCI with a z-score < + 1.645 (upper limit of normal according to Singer F et al, PLoS One. 2012;7(4):e36083) is considered normal.

    Measured: Change from baseline to 6 months post quit date

Secondary outcomes (17)
  1. Lung Clearance Index (LCI)

    Measured by multiple breath washout (MBW) of a tracer gas (N2). LCI is defined as the cumulative expired volume/functional residual capacity (CEV/FRC) at 5% and 2.5% tracer gas concentration in the exhaled breath. An LCI with a z-score < + 1.645 (upper limit of normal according to Singer F et al, PLoS One. 2012;7(4):e36083) is considered normal.

    Measured: 6 months post quit date

  2. Changes in Scond and Sacin

    Measured by multiple breath washout (MBW). MBW assesses ventilation of the peripheral airways.

    Measured: Change from baseline to 6 months post quit date

  3. Scond and Sacin

    Measured by multiple breath washout (MBW). MBW assesses ventilation of the peripheral airways.

    Measured: 6 months post quit date

  4. Forced Expiratory Volume in 1 Second (FEV1)

    Measured by spirometry. Spirometry is a conventional pulmonary function test measuring airflow.

    Measured: 6 months post quit date

  5. Changes in Forced Expiratory Volume in 1 Second (FEV1)

    Measured by spirometry. Spirometry is a conventional pulmonary function test measuring airflow.

    Measured: Change from baseline to 6 months post quit date

  6. Forced Expiratory Volume in 1 Second/Functional Vital Capacity Ratio (FEV1/FVC)

    Measured by spirometry. Spirometry is a conventional pulmonary function test measuring airflow.

    Measured: 6 months post quit date

  7. Changes in Forced Expiratory Volume in 1 Second/Functional Vital Capacity Ratio (FEV1/FVC)

    Measured by spirometry. Spirometry is a conventional pulmonary function test measuring airflow.

    Measured: Change from baseline to 6 months post quit date

  8. Total Lung Capacity (TLC)

    Measured by body plethysmography. Body plethysmography is a conventional pulmonary function test measuring lung volumes.

    Measured: 6 months post quit date

  9. Changes in Total Lung Capacity (TLC)

    Measured by body plethysmography. Body plethysmography is a conventional pulmonary function test measuring lung volumes.

    Measured: Change from baseline to 6 months post quit date

  10. Residual Volume (RV)

    Measured by body plethysmography. Body plethysmography is a conventional pulmonary function test measuring lung volumes.

    Measured: 6 months post quit date

  11. Changes in Residual Volume (RV)

    Measured by body plethysmography. Body plethysmography is a conventional pulmonary function test measuring lung volumes.

    Measured: Change from baseline to 6 months post quit date

  12. Residual Volume to Total Lung Capacity (RV/TLC)

    Measured by body plethysmography. Body plethysmography is a conventional pulmonary function test measuring lung volumes.

    Measured: 6 months post quit date

  13. Changes in Residual Volume to Total Lung Capacity (RV/TLC)

    Measured by body plethysmography. Body plethysmography is a conventional pulmonary function test measuring lung volumes.

    Measured: Change from baseline to 6 months post quit date

  14. Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO)

    Measured by diffusing capacity test.

    Measured: 6 months post quit date

  15. Changes in Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO)

    Measured by diffusing capacity test.

    Measured: Change from baseline to 6 months post quit date

  16. Fraction of exhaled nitric oxide (FeNO)

    Measured by the levels of nitric oxide in the exhaled breath.

    Measured: 6 months post quit date

  17. Changes in Fraction of exhaled nitric oxide (FeNO)

    Measured by the levels of nitric oxide in the exhaled breath.

    Measured: Change from baseline to 6 months post quit date

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 May 2019
  2. Study start10 Apr 2019
  3. Primary completion28 Feb 2022
  4. Study completion28 Feb 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
130 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03938298
Sponsor's protocol ID
2017-02332h
Other IDs
2017
Acronym
PulmENDS
Status last verified
Nov 2023
First submitted
2 May 2019
Last updated
15 Nov 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Farsalinos KE, Polosa R. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf. 2014 Apr;5(2):67-86. doi: 10.1177/2042098614524430.

    PubMed 25083263
  • Subbarao P, Milla C, Aurora P, Davies JC, Davis SD, Hall GL, Heltshe S, Latzin P, Lindblad A, Pittman JE, Robinson PD, Rosenfeld M, Singer F, Starner TD, Ratjen F, Morgan W. Multiple-Breath Washout as a Lung Function Test in Cystic Fibrosis. A Cystic Fibrosis Foundation Workshop Report. Ann Am Thorac Soc. 2015 Jun;12(6):932-9. doi: 10.1513/AnnalsATS.201501-021FR.

    PubMed 26075554
  • Robinson PD, Latzin P, Verbanck S, Hall GL, Horsley A, Gappa M, Thamrin C, Arets HG, Aurora P, Fuchs SI, King GG, Lum S, Macleod K, Paiva M, Pillow JJ, Ranganathan S, Ratjen F, Singer F, Sonnappa S, Stocks J, Subbarao P, Thompson BR, Gustafsson PM. Consensus statement for inert gas washout measurement using multiple- and single- breath tests. Eur Respir J. 2013 Mar;41(3):507-22. doi: 10.1183/09031936.00069712. Epub 2013 Feb 8.

    PubMed 23397305
  • Jetmalani K, Thamrin C, Farah CS, Bertolin A, Chapman DG, Berend N, Salome CM, King GG. Peripheral airway dysfunction and relationship with symptoms in smokers with preserved spirometry. Respirology. 2018 May;23(5):512-518. doi: 10.1111/resp.13215. Epub 2017 Nov 15.

    PubMed 29141272
  • Verbanck S, Schuermans D, Meysman M, Paiva M, Vincken W. Noninvasive assessment of airway alterations in smokers: the small airways revisited. Am J Respir Crit Care Med. 2004 Aug 15;170(4):414-9. doi: 10.1164/rccm.200401-037OC. Epub 2004 May 6.

    PubMed 15130906
  • Verbanck S, Schuermans D, Paiva M, Meysman M, Vincken W. Small airway function improvement after smoking cessation in smokers without airway obstruction. Am J Respir Crit Care Med. 2006 Oct 15;174(8):853-7. doi: 10.1164/rccm.200603-422OC. Epub 2006 Jun 23.

    PubMed 16799076
  • Singer F, Houltz B, Latzin P, Robinson P, Gustafsson P. A realistic validation study of a new nitrogen multiple-breath washout system. PLoS One. 2012;7(4):e36083. doi: 10.1371/journal.pone.0036083. Epub 2012 Apr 27.

    PubMed 22558338

Questions about this trial

What is this clinical trial studying?

A study testing ENDS (vaporizer/e-cig) and smoking cessation counseling and Smoking cessation counseling in people with Smoking Cessation and Pulmonary Disease, run by University of Bern at 2 sites in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in Lung Clearance Index (LCI) (time frame: Change from baseline to 6 months post quit date). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03938298, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Nov 2023.

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