Trial Outcomes & Findings for Effects of E-cigarette Flavors on Youth TCORS 2.0 (NCT NCT03634839)

NCT ID: NCT03634839

Last Updated: 2024-08-09

Results Overview

The Labeled Hedonic Scale will be used to ask about liking and wanting of the e-cigarette (one item Visual Analog Scale with ratings ranging from "most disliked sensation imaginable" to "most liked sensation imaginable" with higher values indicating greater liking). Specific scale semantic structure and corresponding values: most disliked imaginable=-100, dislike extremely=-62.9, dislike very much=-41.6, dislike moderately=-17.6, dislike slightly=-5.9, neutral=0, like slightly=6.3, like moderately=17.8, like very much=44.4, like extremely=65.7, most liked imaginable=100.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

42 participants

Primary outcome timeframe

Following administration of e-cigarette condition 1 (+10 minutes), following administration of e-cigarette condition 2 (+40)

Results posted on

2024-08-09

Participant Flow

84 young adults (18-20 years) were screened for eligibility between November 7, 2022 and June 12, 2023 through Snapchat and referrals from previous participants.

A total of 40 participants completed the study. Specifically, 49 out of 84 participants were randomized, but 7 did not show up and 2 withdrew. Of the 35 who were not randomized, 18 did not meet inclusion criteria and 17 did not show up.

Participant milestones

Participant milestones
Measure
Sweet Non-menthol Then Sweet Menthol, Each With Nicotine 36mg/ml
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They first received Durasmoke watermelon (50:50 PG/VG base) e-liquid. After a 30-minute break, they then received Durasmoke watermelon-menthol (50:50 PG/VG base) e-liquid, each with a nicotine salt concentration of 36 mg/mL. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol Then Sweet Non-menthol, Each With Nicotine 36mg/ml
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They first received Durasmoke watermelon-menthol (50:50 PG/VG base) e-liquid. After a 30-minute break, they then received Durasmoke watermelon (50:50 PG/VG base) e-liquid, each with a nicotine salt concentration of 36 mg/mL. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
First Intervention (2 Hours)
STARTED
20
22
First Intervention (2 Hours)
COMPLETED
20
20
First Intervention (2 Hours)
NOT COMPLETED
0
2
30 Minutes Break
STARTED
20
20
30 Minutes Break
COMPLETED
20
20
30 Minutes Break
NOT COMPLETED
0
0
Second Intervention (2 Hours)
STARTED
20
20
Second Intervention (2 Hours)
COMPLETED
20
20
Second Intervention (2 Hours)
NOT COMPLETED
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Sweet Non-menthol Then Sweet Menthol, Each With Nicotine 36mg/ml
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They first received Durasmoke watermelon (50:50 PG/VG base) e-liquid. After a 30-minute break, they then received Durasmoke watermelon-menthol (50:50 PG/VG base) e-liquid, each with a nicotine salt concentration of 36 mg/mL. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol Then Sweet Non-menthol, Each With Nicotine 36mg/ml
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They first received Durasmoke watermelon-menthol (50:50 PG/VG base) e-liquid. After a 30-minute break, they then received Durasmoke watermelon (50:50 PG/VG base) e-liquid, each with a nicotine salt concentration of 36 mg/mL. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
First Intervention (2 Hours)
Adverse Event
0
2

