Abstract
BackgroundSmoking is a leading cause of numerous human disorders including lung cancer, chronic obstructive pulmonary disease, and atherosclerotic cardiovascular disease. The development of modified risk tobacco products (MRTPs) has been suggested as a possible way to reduce the risks of tobacco smoking by reducing exposure to cigarette smoke toxicants. This study is designed to investigate whether biomarkers of such exposure are reduced when smokers switch from smoking commercial cigarettes to using either a novel or a commercially-available tobacco heating product (THP).Design and MethodsThis study will assess biomarkers of exposure in current smokers who either remain smoking, switch to THP use, or quit all tobacco use completely, for 5 days. The study is an in-clinic (confinement) two-centre, randomised controlled clinical study with a forced-switching design.Subjects of either gender will be aged 23–55 years (minimum legal smoking age plus 3 years), of Japanese origin and with a verified smoking status (assessed by exhaled breath carbon monoxide and urinary cotinine levels). Subjects will have a usual brand cigarette within the International Organisation for Standardisation (ISO) tar band of 6-8 mg and will be judged to be healthy by medical history, physical examination, vital signs, electrocardiography (ECG), clinical biochemistry and lung function tests.The primary objective of this study is to assess changes within groups in selected biomarkers of exposure (BoE) and of biological effect (BoBE) after a forced switch from a commercial control cigarette to either a menthol or a non-menthol THP. Secondary objectives are to assess between-group differences, to determine nicotine pharmacokinetics for cigarettes and THPs, to assess subject’s satisfaction with the study products, and to monitor additional endpoints related to safety and product use.DiscussionData from this study will advance our scientific understanding of the changes in exposure to cigarette smoke toxicants in smokers who switch to using a THP.Trial registrationsUMIN000024988 (25th November 2016); ISRCTN14301360 (14th December 2016)
Highlights
Smoking is a leading cause of numerous human disorders including lung cancer, chronic obstructive pulmonary disease, and atherosclerotic cardiovascular disease
Data from this study will advance our scientific understanding of the changes in exposure to cigarette smoke toxicants in smokers who switch to using a tobacco heating product (THP)
We further aim to investigate the effect of switching from a cigarette to using a THP on 2 biomarkers of biological effect (BoBE), to determine the pharmacokinetics of nicotine delivery in subjects smoking a conventional cigarette or using a THP, and to examine additional endpoints related to safety, product use, satisfaction and the nicotine metabolite ratio (Table 1)
Summary
Smoking is a leading cause of numerous human disorders including lung cancer, chronic obstructive pulmonary disease, and atherosclerotic cardiovascular disease. The development of modified risk tobacco products (MRTPs) has been suggested as a possible way to reduce the risks of tobacco smoking by reducing exposure to cigarette smoke toxicants. Reducing the deleterious individual and population-level impacts of cigarette smoking on health has become a public health priority, leading to the development of a variety of different initiatives across the world to encourage reducing toxicant exposure through smoking cessation [34]. Despite these efforts, smoking rates in adult populations worldwide remain at 15%–25%. Current scientific study and public policy debate, are concerned with whether public health gains could arise from reducing future exposure to toxicants in people who continue to use tobacco through the development of new tobacco products
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