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Electronic Cigarette UseNCT04192032

Assessing the Effect of Flavor on ENDS Users' Experiences and Exposures

A study testing Preferred Juul pod flavor (5% nicotine), Classic Tobacco Juul pod flavor (5% nicotine) and Preferred flavor with HWL in people with Electronic Cigarette Use, run by Florida International University at 1 site in United States.

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

Recently, Maziak established a clinical lab at FIU to test the potential of waterpipe tobacco flavor regulation by the FDA. Given the importance of flavors on adolescent ENDS uptake and use, this lab is equipped to study the impact of flavor manipulations among adolescent ENDS users. Read more about this study

Who is it for?
Ages 18 to 24 yearsHealthy volunteers can take part
Conditions the study is for
Electronic Cigarette Use
What is being tested?
Preferred Juul pod flavor (5% nicotine), Classic Tobacco Juul pod flavor (5% nicotine) and Preferred flavor with HWL
Could I receive a placebo?
No, everyone receives an active treatment
How many people
41 participants
Where
1 siteUnited States
Study dates
15 Nov 2018to 15 Mar 2020
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 to 24 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Generally healthy individuals (determined by physical examination).
  • Age of 18-24 years.
  • Is willing to provide informed consent.
  • Is willing to attend the lab as required by the study protocol.
  • Regular Juul smokers (at least weekly for the past 3 months).
  • Have abstained from Juul use for 12 hours prior to each session.

Who cannot join

  • Report smoking cigarettes regularly (> 5 cigarettes/month in the past year).
  • Report regular use of any other tobacco/nicotine product (e.g., e-cig, pipes, cigars) in the past year.
  • Women who are breast-feeding or test positive for pregnancy (by urinalysis at screening).
  • Individuals with self-reported history of chronic disease or psychiatric conditions.
  • Individuals with history of or active cardiovascular disease, low or high blood pressure, seizures, and regular use of prescription medications (other than vitamins or birth control).
  • Individuals that report THC (marijuana) smoking/vaping.
  • Individuals that report the use of non-commercial (i.e., street) e-cigarette liquid or products
  • Individuals that report current EVALI-related symptoms (i.e., cough, shortness of breath, chest pain, nausea, vomiting, abdominal pain, diarrhea, fever, chills, or weight loss)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Florida International University

    Miami, Florida, 33199

Other trials in United States

About this study

Official title: Assessing the Effect of Flavor on College-Aged JUUL ENDS Users' Experiences and Exposures

Recently, Maziak established a clinical lab at FIU to test the potential of waterpipe tobacco flavor regulation by the FDA. Given the importance of flavors on adolescent ENDS uptake and use, this lab is equipped to study the impact of flavor manipulations among adolescent ENDS users. In this study will recruit 80 young (18-24) JUUL users, in a 2x2 cross over lab study where in one condition they will use their JUUL preferred flavor and the other JUUL standard tobacco flavor. Our aims are to; Aim 1: Compare satisfaction, withdrawal suppression, and harm perception between tobacco-flavored and preferred flavor JUUL. This analysis will reveal the extent to which preferred flavor contributes to smoking satisfaction, withdrawal and craving suppression, and harm perception, compared to the standard tobacco flavor.

Aim 2: Compare puff topography and plasma nicotine levels between tobacco-flavored and preferred flavor JUUL. This analysis will examine the extent to which preferred flavor contributes to puffing behavior and toxicant exposure compared to the standard tobacco flavor.

Read more

Aim 3: Compare exhaled breath condensate (EBC) between tobacco-flavored and preferred flavor JUUL. This analysis will be the first to examine exposure to toxic aldehydes (formaldehyde, acetaldehyde, acrolein, benzaldehyde, and propionaldehyde) produced when using preferred flavor compared to the standard tobacco flavor.

Utilizing powerful clinical lab methods, this study will provide a broad testing of the effect of flavor manipulation on college-aged JUUL users, and provide experimental evidence about the potential of flavor-limitation policies on young ENDS users in the US.

Read the detailed description

The use of e-cigarettes, or electronic nicotine delivery systems (ENDS), among adolescents and young adults continues to be a major public health issue. Because of appealing design, flavor selection, and popularity on social media, JUUL ENDS have gained popularity among young people, many of whom are not aware that JUUL devices contain nicotine. Regulating ENDS flavor represents a promising approach to curb ENDS use among US youth. This project will provide a broad testing of the effect of flavor manipulation on college-aged JUUL users, and assist public health authorities by providing answers to specific questions pertinent to the potential of ENDS regulation through flavor. These include: - How would flavor manipulation influence puffing behavior and plasma nicotine levels among JUUL smokers; - how would smoking smoking preferred or tobacco flavor reflects on smoker's satisfaction, withdrawal suppression, and harm perception; - how would flavor manipulation affect toxicant exposure levels measured on exhaled breath condensate (EBC) on JUUL smokers. Answers to these questions will help public health authorities predict the impact of flavor regulation on ENDS experimentation and continued use.

