Oral Nicotine Pouches for Tobacco Use Disorder

TS
MM
Overseen ByMikahla McDeavitt
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests "tobacco-free" oral nicotine pouches to observe how the body absorbs and reacts to them. The goal is to compare different flavors and doses of these pouches with regular cigarettes. Participants will use various nicotine pouches and their preferred brand of cigarettes under controlled conditions. It suits individuals who have been daily smokers for at least a year and aren't currently using other tobacco products. As a Phase 1 trial, this research aims to understand how the treatment works in people, offering participants the opportunity to be among the first to receive this new treatment.

Will I have to stop taking my current medications?

The trial may require you to stop taking certain medications if they impact safety, as determined by the investigators or medical staff. It's best to discuss your specific medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that people generally use nicotine pouches without problems. One study found that users sometimes experience minor issues like dry mouth or throat irritation, but these effects are usually mild and resolve quickly. It's important to note that while the FDA has approved nicotine pouches for sale, they are not specifically approved for smoking cessation. Although considered safer than traditional tobacco products, they are not entirely risk-free. Users should be aware that nicotine is addictive, which means there is a chance of developing a dependence.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these nicotine pouches for tobacco use disorder because they offer a smokeless and potentially safer alternative to traditional cigarettes. Unlike most current treatments like nicotine replacement therapies (patches, gums, lozenges), these pouches provide a variety of flavors—fruit, mint/menthol, and tobacco—which might make them more appealing to users trying to quit smoking. Additionally, the ability to control nicotine intake through low (4mg) and high (8mg) doses gives users flexibility, which could help tailor the transition away from cigarettes to individual needs. This innovative approach combines the familiar sensation of nicotine with the benefits of reduced exposure to harmful combustion products found in cigarettes.

What evidence suggests that this trial's treatments could be effective for tobacco use disorder?

Research has shown that oral nicotine pouches can help people reduce smoking. In this trial, participants will use various flavored nicotine pouches with different nicotine doses. One study found that pouches with 3mg and 6mg strengths significantly reduced cigarette use over four weeks. Another study showed that 41% of people using these pouches quit smoking, while 38% smoked less. These pouches release nicotine, satisfying cravings and helping manage withdrawal without the harmful chemicals in cigarettes. Overall, early findings suggest that nicotine pouches are a promising tool for those looking to quit or cut down on smoking.34678

Who Is on the Research Team?

TS

Tory Spindle, PhD

Principal Investigator

Johns Hopkins University

Are You a Good Fit for This Trial?

This trial is for healthy adult smokers who smoke daily, have a mild tobacco use disorder, and haven't used other tobacco products or nicotine pouches recently. They must be over 21 years old with normal vital signs and no recent drug use (except THC). Pregnant women, those in another trial within the last month, or using certain medications are excluded.

Inclusion Criteria

Self-report currently smoking daily
Good general health based on screening procedures (e.g., physical exam, blood testing)
No self-reported regular use of other tobacco products (e.g., smokeless products, e-cigarettes) in the past 30 days
See 8 more

Exclusion Criteria

Enrollment in another clinical trial in the past 30 days
History of or current significant medical condition that, in the opinion of the investigators or medical staff, will impact safety
I am not taking any medications or supplements that could affect my safety in the trial.
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants complete 7 dosing conditions with various nicotine pouches and cigarettes, including controlled and ad libitum use

