CClinicalTrials.gg
CompletedNCT04033237Updated May 18, 2026Results posted

Project 4, Study 2: Extended Exposure to Low Nicotine Content Cigarettes in Pregnant Women

A Phase 1/2 interventional study of Very low nicotine content cigarettes in Tobacco Use Disorder, sponsored by University of Vermont. Completed at 2 sites in United States. Open to female participants aged 18 Years to 44 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-05-18.

Sponsored by University of Vermont · Phase 1/2, Interventional, and Basic science

Phase
Phase 1/2
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years to 44 Years
Sex
Female
01

Study summary

Study 2 will evaluate the effects of extended exposure to cigarettes with varying levels of nicotine in pregnant smokers who have less than an Associate's degree. This study will be limited to two conditions: usual brand vs. 0.4 mg nicotine/g tobacco. After a baseline period in which daily smoking rate and other baseline assessments are completed, participants will be randomly (by chance) assigned to either their usual brand or the very low nicotine content condition and followed for 12 weeks.

Read the detailed description

Some inclusion/exclusion criteria are purposely omitted at this time to preserve scientific integrity. They will be included after the trial is complete.

02

Conditions studied

  • Tobacco Use Disorder

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Keywords

  • Biomarkers of exposure
  • Compensatory smoking
  • Nicotine dependence
  • Reduced nicotine cigarettes
  • Tobacco withdrawal
  • Women
  • Pregnancy
  • Health disparities
  • Vulnerable populations
03

In context

Tobacco Use Disorder

968 studies on the registry are indexed under Tobacco Use Disorder; 128 are open to participants now.

This study's enrollment of 30 is below the median of 90 across 851 interventional studies indexed under Tobacco Use Disorder.

Browse Tobacco Use Disorder studies →

Lead sponsor

University of Vermont is the lead sponsor of 215 studies on the registry; 28 are open to participants now.

Of its 16 completed or terminated interventional studies of FDA-regulated products, 9 (56%) have results posted.

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

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Who can participate

Ages eligible
18 Years to 44 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Female
  • Ages 18-44 years
  • Gestational age ≤ 25 weeks

Exclusion criteria

Exclusion Criteria:

  • Male
  • Under 18 years old
  • Over 44 years old
  • Gestational age > 25 weeks
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Study design

Phase
Phase 1 / Phase 2
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    Very low nicotine content cigarettes

    Other: Very low nicotine content cigarettes

  • No intervention
    Usual Brand

Interventions

  • OtherVery low nicotine content cigarettes

    Cigarettes containing 0.4 mg nicotine/g tobacco

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What researchers measure

Primary outcomes

  1. Total Cigarettes Per Day

    Time frame: 12 weeks

07

Results

Posted Oct 30, 2025
Limitations and caveats
The sample included participants who smoke more than is typical during pregnancy and the sample size (N=30) was small. Study generality may be limited by the high smoking rate and the small sample size.

Participant flow

Participant flow — Overall Study
MilestoneVery Low Nicotine Content CigarettesUsual Brand
Started1614
Completed1211
Not completed43

Outcome measures

PrimaryTotal Cigarettes Per Day
Time frame:
12 weeks
Reported as:
Mean · Cigarettes per day
Total Cigarettes Per Day
Cigarettes per dayVery Low Nicotine Content CigarettesUsual Brand
Total Cigarettes Per Day16.31 ± 2.6318.36 ± 2.32

Adverse events

Collected over 12-week intervention period. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Very Low Nicotine Content Cigarettes0/16 (0%)0/16 (0%)11/16 (68.8%)
Usual Brand0/14 (0%)1/14 (7.1%)13/14 (92.9%)
Most frequent serious events
Most frequent serious events
EventVery Low Nicotine Content CigarettesUsual Brand
Placenta previaPregnancy, puerperium and perinatal conditions0/161/14
Most frequent other events
Showing 10 of 15
Most frequent other events
EventVery Low Nicotine Content CigarettesUsual Brand
Increased Beck Depression Inventory scorePsychiatric disorders7/167/14
Increased Overall Anxiety Severity and Impairment Scale scorePsychiatric disorders4/165/14
Gastrointestinal disordersGastrointestinal disorders4/162/14
Infections and infestationsInfections and infestations4/162/14
Musculoskeletal and connective tissueMusculoskeletal and connective tissue disorders1/163/14
Pregnancy, puerperium and perinatalPregnancy, puerperium and perinatal conditions1/163/14
General disorder and administrationGeneral disorders3/160/14
Psychiatric disordersPsychiatric disorders2/162/14
Vascular disordersVascular disorders2/162/14
Cardiac disordersCardiac disorders2/160/14

Baseline characteristics

Age, Continuous
Age, Continuous(Years)Very Low Nicotine Content CigarettesUsual BrandTotal
Mean28.31 ± 4.8027.57 ± 4.7727.97 ± 4.72
Sex: Female, Male
Sex: Female, Male(Participants)Very Low Nicotine Content CigarettesUsual BrandTotal
Female161430
Male000
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Very Low Nicotine Content CigarettesUsual BrandTotal
Non-Latino White151429
Non-Latino other101
Gestational age at screening
Gestational age at screening(Weeks)Very Low Nicotine Content CigarettesUsual BrandTotal
Mean11.94 ± 4.9913.43 ± 6.2612.63 ± 5.57
Cigarettes per day pre-pregnancy
Cigarettes per day pre-pregnancy(Cigarettes per day)Very Low Nicotine Content CigarettesUsual BrandTotal
Mean18.38 ± 5.9123.93 ± 14.0820.97 ± 10.72
Cigarettes per day
Cigarettes per day(Cigarettes per day)Very Low Nicotine Content CigarettesUsual BrandTotal
Mean19.19 ± 8.1516.21 ± 8.0517.80 ± 8.10
08

Study locations

2 sites
  • University of Kentucky
    Lexington, Kentucky 40536, United States
  • University of Vermont
    Burlington, Vermont 05401, United States
09

References and documents

Publications

  • Heil SH, Kock LS, Harfmann RF, Ashford KB, Barnett J, McCubbin A, DeSarno MJ, Higgins ST. Pilot randomized clinical trial examining use of very low nicotine content cigarettes during pregnancy in the United States. Prev Med. 2025 Dec;201:108351. doi: 10.1016/j.ypmed.2025.108351. Epub 2025 Jul 5. PubMed 40623557 ↗

Study documents

  • Study protocol · May 3, 2022
  • Statistical analysis plan · Apr 19, 2024

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 18, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04033237
Lead sponsor
University of Vermont
Collaborators
National Institute on Drug Abuse (NIDA), Food and Drug Administration (FDA), University of Kentucky
Responsible party
Sarah Heil (Professor, University of Vermont) — Principal investigator
First posted
Jul 26, 2019
Start date
Aug 21, 2019
Primary completion
Apr 17, 2024
Completion
Aug 19, 2024
Results posted
Oct 30, 2025
Last update
May 18, 2026

Study contacts

Sarah H. Heil
principal investigator · University of Vermont

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2026. You cannot join it, but the record below documents what was studied.

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