Recently, Maziak established a clinical lab at FIU to test the potential of waterpipe tobacco flavor regulation by the FDA. Given the importance of flavors on adolescent ENDS uptake and use, this lab is equipped to study the impact of flavor manipulations among adolescent ENDS users. In this study, we will recruit 80 young (18-24) JUUL users. Each participant will undergo 3 JUUL smoking sessions: 1) one where they will be vaping their preferred flavor; 2) one where they will be vaping the standard classic tobacco flavor; 3) a third one in which they will be vaping their preferred flavor in a JUUL Ecigarette (JEC) device that has a health warning label (HWL) attached to it. In addition, 10 participants will be invited to come back for two additional sessions: one in which they will be vaping their preferred flavor pod with a 3% nicotine concentration, and one in which they will use their preferred flavor pod with 0% nicotine concentration. Measurement of JUUL satisfaction, dependence, harm perception, and exposure to nicotine and toxicants will be conducted in all 5 sessions.

In the past few months, there has been an increasing number of reports of severe respiratory illness related to e-cigarette use. Both the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention are currently investigating this outbreak. According to the CDC, these cases of e-cigarette, or vaping, associated lung injury (EVALI) have been reported in most patients that report a history of using THC-containing products, particularly those obtained off the street or from other informal sources (e.g. friends, family members, illicit dealers) (https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html). Several steps have been taken to minimize this risk (i.e., excluding marijuana and non-commercial vaping products users; excluding individuals with current potential EVALI symptoms; revision of the consent \& re-consenting of participants that still need to complete study sessions; and providing all participants with a CDC fact sheet about EVALI). For further details please refer to the "Methods" \& "Minimizing Risks" sections.

This study involves minimal risks (explained in more details below in section 8) to participants. These risks are: 1) JUUL use 2) Dependence 3) Venipuncture 4) EVALI risk. The risk involved in participating in the JUUL smoking sessions of this study will not exceed the risk that would otherwise be encountered during similar recreational sessions of JUUL smoking.

Participants will benefit by being involved in a study that can increase their awareness about the health and addictive consequences of JUUL smoking and they will be given educational materials at the end of the study that explain the health impact of e-cigarettes, the current EVALI outbreak, and include resources that are available to help with quitting such as national, state and local cessation services (please see the fact sheets attached in the methods section). The findings of this study will benefit the society at large. Understanding the effect of flavor manipulation on JUUL/ENDS users will be instrumental for local and federal health agencies' potential to curb the spread of ENDS use, and protect public health in the US.

Being tested
Preferred Juul pod flavor (5% nicotine), Classic Tobacco Juul pod flavor (5% nicotine), Preferred flavor with HWL, Preferred flavor, 3% nicotine, Preferred flavor, 0% nicotine
Medical subject headings
Vaping

What participants receive

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

  • Preferred Juul pod flavor (5% nicotine)Other

    Preferred Juul pod flavor (5% nicotine)

  • Classic Tobacco Juul pod flavor (5% nicotine)Other

    Classic Tobacco Juul pod flavor (5% nicotine)

  • Preferred flavor with HWLOther

    Preferred flavor (5% nicotine) with HWL

  • Preferred flavor, 3% nicotineOther

    Preferred flavor, 3% nicotine

  • Preferred flavor, 0% nicotineOther

    Preferred flavor, 0% nicotine

Study groups in NCT04192032
Study groupRoleWhat they receive
Preferred flavor (5% nicotine)ExperimentalPreferred flavor Juul pod (5% nicotine)
Receives: Other: Preferred Juul pod flavor (5% nicotine)
Classic Tobacco FlavorActive comparatorControl flavor (5% Classic Tobacco flavor Juul pod)
Receives: Other: Classic Tobacco Juul pod flavor (5% nicotine)
Preferred flavor with HWLExperimentalPreferred flavored Juul pod (5% nicotine) with HWL
Receives: Other: Preferred flavor with HWL
Preferred flavor (3% nicotine)ExperimentalPreferred flavored Juul pod (3% nicotine)
Receives: Other: Preferred flavor, 3% nicotine
Preferred flavor (0% nicotine)ExperimentalPreferred flavored Juul pod (0% nicotine)
Receives: Other: Preferred flavor, 0% nicotine