7 sessions (each separated by at least 48 hours)
7 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Cigarette
  • Nicotine
Trial Overview The study tests 'tobacco-free' oral nicotine pouches of different flavors and doses against regular cigarettes to see how they affect the body and cravings. Participants will try each product under controlled conditions first, then freely for two hours in a double-blind setup.
How Is the Trial Designed?
7Treatment groups
Experimental Treatment
Active Control
Group I: Original/Tobacco Flavored Pouch (low nicotine dose)Experimental Treatment1 Intervention
Group II: Original/Tobacco Flavored Pouch (high nicotine dose)Experimental Treatment1 Intervention
Group III: Mint/Menthol Flavored Pouch (low nicotine dose)Experimental Treatment1 Intervention
Group IV: Mint/Menthol Flavored Pouch (high nicotine dose)Experimental Treatment1 Intervention
Group V: Fruit Flavored Pouch (low nicotine dose)Experimental Treatment1 Intervention
Group VI: Fruit Flavored Pouch (high nicotine dose)Experimental Treatment1 Intervention
Group VII: Own brand cigarettesActive Control1 Intervention

Nicotine is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Nicotine pouches for:
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Approved in European Union as Nicotine pouches for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials
2,366
Recruited
15,160,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials
2,658
Recruited
3,409,000+

Published Research Related to This Trial

A study analyzing 653 Reddit posts about oral nicotine pouches revealed that users predominantly shared positive experiences and product information, indicating a favorable public perception of these tobacco-free products.
The discussions also highlighted a significant interest in quitting traditional nicotine products, with 12.7% of posts focused on using oral nicotine pouches as a cessation tool, suggesting potential for these pouches in harm reduction strategies.
Perceptions of Oral Nicotine Pouches on Reddit: Observational Study.Shao, Y., Zou, J., Xie, Z., et al.[2022]
ZYN nicotine pouches contain no nitrosamines or polycyclic aromatic hydrocarbons (PAHs), indicating a potentially lower risk profile compared to traditional tobacco products, which often contain harmful constituents.
The levels of harmful and potentially harmful constituents (HPHCs) in ZYN were found to be similar to those in nicotine replacement therapy (NRT) products, suggesting that ZYN may be a safer alternative for nicotine delivery compared to moist snuff, which had significantly higher levels of harmful compounds.
Harmful and potentially harmful constituents (HPHCs) in two novel nicotine pouch products in comparison with regular smokeless tobacco products and pharmaceutical nicotine replacement therapy products (NRTs).Back, S., Masser, AE., Rutqvist, LE., et al.[2023]
Medicinal nicotine has significantly improved smoking cessation rates over the past 20 years, with various products like patches, gum, and inhalers available to help smokers quit.
Innovative nicotine delivery methods, such as high-dose patches and new forms like drinks and lollipops, are being developed to enhance cessation success and manage withdrawal symptoms.
Nicotine delivery systems.Shiffman, S., Fant, RV., Buchhalter, AR., et al.[2015]

Citations

The Effects of Oral Nicotine Pouches on Cigarette Smoking ...Oral nicotine pouches in 3mg and 6mg strengths significantly reduced smoking over 4 weeks among adults open to using pouches for cigarette ...
Nicotine pouches and clinical outcomes related to smoking ...The review focused on tobacco-free NPs containing varying nicotine strengths and flavors. NPs were compared individually to multiple specific ...
Oral nicotine pouches for cessation or reduction of use ...One small study reported lower levels of NNAL in people using oral nicotine pouches compared to those given no specific treatment to stop ...
Prevalence, safety, and role of nicotine pouches in ...Among those who had used nicotine pouches, 41.0% reported success in quitting smoking, while 38.1% experienced partial success, and 20.9% were ...
Oral nicotine pouches for cessation or reduction of use of ...Our critical outcomes were: smoking abstinence at 4+ weeks; number of people reporting serious adverse events (SAEs) at 1+ weeks; and change in ...
Nicotine Pouches | Smoking and Tobacco UseGet the facts about nicotine pouches and their health effects. The bottom line. There are no safe tobacco products, including nicotine pouches.
What is Zyn and what are oral nicotine pouches?The good news is, you can quit using oral nicotine pouches with similar strategies used to quit smoking and vaping. Read about how to quit ...
What to know about nicotine pouches... nicotine pouches are only approved by the FDA for marketing – not tobacco cessation. If you want to quit smoking or using tobacco products ...
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