Study: E-Cigarettes Suppress Smoking Desire

An electronic vapor product (EVP) delivered as much nicotine to the blood and had a similar short-term safety profile to a licensed nicotine replacement therapy (NRT) product, according to a new two-part study. The EVP also suppressed smoking desire and reduced tobacco withdrawal symptoms in subjects.

In the randomized, controlled, four-way crossover trial, part 1 compared an unflavored e-liquid (UF 2.0%) and a flavored e-liquid (FL 2.0%) to a conventional cigarette (CC; JPS Silver King Size, 0.6 mg) and a licensed nicotine inhalator (Nicorette; 15 mg). Part 2 compared e-liquids with increasing nicotine concentrations (0%, 0.4%, 0.9%, 2.0%). Participants used each different product for a daily use session.
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In part 1, maximum plasma nicotine concentration (Cmax) for UF 2.0%, FL 2.0%, Nicorette, and CC, was 3.6, 2.5, 2.5 and 21.2 ng/mL, respectively. The time to maximum plasma nicotine concentration (Tmax) was longer for the EVP (UF 2.0%, 9.0 min; FL 2.0%, 10.0 min) and the nicotine inhalator (13.0 min) compared to CC (3.0 min). In part 2, EVP with 0%, 0.4%, 0.9%, and 2.0% nicotine produced Cmax values of 0.6, 1.0, 1.9, and 3.6 ng/mL, respectively. At the maximum nicotine concentration of 2%, the EVP achieved nicotine delivery comparable to the inhalator.

Study outcomes included adverse events (AEs), vital signs, exhaled carbon monoxide (CO), clinical laboratory parameters, smoking urges, and withdrawal symptoms. Subjects only reported mild, non-serious AEs, and the researchers observed no major differences in AEs between the EVPs and Nicorette. Exhaled CO levels only increased for CC.

The investigators found EVP reduced smoking urges and nicotine withdrawal symptoms at 0% nicotine.

“NRTs have had modest success in helping people to quit,” said lead study author Tanvir Walele, MSc, ERT, senior scientist with Fontem Ventures. “The results demonstrate that unlike NRT, the EVP studied here has the potential to offer a viable alternative for those finding it difficult to quit the behavioral and sensorial aspects of smoking.”

-Mike Bederka

References:

1. Walele T, Sharma G, Savioz R, et al. A randomised, crossover study on an electronic vapour product, a nicotine inhalator and a conventional cigarette. Part A: Pharmacokinetics. Regul Toxicol Pharmacol. 2015 Dec 13. [epub ahead of print]. pii: S0273-2300(15)30138-0. doi: 10.1016/j.yrtph.2015.12.003.

2. Walele T, Sharma G, Savioz R, et al. A randomised, crossover study on an electronic vapour product, a nicotine inhalator and a conventional cigarette. Part B: Safety and subjective effects. Regul Toxicol Pharmacol. 2015 Dec 15. [epub ahead of print]. pii: S0273-2300(15)30139-2. doi: 10.1016/j.yrtph.2015.12.004.