Investigate the Exposure to Selected Smoke Constituents in Smokers Switching to Distillation Based Smoking Article

Study Overview
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Brief Summary
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The overall purpose of this clinical study conducted in confinement under well-defined conditions is to obtain initial data on the levels of human body exposure to selected smoked constituents of the SMAR cigarette. The main objective of this study is to compare the biomarkers of exposure to cigarette smoke constituents in smokers switching to SMAR and to biomarkers in smokers of conventional cigarettes (CC). The biomarkers of exposure will be measured in blood and urine samples collected from the subjects. Moreover, the biomarkers in subjects smoking conventional or SMAR cigarettes will be compared with those biomarkers in smokers who stop smoking for 5 days. The short term safety of this new product will also be evaluated.

Detailed Description
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This is a controlled, randomised, open-label, 3-arm parallel single centre confinement study to investigate exposure to selected smoke constituents in smokers switching from CC to SMAR for 5 days. 112 eligible subjects will be randomised to the 3 study arms: SMAR, conventional cigarettes (CC) and smoking cessation (SC) in a 2:1:1 ratio. Following the screening visit (within 4 weeks prior to the day of admission), the study will be run over an 8-day period in a confined environment, consisting of the admission day (D-2), a 2-day baseline period (D-1 and D0), and a 5-day exposure period (D1 to D5). Subjects will be discharged in the morning of D6. From the discharge of the subject, a 7-day safety follow-up period will be carried out (until D13).

Official Title
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A Controlled, Randomised, Open-label, 3-arm Parallel Single-centre Confinement Study to Investigate Exposure to Selected Smoke Constituents in Smokers Switching From Conventional Cigarettes to SMAR Cigarettes for 5 Days

Conditions
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Smoking

Intervention / Treatment
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* Other: Distillation based smoking article (SMAR cigarette)
* Other: conventional cigarette
* Other: smoking cessation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Caucasian adult smokers (male and female), with acceptable health conditions, aged from 23 to 55 years who usually smoke 10 to 30 non-mentholated conventional cigarettes (with a maximum ISO tar yield of 10 mg) per day, for at least the last 5 consecutive years, will be enrolled in this study. Exclusion Criteria: women of childbearing potential must be excluded if:Subject is pregnant (does not have negative pregnancy tests at screening and at D-2) or breastfeeding/ subject does not agree to use an acceptable method of effective contraception: intrauterine device, intrauterine system, established use of oral/injectable/implantable/ transdermal hormonal methods, barrier methods of contraception (condoms, occlusive caps) with spermicidal foam/gel/film/suppository, vasectomised partner or true abstinence (periodic abstinence and withdrawal are not effective methods) until the end of the safety follow-up period.

Ages Eligible for Study
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Minimum Age: 23 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1. SMAR<br>Subjects will be allowed to smoke SMAR without any limit on consumption during the designated smoking times. | Other: Distillation based smoking article (SMAR cigarette)<br>* Subjects randomised to the SMAR arm will be trained by the site staff on the usage of SMAR and the corresponding lighter prior to smoking the first SMAR. Subjects will be allowed to smoke SMAR without any limit on consumption during the designated smoking times but have to request each SMAR from the site staff when they wish to smoke.<br>|
| Active Comparator: 2 Conventional cigarette (CC)<br>Subjects will be allowed to smoke without any limit on consumption during the designated smoking times. | Other: conventional cigarette<br>* Subjects randomised to the CC arm will continue to smoke their preferred CC brand during the exposure period. Subjects will be allowed to smoke without any limit on consumption during the designated smoking times but will have to request each CC from the site staff when they wish to smoke.<br>|
| Active Comparator: 3. smoking cessation (SC)<br>Subjects will not be allowed to smoke any cigarettes or to use any other nicotine/tobacco-containing products during the 5 days following randomisation. | Other: smoking cessation<br>* Subjects will not be allowed to smoke any cigarettes or to use any other nicotine/tobacco-containing products during the 5 days following randomisation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To demonstrate a reduction in the three primary biomarkers of exposure: Carboxyhaemoglobin concentration in blood, Urinary excretion of S-phenylmercapturic acid and urinary excretion of NNAL and NNAL-glucuronides (total NNAL) |  | 5 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To explore changes from baseline COHb, S-PMA, and total NNAL in the three study arms in the course of the study |  | 5 days | 
| To explore changes from baseline in the three study arms with regard to urinary excretion of biomarkers of exposure to several other smoke constituents. |  | 5 days | 
| To assess urinary excretion of nicotine and its five major nicotine metabolites in the three study arms |  | 5 days | 
| To assess nicotine and cotinine concentrations in plasma in the three study arms To compare levels of all biomarkers of exposure in the SMAR arm to those in the smoking cessation (SC) arm |  | 5 days | 
| To assess the mutagenicity potential in urine at the end of the study in the three study arms |  | 5 days | 
| To monitor blood pressure, pulse rate, electrocardiogram, clinical laboratory parameters (standard clinical biochemistry, standard haematology and urine analysis), and adverse events |  | 5 days | 
| To investigate craving and withdrawal symptoms as well as pulmonary symptoms in all three study arms by means of questionnaires |  | 5 days | 
| To investigate change in cytochrome P450 1A2 (CYP1A2) activity from D0 to D5 in the three study arms |  | 5 days | 
| To assess and compare human smoking topography (HST) in smokers before and after switching to SMAR |  | 5 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Smokers with acceptable health conditions