Pharmacodynamic and pharmacokinetic assessment of electronic cigarettes, combustible cigarettes, and nicotine gum: implications for abuse liability

Introduction:
This article is a summary of a study that examines the abuse liability of three electronic cigarette (EC) products, the Vuse Solo, compared to high and low abuse liability comparator products, combustible cigarettes and nicotine gum, respectively. The study assessed elements of abuse liability including subjective measures and physiological effects, as well as measures of the speed and amount of nicotine uptake following a single use of each study product.

Key Points:

* The study enrolled 45 subjects who were current smokers and naive to EC use.
* The three Vuse Solo ECs and nicotine gum were provided at no cost to subjects, while subjects provided their own usual brand cigarettes throughout the study.
* The study design was a randomized, open-label, cross-over study completed at a single research center.
* The study included five test visits, with a 7-day ambulatory trial of each investigational product preceding each test visit.
* Subjective measures included Product Liking, Intent to Use Product Again, Product Effects, Urge to Smoke, and Urge for Product.
* Nicotine pharmacokinetics were assessed through a series of timed blood samples collected following product use.
* Physiological measures included pulse rate, systolic and diastolic blood pressure, and expired carbon monoxide.
* The study found that use of the Vuse Solo resulted in subjective measures and nicotine uptake that were between those of combustible cigarettes and nicotine gum, although generally closer to nicotine gum.

Main Message:
The main message of this study is that the abuse liability of the Vuse Solo ECs is likely higher than nicotine gum but lower than combustible cigarettes. These findings suggest that EC products such as Vuse Solo may have sufficient abuse liability to serve more effectively than NRT as a cigarette replacement for some smokers. However, the EC category is diverse and evolving, and product differences will need to be considered in bridging study findings to other vapor products. Continued research is needed to better understand the category's utility as an alternative to smoking combustible cigarettes and its potential to contribute to public health.

Stiles, Mitchell F., Leanne R. Campbell, Donald W. Graff, Bobbette A. Jones, Reginald V. Fant, and Jack E. Henningfield. “Pharmacodynamic and Pharmacokinetic Assessment of Electronic Cigarettes, Combustible Cigarettes, and Nicotine Gum: Implications for Abuse Liability.” Psychopharmacology 234, no. 17 (September 2017): 2643–55. https://doi.org/10.1007/s00213-017-4665-y.