Baseline Characteristics

Effects of E-cigarette Flavors on Youth TCORS 2.0

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Sweet Non-menthol Then Sweet Menthol, Each With Nicotine 36mg/ml
n=20 Participants
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They first received Durasmoke watermelon (50:50 PG/VG base) e-liquid. After a 30-minute break, they then received Durasmoke watermelon-menthol (50:50 PG/VG base) e-liquid, each with a nicotine salt concentration of 36 mg/mL. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol Then Sweet Non-menthol, Each With Nicotine 36mg/ml
n=22 Participants
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They first received Durasmoke watermelon-menthol (50:50 PG/VG base) e-liquid. After a 30-minute break, they then received Durasmoke watermelon (50:50 PG/VG base) e-liquid, each with a nicotine salt concentration of 36 mg/mL. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Total
n=42 Participants
Total of all reporting groups
Grade
Excellent (A's)
14 Participants
n=99 Participants
13 Participants
n=107 Participants
27 Participants
n=206 Participants
Grade
Good (B's)
5 Participants
n=99 Participants
6 Participants
n=107 Participants
11 Participants
n=206 Participants
Grade
Fair (C's)
1 Participants
n=99 Participants
2 Participants
n=107 Participants
3 Participants
n=206 Participants
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Grade
Barely passing (D's)
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
20 Participants
n=99 Participants
22 Participants
n=107 Participants
42 Participants
n=206 Participants
Preferred e-cigarette device
Disposable pod device
16 Participants
n=99 Participants
20 Participants
n=107 Participants
36 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Continuous
19.0 years
STANDARD_DEVIATION 0.7 • n=99 Participants
19.2 years
STANDARD_DEVIATION 0.8 • n=107 Participants
19.1 years
STANDARD_DEVIATION 0.8 • n=206 Participants
Preferred e-cigarette device
JUUL
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Preferred e-cigarette device
Vape pen
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Sex: Female, Male
Female
11 Participants
n=99 Participants
11 Participants
n=107 Participants
22 Participants
n=206 Participants
Sex: Female, Male
Male
9 Participants
n=99 Participants
11 Participants
n=107 Participants
20 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
5 Participants
n=99 Participants
1 Participants
n=107 Participants
6 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=99 Participants
2 Participants
n=107 Participants
4 Participants
n=206 Participants
Race (NIH/OMB)
White
11 Participants
n=99 Participants
18 Participants
n=107 Participants
29 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Region of Enrollment
United States
20 participants
n=99 Participants
22 participants
n=107 Participants
42 participants
n=206 Participants
Currently enrolled in a degree program
17 Participants
n=99 Participants
15 Participants
n=107 Participants
32 Participants
n=206 Participants
Preferred e-cigarette device
Any pod device other than a JUUL
2 Participants
n=99 Participants
1 Participants
n=107 Participants
3 Participants
n=206 Participants
Preferred e-cigarette nicotine level
50-59mg/mL or 5.0-5.9%
14 Participants
n=99 Participants
16 Participants
n=107 Participants
30 Participants
n=206 Participants
Preferred e-cigarette nicotine level
Other concentrations
4 Participants
n=99 Participants
1 Participants
n=107 Participants
5 Participants
n=206 Participants
Preferred e-cigarette nicotine level
I don't know the concentration
2 Participants
n=99 Participants
5 Participants
n=107 Participants
7 Participants
n=206 Participants
Ever vaped cooling flavor
20 Participants
n=99 Participants
22 Participants
n=107 Participants
42 Participants
n=206 Participants
Past-month other tobacco use
12 Participants
n=99 Participants
12 Participants
n=107 Participants
24 Participants
n=206 Participants
Past-month vaped THC
18 Participants
n=99 Participants
7 Participants
n=107 Participants
25 Participants
n=206 Participants
Vaping age of onset
14.8 years
STANDARD_DEVIATION 1.9 • n=99 Participants
15.6 years
STANDARD_DEVIATION 1.7 • n=107 Participants
15.2 years
STANDARD_DEVIATION 1.8 • n=206 Participants
Vaping frequency
6.0 days per week
STANDARD_DEVIATION 1.8 • n=99 Participants
6.1 days per week
STANDARD_DEVIATION 1.4 • n=107 Participants
6.1 days per week
STANDARD_DEVIATION 1.6 • n=206 Participants

PRIMARY outcome

Timeframe: Following administration of e-cigarette condition 1 (+10 minutes), following administration of e-cigarette condition 2 (+40)

Population: After each of the two puff bouts, we evaluated participants' reference for the overall experience of the e-cigarette using the LHS, which is a bipolar category ratio scale that spans from -100 (most disliked) to 100 (most liked), with 'neither liked nor disliked' positioned as the midpoint. The scale labels were places along the scale based on their semantic magnitude.

The Labeled Hedonic Scale will be used to ask about liking and wanting of the e-cigarette (one item Visual Analog Scale with ratings ranging from "most disliked sensation imaginable" to "most liked sensation imaginable" with higher values indicating greater liking). Specific scale semantic structure and corresponding values: most disliked imaginable=-100, dislike extremely=-62.9, dislike very much=-41.6, dislike moderately=-17.6, dislike slightly=-5.9, neutral=0, like slightly=6.3, like moderately=17.8, like very much=44.4, like extremely=65.7, most liked imaginable=100.

Outcome measures

Outcome measures
Measure
Sweet Non-menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor non-menthol (Watermelon) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor with menthol (Watermelon-menthol) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Liking: Difference Score in Liking/Wanting of Each E-cigarette Condition
1.268 score on a scale
Standard Error 3.158
-3.916 score on a scale
Standard Error 3.158

PRIMARY outcome

Timeframe: Following administration of e-cigarette condition 1 (+10 minutes), following administration of e-cigarette condition 2 (+40)

Population: To examine wanting/liking, we used subscales from the Drug Effects Questionnaire (DEQ), following the approach established in previous literature. Four items were used to measure wanting/liking effects (the average of 'I feel good e-cigarette effects', 'I want more of that e-cigarette I received', 'I feel the e-cigarette strength', and 'I like the e-cigarette effect').

