Nicotine Dependence Clinical Trial
Official title:
Comparing the Health Effects of Smokeless Tobacco, Cigarette Smoking, and New Tobacco Products Advertised as Safer Alternatives Part of Tobacco Exposure Reduction
The use of smokeless tobacco (ST) as a substitute for cigarette smoking has been suggested
since it is considered by some to be a less harmful tobacco product (Russell, Jarvis and
Feyerabend, 1980; Russell et al, 1981; Rodu, 1994). ST does not have the volatile
constituents and carbon monoxide (CO) that are found in cigarette smoke. Since ST is not
smoked there would be less risk of cardiovascular and lung disease. In addition the harm
associated with second hand smoke would be eliminated. Although the health risks are reduced
in ST users, they still exist due to the presence of nitrosamines found in ST. A better
approach would be to use nicotine replacement that did not contain carcinogens, however the
cost of such NRT could be prohibitive especially in third world countries where the rate of
smoking is continuing to rise and the per capita income is much lower than in the United
States.
Purpose: The goal of this study is to evaluate the health effects of Camel Snus, the new oral
tobacco product produced by RJ Reynolds and Taboka, produced by Phillip Morris. These
products are pasteurized rather than fermented and contain less moisture to eliminate
spitting. They are marketed as an alternative to cigarette smoking.
Cigarette smokers (n=125) will be recruited from the local metropolitan area using multiple
media outlets. Subjects who are medically and psychologically healthy will be recruited for
the study. Cigarette smokers will be informed of the study over the telephone and asked to
answer a brief tobacco use history and medical screening questionnaire. If subjects pass the
initial screening for the study, they will be asked to attend an orientation meeting at the
Tobacco Use Research Center where the study will be explained in more detail, informed
consent will be obtained and a full screening evaluation will occur. This evaluation includes
the completion of several comprehensive tobacco use and social history forms and a complete
physical and psychological screening.
Subjects will be required to attend the clinic once during Week 1 and once during Week 2 of
the study in order to obtain baseline data. At the end of Week 2, cigarette smokers will be
randomly assigned to either: 1) quit tobacco use and will be offered the choice of using
nicotine gum or lozenge, depending on personal preference (n= 25) or they will be assigned to
switch to: 2) Taboka (n=50) or 3) Camel Snus (n=50). Subjects sampled different flavors of
the products for 1 week and then used the product for the next 4 weeks. During the four
weeks, subjects will be asked to attend weekly clinic visits during which time study data
will be collected. After the 4 weeks of study product use, subjects will be required to taper
off of the tobacco or nicotine product over the next one week and then cease all tobacco use.
Follow-up visits will be conducted 1 week and 11 weeks after completion of the study and
outcome measures will be taken at that time. Blood and urine samples will be collected and
analyzed for tobacco related toxicants during the treatment period.
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