ClinicalTrials.gg
RecruitingNCT06264154Updated Feb 19, 2026

The Role of Flavor in the Substitutability of E-cigarettes for Combustible Cigarettes Among Persistent Smokers

An interventional study of E-cigarettes in Smoking, Tobacco Use and Cigarette Smoking, sponsored by Abramson Cancer Center at Penn Medicine. Recruiting at 1 site in United States. Open to participants aged 21 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-19.

Sponsored by Abramson Cancer Center at Penn Medicine · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Aug 2024; still recruiting 2 years 2 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
210
Allocation
Randomized
Ages
21 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 13 studies in Smoking by Abramson Cancer Center at Penn Medicine — 2 open to participants now, 2 under way, none of them phase 3. Smoking · Abramson Cancer Center at Penn Medicine.

Planned enrollment
7th of 12
210 · median 215
Started
2024
with 1 other
No phase
11 of 13
2 open now
Registered
12th of 13
by date

Among the 13 studies in Smoking by Abramson Cancer Center at Penn Medicine, this one is the 7th largest by planned enrollment of the 12 interventional ones that give a count, is one of 2 that started in 2024, is one of 11 with no phase, and was the 12th registered.

Smoking

1,509 studies on the registry are indexed under Smoking; 193 are open to participants now.

Browse Smoking studies →

Open to participants now

2 of the 13 studies in Smoking by Abramson Cancer Center at Penn Medicine are open now, in 1 country. Recruiting first, the newest first:

By country, each count listing its studies:

All 2 open studies →

Where they have run

Who these studies take

Of the 140 Smoking studies recruiting now, 74 (53%) set no upper age limit and 48 (34%) stop at 75 or younger; 3 take children under 18; 65 take healthy volunteers.

This study: 21 Years and older · all sexes · healthy volunteers too.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 13 studies in Smoking by Abramson Cancer Center at Penn Medicine, or all of them as a file.
02

Study summary

This between-subjects study aims to evaluate the effect of flavor on initial and sustained switching from combustible cigarettes to e-cigarettes among 210 cigarette smokers. After measuring baseline cigarette smoking rate, participants will be randomized to a six-week regimen of fruit-flavored, tobacco-flavored, or menthol-flavored e-cigarettes and be instructed to switch (versus smoking cigarettes) over a 6-week period. Flavor-associated subjective reward and the reinforcing value of flavored e-cigarettes relative to combustible cigarettes will be assessed as mechanisms.

Read the detailed description

The average smoker will attempt to quit smoking at least 30 times before abstaining for 12 months or longer. These attempts typically occur over decades of smoking, carcinogen and toxicant exposure, resulting in 480,000 deaths annually. As highlighted in the Surgeon General's Report, helping smokers who cannot quit smoking switch to less harmful non-combustible nicotine-containing products, such as e-cigarettes, has the potential to reduce this health burden dramatically. Substituting e-cigarettes for combustible cigarettes might only be possible for persistent smokers if e-cigarettes are accessible and appealing. Harm reduction proponents have advocated for the continued availability of e-cigarette flavors to appeal to and aid cigarette smokers unable to quit with traditional methods. Yet, there are no prospective studies of the effect of flavor on initial and sustained switching from combustible to electronic cigarettes. Converging laboratory, epidemiological, and clinical research suggests that fruit-flavored e-cigarettes with nicotine may be a viable substitute for combustible cigarettes among persistent smokers. The proposed study seeks to answer two novel questions relevant to public health and the regulation of e-cigarette flavoring. First, do persistent smokers substitute fruit-flavored e- cigarettes more readily than traditional-flavored e-cigarettes (tobacco or menthol) for combustible cigarettes? Second, are fruit-flavored e-cigarettes more rewarding and reinforcing than traditional-flavored e-cigarettes, and do these effects facilitate switching? The proposed research will fill these gaps in the evidence base by randomizing 210 persistent cigarette smokers to a six-week regimen of fruit-flavored (FF: watermelon and blueberry, n=70), tobacco-flavored (TF n=70) or menthol-flavored (MF n=70) e-cigarettes in a between-subjects design. Baseline smoking rate will be established during days 1-5. After biochemically verified overnight cigarette smoking abstinence, laboratory visits on days 6 and 7 will assess flavor-associated subjective reward and the reinforcing value of flavored e-cigarettes relative to combustible cigarettes. Participants will then switch from cigarette smoking to e-cigarette use for six weeks. Participants will collect spent cigarette filters daily to assess cigarettes smoked per day (cpd) if they smoke. The primary outcome measure is the longitudinal daily count of cigarettes from baseline to the end of the six-week switch period, with cigarettes per day at a 6-month follow-up as a secondary endpoint.

03

Conditions studied

  • Smoking
  • Tobacco Use
  • Cigarette Smoking
  • E-Cig Use
04

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Able to communicate fluently in English (i.e. speaking, writing, and reading)
  2. Male and female smokers who are > 21 years of age and self-report smoking at least 5 cigarettes (menthol and/or non-menthol) per day for at least the last 12 months
  3. 5 or more failed quit attempts and the use of smoking cessation medication on at least one prior attempt.
  4. Ever use of an e-cigarette
  5. Have a carbon monoxide (CO) greater than 10 ppm
  6. Not using any forms of nicotine regularly other than cigarettes
  7. Be willing to switch to e-cigarettes for 6 weeks and use the assigned flavors
  8. Plan to live in the area for the duration of the study
  9. Capable of giving written , which includes compliance with the requirements and restrictions listed in the combined consent and HIPAA form.

