| Participants |
Estimated 200
Inclusion criteria:
Provides voluntary consent to participate in the study as documented on the signed informed consent form (ICF) Is 22 to 65 years of age, inclusive, at the time of consent Is willing to comply with the requirements of the study Reports typically smoking 5 or more combustible cpd at screening Has been a daily smoker for at least 12 months prior to screening. Brief periods of non‐smoking (e.g. up to ~7 consecutive days due to illness, trying to quit, participation in a study where smoking was prohibited) ≥ 56 days prior to screening will be permitted at the discretion of the investigator. Has a positive urine cotinine test (≥ 200 ng/mL) at screening and test visit 1 Has an eCO value > 10 ppm at screening and test visit 1 Has daily access to a cell phone for daily product use reporting If female, meets one of the following criteria:
Abstinence from heterosexual intercourse Hormonal contraceptives (birth control pills, injectable/implant/insertable hormonal birth control products, transdermal patch) Intrauterine device (with or without hormones) OR agrees to use a double barrier method (e.g. condom and spermicide) during the study
If a female of non‐childbearing potential ‐ should be surgically sterile (i.e. has undergone complete hysterectomy, bilateral oophorectomy, or tubal ligation) or in a menopausal state (at least 1 year without menses), as confirmed by follicle stimulating hormone (FSH) levels.
Exclusion criteria:
Has a history or presence of clinically significant uncontrolled gastrointestinal, renal, hepatic, neurologic, haematologic, endocrine, oncologic, urologic, pulmonary, immunologic, psychiatric, or cardiovascular disease, or any other condition that, in the opinion of the investigator, would jeopardize the safety of the subject or impact the validity of the study results Has a clinically significant abnormal finding on the physical examination, medical history, vital signs, electrocardiogram (ECG), or clinical laboratory results, in the opinion of the investigator Has a positive test for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV) at screening Has a positive COVID‐19 test at screening or during the study Has had an acute illness (e.g. upper respiratory infection, viral infection) within 14 days prior to test visit 1 Has a fever (> 100.5°F) at screening or test visit 1 Has a body mass index (BMI) greater than 40.0 kg/m2 or less than 18.0 kg/m2 at screening Has a systolic blood pressure < 90 mmHg or > 150 mmHg, diastolic blood pressure < 40 mmHg or > 95 mmHg, or heart rate < 40 bpm or > 99 bpm at screening Has a post‐bronchodilator forced expiratory volume in 1 second:forced vital capacity (FEV1:FVC) ratio < 0.7 and FEV1 < 50% of predicted at screening Has a post‐bronchodilator FEV1 increase ≥ 12% and > 200 mL from pre‐ to post‐bronchodilator at screening Has used an ENDS product on > 7 days during each of the 3 months prior to screening or any use from screening to test visit 1 other than as may be required for this study Reports use of a very‐low nicotine content cigarette (e.g. Moonlight, Spectrum, VLN) as usual brand Has used nicotine‐containing products other than manufactured cigarettes (e.g. ENDS products (e‐cigarettes), roll‐your‐own cigarettes, bidis, snuff, nicotine inhaler, pipe, cigar, chewing tobacco, nicotine patch, nicotine spray, nicotine lozenge, or nicotine gum) within 14 days prior to test visit 1
Has used any products for the purpose of smoking cessation, including, but not limited to, nicotine replacement therapies, varenicline (Chantix), or bupropion (Zyban) from 30 days prior to screening through the duration of the study Is a self‐reported puffer (i.e. draws smoke from the cigarette into the mouth and throat but does not inhale) Is postponing a planned smoking quit attempt in order to participate in the study Has a history of drug or alcohol abuse within 12 months prior to screening, as determined by the investigator Is allergic to PG or glycerin Has a positive urine drug or alcohol breath test at screening or test visit 1. At the discretion of the investigator, a subject testing positive for tetrahydrocannabinol may be permitted to participate if the subject reports use by routes other than inhalation. If female, the subject is pregnant, breastfeeding, or intends to become pregnant from screening through the duration of the study Has been treated for depression, diabetes, asthma, emphysema, or chronic obstructive pulmonary disease within 12 months prior to test visit 1 Has previously been diagnosed with any form of cancer, except for basal cell or squamous epithelial carcinomas of the skin that have been resected at least 12 months prior to screening 1 Has a planned surgery that would occur during study participation Has participated in a previous clinical study for an investigational drug, device, biologic, or tobacco product within 30 days prior to test visit 1 Is or has a first‐degree relative (e.g. spouse, parent, sibling, or child) who is a current or former employee of a tobacco or ENDS manufacturer or is a named party or class representative in litigation with the tobacco or ENDS industry Is or has a first‐degree relative (e.g. spouse, parent, sibling, or child) who is a current employee of the clinic site Is or has a first‐degree relative (e.g. spouse, parent, sibling, or child) who is a current employee of the sponsor Has previously taken part in (from completion of any baseline measurements), has been withdrawn from, or has completed this study
