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NCT Number: NCT07348224

Pharmacokinetics and Pharmacodynamics of Synthetic Nicotine and Nicotine Analogues

Electronic cigarettes are battery-operated devices that can produce an aerosol by heating a liquid which commonly contains nicotine. In recent years, products containing synthetically produced nicotine and nicotine analogues have entered the market. However, it remains unclear whether these types of nicotine have the same effects as conventional nicotine derived from the tobacco plant. The aim of this study is to investigate the effects of these nicotine types and to gain a better understanding of their respective mechanisms of action.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

In the first part of the study, participants will use electronic cigarettes containing synthetic nicotine or nicotine analogs at three sessions in the hospital, following a specific schedule. In the second part, each product will be used for four days outside the hospital. The study is double-blind, meaning neither the participants nor the study team will know which product is being used.

The study comprises a total of seven appointments at the hospital. During these appointments, participants will be asked questions about their electronic cigarette and tobacco use, and samples of saliva, urine, and blood will be collected.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Men or women, age 18 or older at screening who have used EC with nicotine during at least 10 of the past 30 days
  • Saliva cotinine concentration of > 30 ng/mL at screening
  • Ability to communicate well with the investigator and to understand and comply with the requirements of the study
  • Women of child-bearing age engaging in sexual activities which can lead to pregnancy: willingness of using a reliable/hormonal contraception method during the study (hormonal, e.g. pill, intrauterine devices, or mechanical method, e.g. condom, diaphragm)
  • Signed informed consent form

Exclusion criteria

  • Known hypersensitivity/allergy to a content of the e-liquids
  • Smoking of more than 5 cigarettes per day in the past 30 days
  • Pregnant or lactating women
  • Intention to become pregnant during the course of the study
  • BMI < 18 or > 30 kg/m2 at screening
  • History or clinical evidence of alcoholism or drug abuse within the 3-year period prior to screening
  • Loss of ≥ 250 mL of blood within 3 months prior to screening, including blood donation
  • Treatment with an investigational drug within 30 days prior to screening
  • Treatment with prescribed or over-the-counter medications with known influence on CYP2A6 function within 1 week prior to screening (with the exception of contraception)
  • History or clinical evidence of any disease (e.g. gastrointestinal tract-disease) and/or existence of any surgical or medical condition, which in the opinion of the investigator might interfere with the absorption, distribution, metabolism or excretion of the study drugs, or which might increase the risk of toxicity.
  • Legal incapacity or limited legal capacity at screening
  • Any circumstances or conditions, which, in the opinion of the investigator, may affect full participation in the study or compliance with the protocol

Treatment and study plan

Vaping of synthetic S-nicotine

Other

Vaping of e-liquids containing synthetic S-nicotine

Vaping of racemic nicotine (S-/R-nicotine)

Other

Vaping of e-liquids containing synthetic racemic nicotine (S-/R-nicotine)

Vaping of 6-methylnicotine

Other

Vaping of e-liquids containing the nicotine analogue 6-methylnicotine (6MN)

Primary outcomes

  1. Maximum total nicotine concentrations (Cmax)

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Comparison of the maximum total nicotine (i.e. sum of both enantiomers) in blood concentrations (Cmax) between groups

Secondary outcomes

  1. Maximum concentration (Cmax) of 6-methylnicotine

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Maximum concentration of 6-methylnicotine in blood

  2. Maximum concentration (Cmax) of 6-methylnicotine's metabolites

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Maximum concentration of 6-methylnicotine's metabolites in blood

  3. AUC (area under the concentration-time curve) nicotine enantiomers

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Area under the concentration-time curve (AUC) of nicotine enantiomers in blood

  4. AUC (area under the concentration-time curve) 6-methylnicotine

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Area under the concentration-time curve (AUC) of 6-methylnicotine in blood

  5. AUC (area under the concentration-time curve) 6-methylnicotine's metabolites

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Area under the concentration-time curve (AUC) of 6-methylnicotine's metabolites in blood

  6. Tmax (time of Cmax) nicotine enantiomers

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Tmax of nicotine enantiomers in blood

  7. Tmax (time of Cmax) 6-methylnicotine

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Tmax of 6-methylnicotine in blood

  8. Tmax (time of Cmax) 6-methylnicotine's metabolites

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Tmax of 6-methylnicotine's metabolites in blood

