Randomised trial investigating effect of a novel nicotine delivery device (Eclipse) and a nicotine oral inhaler on smoking behaviour, nicotine and carbon monoxide exposure, and motivation to quit

Objective-To monitor the effect of a novel nicotine delivery device that ma y produce fewer carcinogens (Eclipse) on cigarette smoking, carbon monoxide and nicotine concentrations, and motivation to give up smoking. The smoker 's own brand of cigarette and a nicotine replacement product (Nicotrol inha ler) were used as comparisons. Design-After baseline data were recorded, smokers were randomised to either Eclipse or inhaler for two weeks and then switched to the other product fo r another two weeks. Thereafter a second baseline was obtained. Setting and participants-Fifty smokers were included and data are reported for the 40 with complete data sets. The smokers were not trying to quit but were interested in trying a new product to reduce their risk. They visited a smoking clinic 10 times during the six week period of the trial. intervention-No counselling to aid reduction by Eclipse or inhaler was give n. Main outcome measures-At each visit smoking status and carbon monoxide conc entrations were recorded. In half of the visits withdrawal symptoms, attitu des towards smoking, heart rate, and blood nicotine concentrations were als o recorded. Results-Eclipse use decreased the number of cigarettes smoked per day (cpd) from 19.1 cpd at baseline to 2.1 cpd (p < 0.001), but increased carbon mon oxide concentrations in parts per million (ppm) from 21.0 ppm to 33.0 ppm ( p < 0.001). A similar decrease in cigarettes smoked per day was seen with t he Nicotrol inhaler, from 19.1 cpd to 4.8 cpd (p < 0.001), but carbon monox ide decreased from 21.0 ppm to 12.7 ppm (p < 0.001). The blood nicotine con centration remained fairly stable with Eclipse, increasing slightly from 16 .8 ng/ml to 18.0 ng/ml, while for the inhaler a significant drop was noted, from 16.8 ng/ml to 12.2 ng/ml (p < 0.002). Craving and withdrawal did not increase with Eclipse. Few significant adverse events occurred with Eclipse . Conclusions-Eclipse can dramatically decrease cigarette consumption without causing withdrawal symptoms or decreases in nicotine concentrations or mot ivation to quit altogether. Unlike the inhaler, Eclipse produces an increas e in carbon monoxide concentration, Thus Eclipse may not be a safer cigaret te.