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CompletedNCT01400815Updated Nov 19, 2021Results posted

Randomized Trial to Evaluate the Effectiveness of X-22 as a Smoking Cessation Aid

A Phase 2 interventional study of X-22 Smoking Cessation Product and Active Control Cigarettes in Smoking Cessation, sponsored by 22nd Century Limited, LLC. Completed at 3 sites in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2021-11-19.

Sponsored by 22nd Century Limited, LLC · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
234
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

A randomized, active controlled clinical trial in which a total of 216 healthy smokers will be enrolled and followed over approximately 19 weeks.

The trial will evaluate the efficacy and safety of using X-22 as a smoking cessation aid.

Healthy smokers who plan to quit smoking will be screened for eligibility. Subjects will be randomized in a 1:1 ratio to 1 of the 2 treatment arms:

  • Group 1: X-22 Cigarettes (very low nicotine)
  • Group 2: Active Control Cigarettes The randomization will be stratified by gender. Efficacy will be assessed by analysis of cigarette consumption using self-report diaries and measurement of exhaled carbon monoxide (CO) and cotinine concentrations.

Safety will be assessed by evaluation of adverse events, physical examinations, clinical laboratory tests, and measurement of heart rate, blood pressure, and body weight at each study visit.

02

Conditions studied

  • Smoking Cessation

Keywords

  • smoking
  • smoking cessation
  • quitting smoking
03

In context

Lead sponsor

This is the only study on the registry with 22nd Century Limited, LLC as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Subjects must meet all of the following inclusion criteria to be eligible for participation in this study.

    1. Subjects must be considered by the investigator to be in general good health and between 18 and 65 years of age, inclusive.
    2. Subjects must have a history of smoking at least 10 cigarettes per day for at least 1 year, with less than 3 months of abstinence during the past year, and a continuous smoking history for at least 3 months prior to study entry.
    3. Subjects must indicate that they plan to quit smoking within the next 3 months.
    4. Subjects must have a CO measurement of ≥ 10 ppm at screening and baseline (Visit 1 and Visit 2).
    5. Subjects must be willing and able to return for scheduled follow-up examinations for a total of 5 months.
    6. Female subjects must have been postmenopausal for the previous 6 months or be surgically sterile, or must have a negative pregnancy test and use one of the following acceptable methods of birth control for the duration of the study and for at least 3 months prior to screening:
  • abstinence, meaning a total lack of sexual activity,
  • oral contraceptives ("the pill"),
  • contraceptive injections,
  • intrauterine device,
  • double-barrier method (diaphragm or condom plus spermicidal cream),
  • contraceptive patch, hormonal implant, hormonal vaginal ring, or
  • male partner sterilization at least 3 months prior to screening. 7. Subjects must sign and be given a copy of the written Informed Consent form. 8. Subjects must be able to read, understand and complete the questionnaires independently.

Exclusion criteria

Exclusion Criteria:

  • Subjects who meet any of the following exclusion criteria are not to be enrolled in this study.

    1. Subjects who have a household member who is already enrolled in this trial.
    2. Subjects who have attempted to quit smoking using one or more FDA-approved smoking cessation products (eg, nicotine replacement therapy [NRT] including nicotine gum, nicotine lozenges, nicotine patches, nicotine nasal spray, or nicotine inhaler; Zyban [bupropion]; or Chantix [varenicline]) for longer than 1 week in the past 3 months.
    3. Subjects who have been enrolled in another structured smoking cessation program (e.g., behavioral modification, hypnosis, acupuncture, or other alternative therapies) in the last 30 days.
    4. Subjects who have been in another smoking cessation trial in the past 6 months.
    5. Subjects who regularly use (greater than once per month) tobacco-based products other than cigarettes (eg, chew, snuff, snus, shisha, etc.).
    6. Subjects with a history of coronary artery disease, myocardial infarction, stroke, chronic obstructive pulmonary disease, or other significant pulmonary diseases. Controlled hypertensive subjects and mild asthmatics whose disease is controlled only with an as-needed inhaled beta agonist are acceptable.
    7. Subjects with a history of cancer within the past 60 months other than basal cell carcinoma.
    8. Subjects with a history of thromboembolic disease or taking warfin or any other anticoagulant, or anti-platelet drug such as clopidogrel (Plavix®) or pentoxifylline (Trental®). Low dose aspirin therapy is acceptable.
    9. Subjects with screening laboratory abnormalities that are considered by the investigator to be clinically significant.
    10. Subjects with a body mass index (BMI) >35.
    11. Subjects with poorly controlled diabetes or insulin-dependent diabetes.
    12. Subjects with other known serious pathophysiology or topical or systemic disorders of any kind that would confound the results of the study.
    13. Subjects with screening ECG abnormalities that are considered by the investigator to be clinically significant.
    14. Subjects who have used any illegal drug in the past 3 months.
    15. Subjects who have a positive urine drug screening result.
    16. Subjects who are pregnant or lactating, or who plan to become pregnant during the course of the study.
    17. Subjects participating in any other clinical trial of an investigational drug or device during the time of this clinical investigation or within 30 days prior to Screening visit.
    18. Subjects taking anti-depressants, anti-psychotics, clonidine, or any of the classes of drugs listed in the RapidCHECK® 12 Panel in the last 60 days (see Section 12.1.1).
    19. Subjects with systolic blood pressure over 140 mmHg and/or diastolic blood pressure over 90 mmHg.
    20. Subjects consuming an average of 3 or more drinks of alcohol per day.
    21. Subjects consuming greater than an average of 2 packs of cigarettes per day.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
234 participants (actual)

Study arms

  • Experimental
    X-22 Smoking Cessation Product

    The X-22 Smoking Cessation Product is a tobacco-based (botanical) medical product consisting of very low nicotine (VLN) cigarettes.

