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- Sperimentazione clinica NCT07698470
Brain/Craving Response to Smoking Cues After Oral Nicotine Pouch Use
Cue-Exposure Response Evaluation: Brain Reactivity to ONPs
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
This study will evaluate the acute effects of oral nicotine pouch (ONP) use on subjective cigarette craving and prefrontal neural responses to smoking-related cues among adult cigarette smokers. Although oral nicotine pouches do not involve combustion or inhalation, their effects on craving relief and neural cue reactivity following nicotine abstinence remain poorly understood. Characterizing these acute responses may improve understanding of the potential role of oral nicotine pouches as lower-risk nicotine products.
This is a single-arm, within-subject, repeated-measures study consisting of one baseline screening visit and one experimental visit. During the baseline visit, informed consent will be obtained, eligibility will be confirmed, demographic and tobacco use information will be collected, nicotine dependence will be assessed, and head circumference will be measured to determine appropriate functional near-infrared spectroscopy (fNIRS) cap sizing. Participants will also receive instructions to abstain from nicotine use for at least 12 hours before the experimental visit.
At the experimental visit, overnight nicotine abstinence will be verified before participants complete baseline assessments of subjective craving and nicotine withdrawal. Participants will then complete a standardized smoking cue reactivity task while prefrontal brain activity is recorded using functional near-infrared spectroscopy (fNIRS). Following completion of the baseline task, participants will self-administer one commercially available 6 mg oral nicotine pouch and complete a standardized 25-minute absorption period. Participants will then complete an identical post-pouch cue reactivity task with simultaneous fNIRS recording, followed by post-session assessments of craving, withdrawal, subjective product effects, and product perceptions.
The smoking cue reactivity task consists of repeated presentations of smoking-related and neutral visual cues, followed by guided imagery in which participants imagine smoking a cigarette or performing a comparable neutral behavior while holding the corresponding object. The task is administered before and after nicotine pouch administration using identical procedures to permit within-subject comparisons of neural and subjective responses.
Functional near-infrared spectroscopy is a non-invasive neuroimaging technique that measures changes in oxygenated and deoxygenated hemoglobin within cortical tissue as an indirect measure of neural activity. Brain activity will be recorded continuously throughout both cue reactivity task runs using a standardized prefrontal optode montage. Participants will be monitored throughout study procedures for discomfort, and study procedures will be discontinued if requested by the participant or if study staff determine continuation is not appropriate.
Tipo di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
- Nome: USC Nicotine and Tobacco Studies
- Numero di telefono: 213-821-0807
- Email: USCONPStudy@gmail.com
Luoghi di studio
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California
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Los Angeles, California, Stati Uniti, 90089
- Reclutamento
- University of Southern California - 3641 Watt Way (HNB B22)
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Contatto:
- USC Nicotine and Tobacco Studies
- Numero di telefono: 213-821-0807
- Email: USCONPStudy@gmail.com
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Age 21 years - 55 years
- Self-reported use of cigarettes within the past 30 days
Biochemical confirmation of cigarette use:
o Carbon monoxide (CO) breath sample ≥10 ppm
- Fagerström Test for Nicotine Dependence (FTND) score ≥5, indicating moderate to high nicotine dependence
- Fluent in English
- Willing to try an oral nicotine pouch
- Willing to abstain from nicotine for at least 12 hours prior to each experimental session
Exclusion Criteria:
- Age younger than 21 years or older than 55 years
Biochemical evidence inconsistent with recent cigarette use:
o CO breath sample <10 ppm
- Expressed intent to reduce or quit nicotine use within the next 30 days
- History of medical conditions contraindicated for nicotine use (e.g., uncontrolled hypertension, recent cardiac events)
- Primary use of non-cigarette products (e.g., cigars, pipe tobacco, smokeless tobacco)
- Prior use of oral nicotine products in their lifetime
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Scienza basilare
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
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Sperimentale: Acute Oral Nicotine Pouch Administration
Adult cigarette smokers will complete one experimental session consisting of pre-pouch cue reactivity and subjective assessments, administration of a single 6 mg oral nicotine pouch, a standardized 25-minute absorption period, and identical post-pouch assessments.