What is being measured

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

  1. Plasma nicotine

    Change in plasma nicotine level

    Measured: During five participant visits. Blood will be taken 2 times in each JUUL use session: before and after an approximately 60-min ad lib use period

Secondary outcomes (7)
  1. Puff topography

    Measurement of puffing behavior

    Measured: During participants' five study visits. Puffing behavior is continuously measured during each Juul use session (an approximately 60-min ad lib use period)

  2. Minnesota Nicotine Withdrawal Scale

    This scale is used to assess the extent to which product use reduces tobacco abstinence symptoms, and consists of 11 items scored 0 - 100. These items are presented as Visual Analog Scale with item (measure) centered above a horizontal line anchored on the left with not at all and on the right with extremely.

    Measured: During participants' five study visits. Questionnaire will be administered 2 times in each Juul use session: before and after an approximately 60-min ad lib use period.]

  3. Tiffany-Drobes Questionnaire of Smoking Urges

    This scale is used to assess the extent to which product use reduces tobacco abstinence symptoms, and consists of 10 items that are scored 0 - 7. Rated on a 7-point Likert scale ranging from 0 (strongly disagree) to 6 (strongly agree).

    Measured: During participants' five study visits. Questionnaire will be administered 2 times in each Juul use session: before and after an approximately 60-min ad lib use period.]

  4. Carbon monoxide levels

    Change in carbon monoxide levels (in parts per million)

    Measured: During participants' five study visits. Carbon monoxide levels will be measured 2 times in each Juul use session: before and after an approximately 60-min ad lib use period

  5. Harm perception

    This scale will assess waterpipe harm perception and measure perceptions of waterpipe relative risk compared to cigarettes. The scale will be scored on a 7-point scale ranging from 1 (not at all harmful), to 7 (extremely harmful).

    Measured: During participants' five study visits. Questionnaire will be administered after each of the 2 Juul use sessions. Each session is approximately 60-min ad lib use period.]

  6. Duke Sensory Questionnaire

    This scale will assess participants sensory experience of the inhaled product. The scale has nine items. All items will be scored on a 7-point Likert scale anchored at the extremes (1= not at all; 7=extremely).

    Measured: During participants' five study visits. Questionnaire will be administered after each of the 2 smoking sessions. Each session is approximately 60-min ad lib use period.]

  7. The Cigarette/ENDS Evaluation Scale (WES)

    This scale assesses participants' perception of ENDS use. The scale has 11 items. All items will be scored on a 7-point Likert scale anchored at the extremes (1= not at all; 7=extremely).

    Measured: During participants' five study visits. Questionnaire will be administered after each of the 2 Juul use sessions. Each session is approximately 60-min ad lib use period.

Timeline

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

  1. First posted10 Dec 2019
  2. Study start15 Nov 2018
  3. Primary completion15 Mar 2020
  4. Study completion15 Mar 2020

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
Other
Allocation
Randomised
Intervention model
Crossover
Model description
In this study, we will recruit 80 young (18-24) JUUL users. Each participant will undergo 3 JUUL smoking sessions: 1) one where they will be vaping their preferred flavor; 2) one where they will be vaping the standard classic tobacco flavor; 3) a third one in which they will be vaping their preferred flavor in a JUUL Ecigarette (JEC) device that has a health warning label (HWL) attached to it. In addition, 10 participants will be invited to come back for two additional sessions: one in which they will be vaping their preferred flavor pod with a 3% nicotine concentration, and one in which they will use their preferred flavor pod with 0% nicotine concentration. Measurement of JUUL satisfaction, dependence, harm perception, and exposure to nicotine and toxicants will be conducted in all 5 sessions.
Masking
None (open label)
Enrolment
41 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04192032
Sponsor's protocol ID
107308
Status last verified
Jan 2021
First submitted
2 Dec 2019
Last updated
26 Jan 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Preferred Juul pod flavor (5% nicotine), Classic Tobacco Juul pod flavor (5% nicotine) and Preferred flavor with HWL in people with Electronic Cigarette Use, run by Florida International University at 1 site in United States.

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 6 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 26 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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?

Plasma nicotine (time frame: During five participant visits. Blood will be taken 2 times in each JUUL use session: before and after an approximately 60-min ad lib use period). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 26 Jan 2021.

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