    Drug: X-22 Smoking Cessation Product

  • Active comparator
    Active Control Cigarette

    The Active Control cigarette is identical to the X-22 cigarette except for the tobacco, which has a nicotine content similar to that of a conventional "light" cigarette.

    Drug: Active Control Cigarettes

Interventions

  • DrugX-22 Smoking Cessation Product

    The X-22 Smoking Cessation Product is a tobacco-based (botanical) medical product consisting of very low nicotine (VLN) cigarettes. Subjects will be allowed to smoke as much as desired throughout the 6-week treatment period.

  • DrugActive Control Cigarettes

    The Active Control cigarette is identical to the X-22 cigarette except for the tobacco, which has a nicotine content similar to that of a conventional "light" cigarette. Subjects will be allowed to smoke as much as desired throughout the 6-week treatment period.

06

What researchers measure

Primary outcomes

  1. Efficacy - 4 Weeks of Continuous Abstinence From Smoking Cigarettes

    The primary efficacy measurement is the number of subjects with 4 weeks of continuous abstinence from smoking cigarettes (Weeks 7-10), as assessed by subject diary and confirmed by exhaled carbon monoxide (CO), after treatment termination, at Visits 6 and 7. A responder: did not smoke and had less than 10 ppm exhaled CO.

    Time frame: Weeks 7 and 9 = telephone call, Week 8 = visit 6 and Week 10 = visit 7

07

Results

Posted Nov 19, 2021

Participant flow

Participant flow — Overall Study
MilestoneX-22 Smoking Cessation ProductActive Control Cigarette
Started118116
Completed8095
Not completed3821
Withdrew: Adverse event30
Withdrew: Death01
Withdrew: Lost to follow-up1811
Withdrew: Protocol violation01
Withdrew: Physician decision10
Withdrew: Withdrawal by subject158
Withdrew: Subject in jail10

Outcome measures

PrimaryEfficacy - 4 Weeks of Continuous Abstinence From Smoking Cigarettes

The primary efficacy measurement is the number of subjects with 4 weeks of continuous abstinence from smoking cigarettes (Weeks 7-10), as assessed by subject diary and confirmed by exhaled carbon monoxide (CO), after treatment termination, at Visits 6 and 7. A responder: did not smoke and had less than 10 ppm exhaled CO.

Time frame:
Weeks 7 and 9 = telephone call, Week 8 = visit 6 and Week 10 = visit 7
Reported as:
Count of participants · Participants
Efficacy - 4 Weeks of Continuous Abstinence From Smoking Cigarettes
ParticipantsX-22 Smoking Cessation ProductActive Control Cigarette
Week 8 - No Cigarettes Smoked per Diary (Weeks 7 and 8)1414
Week 8 - Exhaled CO <= 10ppm3236
Week 8 responder1411
Week 10 - No Cigarettes Smoked per Diary (Weeks 9 and 10)1618
Week 10 - Exhaled CO <= 10ppm3830
Week 10 responder1613
Overall Responder1310

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
X-22 Smoking Cessation Product0/118 (0%)5/118 (4.2%)60/118 (50.8%)
Active Control Cigarette1/116 (0.9%)1/116 (0.9%)58/116 (50%)
Most frequent serious events
Most frequent serious events
EventX-22 Smoking Cessation ProductActive Control Cigarette
SepsisInfections and infestations0/1181/116
Abdominal hernia obstructiveGastrointestinal disorders1/1180/116
Head injuryInjury, poisoning and procedural complications1/1180/116
Traumatic comaInjury, poisoning and procedural complications1/1180/116
Uterine leiomyomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/1180/116
AlcoholismPsychiatric disorders1/1180/116
Most frequent other events
Showing 10 of 108
Most frequent other events
EventX-22 Smoking Cessation ProductActive Control Cigarette
NasopharyngitisInfections and infestations20/11817/116
HeadacheNervous system disorders5/1188/116
CoughRespiratory, thoracic and mediastinal disorders7/1187/116
Oropharyngeal painRespiratory, thoracic and mediastinal disorders0/1185/116
Nasal congestionRespiratory, thoracic and mediastinal disorders5/1183/116
ConstipationGastrointestinal disorders0/1184/116
SinusitisInfections and infestations2/1183/116
Upper-airway cough syndromeRespiratory, thoracic and mediastinal disorders0/1183/116
Tooth infectionInfections and infestations3/1180/116
LacerationInjury, poisoning and procedural complications3/1180/116

Baseline characteristics

Age, Continuous
Age, Continuous(Years)X-22 Smoking Cessation ProductActive Control CigaretteTotal
Mean42.1 ± 11.041.8 ± 11.241.9 ± 11.1
Sex: Female, Male
Sex: Female, Male(Participants)X-22 Smoking Cessation ProductActive Control CigaretteTotal
Female5452106
Male6464128
Race (NIH/OMB)
Race (NIH/OMB)(Participants)X-22 Smoking Cessation ProductActive Control CigaretteTotal
American Indian or Alaska Native000
Asian213
Native Hawaiian or Other Pacific Islander000
Black or African American263359
White8881169
More than one race000
Unknown or Not Reported213
08

Study locations

3 sites
  • Benchmark Research Sacramento
    Sacramento, California 95816, United States
  • Benchmark Research New Orleans
    Metairie, Louisiana 70006, United States
  • Benchmark Research Austin
    Austin, Texas 78705, United States
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 19, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01400815
Lead sponsor
22nd Century Limited, LLC
Responsible party
Sponsor
First posted
Jul 22, 2011
Start date
Jul 2011
Primary completion
Dec 2012
Completion
Dec 2012
Results posted
Nov 19, 2021
Last update
Nov 19, 2021

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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