  9. T1/2 (elimination half-life) nicotine enantiomers

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Elimination half-life (T1/2) of nicotine enantiomers in blood

  10. T1/2 (elimination half-life) 6-methylnicotine

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Elimination half-life (T1/2) of 6-methylnicotine in blood

  11. T1/2 (elimination half-life) 6-methylnicotine's metabolites

    Time frame: 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff

    Elimination half-life (T1/2) of 6-methylnicotine's metabolites in blood

  12. Blood nicotine metabolite ratio (NMR)

    Time frame: 15 minutes before vaping

    Nicotine clearance assessed using the 3'-hydroxycotinine/cotinine ratio (i.e. nicotine metabolite ratio (NMR)

  13. Saliva nicotine metabolite ratio (NMR)

    Time frame: At baseline

    Nicotine clearance assessed using the 3'-hydroxycotinine/cotinine ratio (i.e. nicotine metabolite ratio (NMR)

  14. Heart rate

    Time frame: Baseline, 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff, at study completion (2.5-6.5 weeks after screening)

    bpm

  15. Blood pressure

    Time frame: Baseline, 15 minutes before vaping and 2, 5, 15, 30, 60, 120, and 180 minutes after the last puff, at study completion (2.5-6.5 weeks after screening)

    mmHg

  16. Modified Minnesota Nicotine Withdrawal Scale (MNWS)

    Time frame: Baseline, 10 minutes, 1 hour and 3 hours after last puff

    Score/questionnaire asssessing withdrawal: The Modified Minnesota Nicotine Withdrawal Scale (MNWS) (excluding items related to sleep disturbance and constipation) including eight items (angry/irritable/frustrated, anxious/nervous, depressed mood/sad, desire or craving to smoke, difficulty concentrating, increased appetite/hungry, restless and impatient), rated on a 0=none to 4=severe scale.

  17. Tiffany Questionnaire on Smoking Urges-Brief (QSU) total (global) craving score

    Time frame: Baseline, 10 minutes, 1 hour and 3 hours after last puff

    Score/questionnaire asssessing craving: The Tiffany Questionnaire on Smoking Urges-Brief (QSU) total (global) craving score as the average of all responses (mean of ten items, rated on a 1=strongly disagree to 7=strongly agree scale).

  18. Positive and Negative Affect Schedule (PANAS)

    Time frame: Baseline, 10 minutes, 1 hour and 3 hours after last puff

    Score/questionnaire asssessing satisfaction: The Positive and Negative Affect Schedule (PANAS) including items assigned as Positive or Negative Affect (each score is the sum of ten items, rated on a 1=very slightly/not at all to 5=extremely scale).

  19. Respiratory symptoms

    Time frame: Baseline and 5 minutes after last puff

    Questions regarding shortness of breath, wheezing, cough, phlegm; posisble answers: yes/no

  20. Direct effects

    Time frame: 10 minutes post-use

    Questions regarding e.g. satisfying, calming, pleasant, vape another one right now, using visual analog scales (0-100 mm) with a single word scored from left (not at all) to right (extremely).

  21. Modified e-cigarette evaluation questionnaire (mCEQ)

    Time frame: Following 4 days ad libitum use of each product

    Questionnaire asssessing subjective effects

  22. Urinary total nicotine equivalents (TNE) concentrations

    Time frame: Following 4 days ad libitum use of each product

    Molar sum of urinary total (parent and glucuronide) nicotine, cotinine and 3'-hydroxycotinine

  23. Urinary volatile organic compounds (VOC) concentrations

    Time frame: Following 4 days ad libitum use of each product

    VOC in urine

Other outcomes

  1. Reported adverse events

    Time frame: Throughout study completion, an average of 2.5-6.5 weeks

    Classification and severity grading scale in accordance with the "Common Terminology Criteria for Adverse Events CTCAE Version 5.0" terminology.

Study contacts

Contact information is provided by the study sponsor or research team.

Evangelia Liakoni, Prof.

CONTACT

[email protected]

+41 31 632 54 61

Sponsors and collaborators

Lead sponsor

Insel Gruppe AG, University Hospital Bern

Other

Collaborators

  • Swiss Tobacco Prevention Funds

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jan 16, 2026
Registry last updated
Jul 14, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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