Acute Effects of Oral Nicotine Pouches

This study will be conducted at the Johns Hopkins Behavioral Pharmacology Research unit (BPRU). Participants will complete a screening visit, and, if eligible, will then complete 2 outpatient experimental sessions (separated by at least 48 hours). The study will use a mixed between/within-subjects crossover design. The between-subjects component is because there are two groups of participants (60 cigarette smokers, 60 infrequent nicotine users) and the within-subjects component is because participants complete all experimental sessions (thus, serving as the participant's own control). Smokers will be instructed to abstain from all tobacco 12 hours prior to each session so that the participants begin study sessions in a state of nicotine/tobacco withdrawal. Sessions will be completed in a counterbalanced order to reduce order effects. During each experimental session, a battery of assessments including subjective questionnaires (abuse liability, nicotine-related effects, withdrawal suppression), cognitive performance, blood collection for pharmacokinetic analysis (this will be optional), vital signs, and pouch use (or topography) will be conducted

Inclusion criteria

(all participants):

• greater than or equal to 21 years old
• good general health based on screening procedures
• vital signs in normal range (resting heart rate less than 110bpm, systolic blood pressure less than 150mmHg, diastolic blood pressure less than 100mmHg)
• negative urine test for illicit drug use (excluding THC) and negative breath alcohol test at screening and before each session
• no self-reported prior use of oral nicotine pouches
• Not actively trying to quit smoking or using smoking cessation medication (e.g., nicotine replacement therapy)

Additional inclusion criteria (smokers):

• self-report currently smoking cigarettes daily
• exhaled breath CO greater than or equal to 10ppm and urine cotinine greater than 100 ng/ml at screening
• meet criteria for tobacco use disorder
• no self-reported regular use of other tobacco products (e.g., smokeless products, e-cigarettes) in the past 30 days

Additional inclusion criteria (non-nicotine users):

• self-report previously using nicotine/tobacco but no more than 100 lifetime uses across all routes of administration
• no self-reported nicotine/tobacco uses in the past 30 days
• urine cotinine less than 100 ng/ml at screening.

Exclusion criteria

(all participants):

• psychoactive drug use (aside from cannabis, nicotine, alcohol, or caffeine) in past month
• current use of OTC drugs, supplements/vitamins, or prescription medications that, in the opinion of medical staff, will impact safety
• currently have severe dependence for cannabis
• history of or current significant medical condition that, in the opinion of medical staff, will impact safety
• current psychiatric condition or substance use disorder (aside from tobacco use disorder for smokers), that, in the opinion of medical staff, will impact safety
• women who are pregnant, planning to become pregnant, or are breast-feeding