Switching to Reduced Oxidant or Nicotine Content Cigarettes in Smokers

Study Overview
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Brief Summary
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The overall objectives of this clinical study are to determine in smokers the short term effects of switching to tobacco products that deliver low levels of nicotine or reactive oxygen/nitrogen species (ROS/RNS) on smoking behavior and biomarkers of tobacco smoke exposure and oxidative stress.

Detailed Description
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Researchers at Penn State Hershey are seeking healthy adult cigarette smokers between 21-65 who smoke any of the following brands on a regular basis: Marlboro Red, Marlboro Menthol, Pall Mall Red, Pall Mall Menthol, Kool Menthol, Salem Menthol, L&M Menthol, Pyramid Red, Newport Red, Newport Menthol. If you smoke one of these brand styles on a regular basis you may be eligible to participate in a compensated short term study on health and smoking behavior at Penn State Hershey Medical Center. Study participation lasts 22 days, with 4 study visits at the Medical Center. Smokers are asked to use their usual brand for one week and then switch to 1 of 3 brands for the remaining two weeks. The three brands participants are randomly assigned to after the first week of participation are either Group 1. reduced nicotine content cigarette (Spectrum Research Cigarettes) or Group 2. reduced oxidant cigarette (American Spirit) or assigned to Group 3. usual brand. Whichever group you are assigned to, you will be asked to smoke only these until the end of the study. All cigarettes following visit 1 will be provided free of charge. Study overview: Visit 1/ Duration: 60 minutes Provide a blood and urine sample Complete a 20 minute interview Use a simple, hand held smoking device to smoke all cigarettes for 2 days Collect cigarette butts on 1 day Visit 2: Randomized Phase /Duration: 20-30 minutes Provide a blood and urine sample Complete a 10 minute interview Use a simple, hand held smoking device to smoke all cigarettes for 2 days Collect cigarette butts on 1 day Visit 3/ Duration: 20-30 minutes Provide a blood and urine sample Complete a 10 minute interview Use a simple, hand held smoking device to smoke all cigarettes for 2 days Collect cigarette butts on 1 day Visit 4/ Duration: 20-30 minutes Provide a blood and urine sample Complete a 10 minute interview Sign compensation form For information on additional tobacco studies being conducted at Penn State Hershey, please call 1-844-207-6392 *This research is being conducted under the investigator John Richie at Penn State Hershey; 500 University Drive Hershey, PA

Official Title
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Switching to Reduced Nicotine Content Cigarettes or Reduced Reactive Oxygen/Reactive Nitrogen Species Cigarettes in Smokers

Conditions
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Tobacco Smoking Behavior

Intervention / Treatment
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* Other: Reduced Nicotine Cigarettes
* Other: Reduced ROS/RNS
* Other: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 21-65 Smoke 10 cigarettes/day or more for at least one year Read and write in English Menthol and nonmenthol smokers who use relatively high nicotine and ROS/RNS cigarettes Able to understand and provide consent to study procedures Plan to live in the local area for the next month Women not pregnant or nursing and taking steps to avoid pregnancy No quit attempt in the last one months and not planning to quit in the next month Exclusion Criteria: Currently pregnant or nursing Unstable or significant medical condition, such as COPD or kidney failure, that is likely to affect biomarker data Use of non-cigarette nicotine delivery product in the past week (included cigars, pipes, chew, snus, hookah, e-cig, and marijuana) Currently reducing or planning to reduce cigarette consumption in the next month Use of smoking cessation medicine in the past 3 months History of difficulties providing blood samples: fainting, poor veins, anxiety, etc. Uncontrolled serious psychotic illness or substance abuse or inpatient treatment for these in the last 6 months (substance abuse includes weekly, almost daily or daily use of other illegal drugs and prescription drugs that are not being used for medically prescribed purposes or alcohol abuse that would hinder the participant's ability to participate) Significant medical condition, i.e. stroke, MI, cancer, in the last month Currently using illegal drugs

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Reduced Nicotine Cigarettes<br>Participants will be randomized to receive low nicotine cigarettes to replace their usual high nicotine brand. | Other: Reduced Nicotine Cigarettes<br>* Human topography data will show if smokers smoke their cigarettes differently from baseline following randomization. Select biosamples of participants will be used to analyze how biomarkers differ among groups<br>* Other names: Cigarette contains .28mg (.29mg/menthol) of nicotine;|
| Experimental: Reduced ROS/RNS<br>Participants will be randomized to receive Reduced Oxidative/Nitrogen Species (ROS/RNS) cigarettes to replace their usual cigarettes. | Other: Reduced ROS/RNS<br>* Human topography data will show if smokers smoke their cigarettes differently from baseline following randomization. Select biosamples of participants will be used to analyze how biomarkers differ among groups<br>* Other names: Cigarette to be determined by lab experiment;|
| Placebo Comparator: Control Group<br>Participants will be assigned to continue smoking their usual brand of cigarettes. | Other: Control<br>* Human topography data will show if smokers change the way they smoke due to being in a research study. Select biosamples of participants will be used to analyze how biomarkers differ among groups<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Smoking Topography | measures of smoking topography include parameters such as puff volume, frequency and intensity as measured using a smoking topography instrument. | 8 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biomarkers of oxidative stress | biomarkers of oxidative stress are as followed: glutathionylated and cysteinylated proteins in blood and F2-isoprostanes and 8-hydroxydeoxyguanosine (8-OHdG). | 4 times over the 22 day study period |