All participants complete the same study procedures and serve as their own control for pre- versus post-intervention comparisons.
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Participants will self-administer one commercially available 6 mg oral nicotine pouch following overnight nicotine abstinence.
The pouch will be used for approximately 25 minutes before participants complete the post-pouch cue reactivity assessment.
Participants will complete a standardized smoking cue reactivity task before and after oral nicotine pouch administration.
During each task, participants will view smoking-related and neutral images, complete guided imagination trials while holding either a cigarette or a neutral object, and undergo simultaneous functional near-infrared spectroscopy (fNIRS) to measure prefrontal brain activity.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in Prefrontal Neural Cue Reactivity to Smoking-Related Cues Measured by Functional Near-Infrared Spectroscopy (fNIRS)
Lasso di tempo: Baseline (pre-pouch) and approximately 25 minutes after administration of a 6 mg oral nicotine pouch (post-pouch) during the experimental session.
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Prefrontal neural responses to smoking-related and neutral cues will be assessed using functional near-infrared spectroscopy (fNIRS).
The primary outcome will be the within-subject change in oxygenated (HbO) and deoxygenated (HbR) hemoglobin concentration from the pre-pouch assessment to the post-pouch assessment.
Larger positive HbO responses to smoking-related cues indicate greater neural cue reactivity.
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Baseline (pre-pouch) and approximately 25 minutes after administration of a 6 mg oral nicotine pouch (post-pouch) during the experimental session.
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Change in Subjective Cigarette Craving Measured by the Questionnaire of Smoking Urges-Brief (QSU-Brief)
Lasso di tempo: Baseline (pre-pouch) and approximately 25 minutes after administration of a 6 mg oral nicotine pouch (post-pouch) during the experimental session.
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Subjective cigarette craving will be assessed using the Questionnaire of Smoking Urges-Brief (QSU-Brief).
The QSU-Brief consists of 10 items, each rated on a 7-point Likert scale (1 = strongly disagree to 7 = strongly agree).
Total scores range from 10 to 70, with higher scores indicating greater cigarette craving (worse outcome).
The primary outcome will be the within-subject change in total QSU-Brief score from the pre-pouch assessment to the post-pouch assessment.
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Baseline (pre-pouch) and approximately 25 minutes after administration of a 6 mg oral nicotine pouch (post-pouch) during the experimental session.
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Collaboratori e investigatori
Investigatori
- Investigatore principale: Natalia Peraza, University of Southern California
- Cattedra di studio: John Monterosso, University of Southern California
Pubblicazioni e link utili
Pubblicazioni generali
- Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991 Sep;86(9):1119-27. doi: 10.1111/j.1360-0443.1991.tb01879.x.
- Hughes JR, Hatsukami D. Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry. 1986 Mar;43(3):289-94. doi: 10.1001/archpsyc.1986.01800030107013.
- Shiffman S, Dunbar M, Kirchner T, Li X, Tindle H, Anderson S, Scholl S. Smoker reactivity to cues: effects on craving and on smoking behavior. J Abnorm Psychol. 2013 Feb;122(1):264-80. doi: 10.1037/a0028339. Epub 2012 Jun 18.
- Goldstein RZ, Volkow ND. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am J Psychiatry. 2002 Oct;159(10):1642-52. doi: 10.1176/appi.ajp.159.10.1642.
- Killen JD, Fortmann SP. Craving is associated with smoking relapse: findings from three prospective studies. Exp Clin Psychopharmacol. 1997 May;5(2):137-42. doi: 10.1037//1064-1297.5.2.137.
- Leventhal A, Cho J, Barrington-Trimis J, Pang R, Schiff S, Kirkpatrick M. Sensory attributes of e-cigarette flavours and nicotine as mediators of interproduct differences in appeal among young adults. Tob Control. 2020 Nov;29(6):679-686. doi: 10.1136/tobaccocontrol-2019-055172. Epub 2019 Dec 18.