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| Outcomes |
Primary outcomes:
Weekly RELX ENDS product use; time frame: 56 days. Self‐reported number of RELX ENDS pods started each week
Daily number of cigarettes smoked; time frame: 56 days. Self‐reported number of cigarettes smoked daily by study week
Number of puffs from the RELX ENDS each day; time frame: 56 days. Self‐reported number of puffs from the RELX ENDS daily by study week (0, < 100, ≥ 100 per day)
Secondary outcomes:
Biomarkers of exposure measured in blood; time frame: baseline, day 28, and day 56; change in carbon monoxide concentration in the blood
Biomarkers of tobacco exposure measured in urine; time frame: baseline, day 28, and day 56; change in creatinine‐adjusted NNAL, NNN, 3‐HPMA, CEMA, HMPMA, S‐PMA, HEMA, 1‐OHP, o‐toluidine, nicotine equivalents, and propylene glycol excreted in urine
Subjective effects as measured by the Penn State [Electronic] Cigarette Dependence Index (PS[E]CDI); time frame: baseline, day 14, day 28, day 42, and day 56. Change in product dependence as measured by the PSCDI/PS[E]CDI total score. Total scores may range for 0 to 20, with higher levels of dependence associated with higher scores.
Subjective effects as measured by the Cough Questionnaire; time frame: baseline, day 14, day 28, day 42, and day 56. Change in self‐reported cough symptoms as measured by responses to the Cough Questionnaire
Subjective effects as measured by the Questionnaire of Smoking Urges‐Brief (QSU‐Brief); time frame: baseline, day 14, day 28, day 42, and day 56. Change in smoking urge as measured by the QSU‐Brief factor 1 and factor 2 scores. Questionnaire responses are measured on a Likert scale range of 1 [not at all] to 7 [extremely].
Subjective effects as measured by the Minnesota Tobacco Withdrawal Scale‐Revised (MTWS‐R); time frame: baseline, day 14, day 28, day 42, and day 56. Change in withdrawal symptoms as measured by the MTWS‐R total score, which includes the DSM‐5 and craving items from the Minnesota Tobacco Withdrawal Scale. Questionnaire responses are measured on a Likert scale range of 0 [none] to 4 [severe]).
Subjective effects as measured by the Modified Product Evaluation Scale (mPES); time frame: baseline, day 14, day 28, day 42, and day 56. Change in product assessments as measured by mPES satisfaction, psychological reward, aversion, and relief subscale scores. Questionnaire responses are measured on a Likert scale range of 1 [not at all] to 7 [extremely].
Subjective effects as measured by the Future Intent to Use Questionnaire; time frame: baseline, day 14, day 28, day 42, and day 56. Change in future intent to use cigarettes and ENDS products as measured by responses to the Future Intent to Use Questionnaire Questionnaire responses are measured on a Likert scale range of 1 [extremely unlikely] to 7 [extremely likely]
Subjective Effects as measured by the Health Effects Perceptions Questionnaire; time frame: baseline and day 56. Harmful and addictiveness perceptions as measured by responses to the Health Effects Perceptions Questionnaire
Puff topography ‐ number of puffs; time frame: baseline, day 28, and day 56. Change in the number of puffs during a 1‐hour puff topography session
Puff topography ‐ puff duration; time frame: baseline, day 28, and day 56. Change in puff duration during a 1‐hour puff topography session
Puff topography ‐ puff volume. time frame: baseline, day 28, and day 56. Change in puff volume during a 1‐hour puff topography session
Puff topography ‐ peak puff flow rate; time frame: baseline, day 28, and day 56; change in peak puff flow rate during a 1‐hour puff topography session
Puff topography ‐ average flow rate; time frame: baseline, day 28, and day 56. Change in average flow rate during a 1‐hour puff topography session
Puff topography ‐ inter‐puff interval; time frame: baseline, day 28, and day 56. Change in inter‐puff interval during a 1‐hour puff topography session
RELX ENDS product use; time frame: day 28 and day 56; change in pod weight during a 1‐hour topography session
Incidence of product‐use emergent adverse events [safety and tolerability]; time frame: 56 days Incidence of product‐use emergent adverse events |