Exclusion criteria

Exclusion Criteria:

Smoking Behavior Regular use of nicotine-containing products other than cigarettes (e.g., chewing tobacco, snuff, snus, cigars, e-cigs, etc.). Regular e-cigarette use is defined as greater than 5 days/past 30 days

  1. Participants agreeing to abstain from using nicotine-containing products other than cigarettes for the duration of the study will be considered eligible.
  2. Current enrollment or plans to enroll in a smoking cessation program over the duration of the study.
  3. Current use of smoking cessation medication
  4. Provide a CO breath test reading less than 10 ppm at Intake.

Alcohol and Drug

  1. History of substance abuse (other than nicotine dependence) in the past 12 months.
  2. Current alcohol consumption that exceeds 20 standard drinks/week.
  3. Current use of recreational drugs (other than nicotine and cannabis)
  4. Breath alcohol reading (BrAC) greater than .000 at Intake.

Medical

  1. Women, including all individuals assigned as "female" at birth, who are pregnant, breastfeeding, or planning a pregnancy over the duration of the study period.
  2. Serious or unstable disease within the past year (e.g. cancer, heart disease). Applicable conditions will be evaluated on a case-by-case basis by the Principal Investigator.
  3. Allergies to either propylene glycol or flavor additives

Psychiatric

1. Lifetime history of schizophrenia or psychosis.

General Exclusion

  1. Past, current, anticipated, or pending enrollment in another research program over the study period that could potentially impact subject safety, study data, and/or the study design as determined by the Principal Investigator.
  2. Any medical condition, illness, disorder, adverse event (AE), or concomitant medication that could compromise participant safety or significantly impact study performance as determined by the Principal Investigator. Subjects may be deemed ineligible for any of the aforementioned reasons at any point throughout the study, as well as during the initial telephone screen.
  3. Significant non-compliance with protocol and/or study design as determined by the Principal Investigator and/o. Subjects may be deemed ineligible at any point throughout the study.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
210 participants (estimated)

Study arms

  • Experimental
    Fruit-flavored E-cigarettes

    Participants randomized to fruit-flavored e-cigarettes will be provided with an e-cigarette device and be instructed to switch from smoking combustible cigarettes to using only the study provided e-cigarette device and fruit-flavored nicotine pods. Participants will be able to choose between blueberry or watermelon-flavored pods. They will receive their supply of nicotine pods in 7-day increments, based on baseline smoking behavior.

    Other: E-cigarettes

  • Active comparator
    Tobacco-flavored E-cigarettes

    Participants randomized to tobacco-flavored e-cigarettes will be provided with an e-cigarette device and be instructed to switch from smoking combustible cigarettes to using only the study provided e-cigarette device and tobacco nicotine pods. Participants will receive their supply of nicotine pods in 7-day increments, based on baseline smoking behavior.

    Other: E-cigarettes

  • Active comparator
    Menthol-flavored E-cigarettes

    Participants randomized to menthol-flavored e-cigarettes will be provided with an e-cigarette device and be instructed to switch from smoking combustible cigarettes to using only the study provided e-cigarette device and menthol nicotine pods. Participants will receive their supply of nicotine pods in 7-day increments, based on baseline smoking behavior.

    Other: E-cigarettes

Interventions

  • OtherE-cigarettes

    All participants are instructed to switch from smoking combustible cigarettes to using e-cigarettes for 6 weeks. Participants will receive an e-cigarette device and flavored nicotine pods according to their randomly assigned flavor.

06

What researchers measure

Primary outcomes

  1. Cigarette Consumption

    The primary outcome is the longitudinal daily count of cigarettes from baseline to the end of the e-cigarette switch phase. Daily cigarette consumption will be determined by counting the daily spent cigarette filters returned for each of the 42 days (days 8 - 49).

    Time frame: 42 days (days 8 - 49)

  2. Cigarette Smoking Behavior

    Cigarette smoking behavior at the 6-month follow-up will serve as a secondary endpoint.

    Time frame: 19 Weeks (Day 50-6-Month Follow-Up)

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Klapec O, Strasser AA, Paul Wileyto E, Audrain-McGovern J. Evaluating the substitutability of fruit versus menthol and tobacco-flavored e-cigarettes on combustible cigarette cessation: Randomized clinical trial protocol. Contemp Clin Trials Commun. 2026 Jun 6;51:101652. doi: 10.1016/j.conctc.2026.101652. eCollection 2026 Jun. PubMed 42293363 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Aug 2024 (actual). Primary completion is estimated for Jun 2027, 34 months after the start.

Of 401 non-industry interventional studies with no phase under Smoking, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 42. This study's planned 34 months is above that.

Counting every sponsor, half of 456 studies reached it within 23 months; a quarter within 8 and three quarters within 40.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 8, 2024
First posted
Feb 16, 2024
StartActual
Aug 26, 2024
Primary completionEst.
Jun 2027
CompletionEst.
Dec 2027
Last update
Feb 19, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06264154
Responsible party
Janet E. Audrain-McGovern, PhD (Professor, University of Pennsylvania) — Principal investigator
First posted
Feb 16, 2024
Start date
Aug 26, 2024
Primary completion
Jun 2027 (estimated)
Completion
Dec 2027 (estimated)
Last update
Feb 19, 2026

Study contacts

Janet Audrain-McGovern, Ph.D.
Contact
audrain@pennmedicine.upenn.edu
(215) 746-7145
Janet Audrain-McGovern, Ph.D.
principal investigator · University of Pennsylvania

Oversight

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

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