- Sofuoglu M, Herman AI, Nadim H, Jatlow P. Rapid nicotine clearance is associated with greater reward and heart rate increases from intravenous nicotine. Neuropsychopharmacology. 2012 May;37(6):1509-16. doi: 10.1038/npp.2011.336. Epub 2012 Feb 15.
- Leventhal AM, Waters AJ, Boyd S, Moolchan ET, Lerman C, Pickworth WB. Gender differences in acute tobacco withdrawal: effects on subjective, cognitive, and physiological measures. Exp Clin Psychopharmacol. 2007 Feb;15(1):21-36. doi: 10.1037/1064-1297.15.1.21.
- Rest EC, Brikmanis KN, Mermelstein RJ. Preferred flavors and tobacco use patterns in adult dual users of cigarettes and ENDS. Addict Behav. 2022 Feb;125:107168. doi: 10.1016/j.addbeh.2021.107168. Epub 2021 Oct 30.
- Pang RD, Goldenson NI, Kirkpatrick M, Barrington-Trimis JL, Cho J, Leventhal AM. Sex differences in the appeal of flavored e-cigarettes among young adult e-cigarette users. Psychol Addict Behav. 2020 Mar;34(2):303-307. doi: 10.1037/adb0000548. Epub 2020 Jan 20.
- Kroczek AM, Haeussinger FB, Fallgatter AJ, Batra A, Ehlis AC. Prefrontal functional connectivity measured with near-infrared spectroscopy during smoking cue exposure. Addict Biol. 2017 Mar;22(2):513-522. doi: 10.1111/adb.12344. Epub 2015 Dec 21.
- Keijsers M, Vega-Corredor MC, Hoermann S, Tomintz M. Cue Reactivity to Electronic Cigarettes: A Systematic Review. Subst Abuse. 2022 Jul 28;16:11782218221114971. doi: 10.1177/11782218221114971. eCollection 2022.
- Ekhtiari H, Nasseri P, Yavari F, Mokri A, Monterosso J. Neuroscience of drug craving for addiction medicine: From circuits to therapies. Prog Brain Res. 2016;223:115-41. doi: 10.1016/bs.pbr.2015.10.002. Epub 2015 Dec 19.
- FDA. FDA Authorizes Marketing of 20 ZYN Nicotine Pouch Products after Extensive Scientific Review. Accessed May 14, 2025. https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-20-zyn-nicotine-pouch-products-after-extensive-scientific-review
- Azzopardi D, Liu C, Murphy J. Chemical characterization of tobacco-free "modern" oral nicotine pouches and their position on the toxicant and risk continuums. Drug Chem Toxicol. 2022 Sep;45(5):2246-2254. doi: 10.1080/01480545.2021.1925691. Epub 2021 May 25.
- Azzopardi D, Haswell LE, Frosina J, McEwan M, Gale N, Thissen J, Meichanetzidis F, Hardie G. Assessment of biomarkers of exposure and potential harm, and physiological and subjective health measures in exclusive users of nicotine pouches and current, former and never smokers. Biomarkers. 2023 Feb;28(1):118-129. doi: 10.1080/1354750X.2022.2148747. Epub 2022 Dec 13.
- Han DH, Cho J, Harlow AF, Tackett AP, Vogel EA, Wong M, Barrington-Trimis JL, Lerman C, Unger JB, Leventhal AM. Young adults' beliefs about modern oral nicotine products: Implications for uptake in nonvapers, dual use with e-cigarettes, and use to reduce/quit vaping. Exp Clin Psychopharmacol. 2023 Apr;31(2):455-463. doi: 10.1037/pha0000595. Epub 2022 Sep 1.
- NIDA. What is the scope of tobacco, nicotine, and e-cigarette use in the United States? . Accessed June 4, 2025. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-scope-tobacco-use-its-cost-to-society
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