Difference between e-cigarette effects for each e-cigarette condition as measured by the computerized version of the Drug Effects Questionnaire (DEQ). Participants will self-report their responses using a computer mouse to indicate where on the scale response falls. A modified version of the Drug Effects Questionnaire (DEQ) will be used in which participants rate acute responses to the e-cigarette on a 0-100mm scale from "not at all" (0mm) to "extremely" (100mm). Higher values indicate stronger reinforcing efficacy (i.e., wanting/liking effects).

Outcome measures

Outcome measures
Measure
Sweet Non-menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor non-menthol (Watermelon) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor with menthol (Watermelon-menthol) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Reinforcing Efficacy: Difference Score in Drug Effects of Each E-cigarette Condition
37.06 score on a scale
Standard Error 3.01
35.18 score on a scale
Standard Error 3.01

PRIMARY outcome

Timeframe: At baseline (+0 minutes), Following administration of e-cigarette condition 1 (+10 minutes), following administration of e-cigarette condition 2 (+40)

Difference from baseline in craving for each e-cigarette condition will be measured by the Generalized Labeled Magnitude Scale (gLMS). Participants will self-report their craving for e-cigarettes using a computer mouse to indicate where on the scale response falls. The Generalized Labeled Magnitude Scales (gLMS) are category ratio scales with seven semantic labels: "no sensation", "barely detectable", "weak", "moderate", "strong", "very strong", and "strongest imaginable", positioned quasi-logarithmically as per empirically determined semantic magnitudes on a 0-100 scale (strongest imaginable at the 100 end).

Outcome measures

Outcome measures
Measure
Sweet Non-menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor non-menthol (Watermelon) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor with menthol (Watermelon-menthol) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Craving: Change in Craving Score for E-cigarette
2.72 score on a scale
Standard Error 0.22
2.43 score on a scale
Standard Error 0.22

PRIMARY outcome

Timeframe: Following administration of e-cigarette condition 1 (+10 minutes), following administration of e-cigarette condition 2 (+40)

Difference in irritation at each e-cigarette condition as measured by the computerized Generalized Labeled Magnitude Scale (gLMS). Participants will self-report their responses using a computer mouse to indicate where on the scale response falls. The Generalized Labeled Magnitude Scales (gLMS) are category ratio scales with seven semantic labels: "no sensation", "barely detectable", "weak", "moderate", "strong", "very strong", and "strongest imaginable", positioned quasi-logarithmically as per empirically determined semantic magnitudes on a 0-100 scale (strongest imaginable at the 100 end).

Outcome measures

Outcome measures
Measure
Sweet Non-menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor non-menthol (Watermelon) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol, Nicotine 36mg/ml
n=40 Participants
Sweet flavor with menthol (Watermelon-menthol) with 36mg/ml Nicotine Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Irritation/Harshness: Difference Score in Irritation of Harshness of Each E-cigarette Condition
20.92 score on a scale
Standard Error 1.68
22.86 score on a scale
Standard Error 1.68

Adverse Events

Sweet Non-menthol With Nicotine 36mg/ml

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Sweet Menthol With Nicotine 36mg/ml

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Sweet Non-menthol With Nicotine 36mg/ml
n=40 participants at risk
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They received Durasmoke watermelon (50:50 PG/VG base) e-liquid. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Sweet Menthol With Nicotine 36mg/ml
n=42 participants at risk
Participants attended a one-time, two-hour laboratory session with two exposures to flavored nicotine-containing e-liquids in a randomized order. They received Durasmoke watermelon-menthol (50:50 PG/VG base) e-liquid. Flavoring Agents: Flavor of e-liquid - sweet or tobacco Nicotine: Nicotine level (36 mg/ml)
Product Issues
Vomiting
0.00%
0/40 • Two hours during a single lab session
Two mild levels of adverse events were observed. The adverse event definition aligns with the definitions on ClinicalTrials.gov.
4.8%
2/42 • Number of events 2 • Two hours during a single lab session
Two mild levels of adverse events were observed. The adverse event definition aligns with the definitions on ClinicalTrials.gov.

Additional Information

Dr. Suchitra Krishnan-Sarin

Yale University

Phone: (203)974-7595

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place