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Cigarette Smoking-Related CarcinomaARISENCT06763536

Oral Nicotine Pouches Versus Nicotine Replacement Therapy to Reduce Cigarette Use for Smokers in Rural Appalachia

A study testing Carbon Monoxide Measurement, Nicotine Lozenge and Oral Nicotine Pouch in people with Cigarette Smoking-Related Carcinoma, run by Ohio State University Comprehensive Cancer Center at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This clinical trial compares the use of oral nicotine pouches to nicotine replacement therapy, consisting of nicotine patches and lozenges, to reduce cigarette use in smokers living in rural Appalachia. The lung and oral cancers that plague Appalachia are fueled by cigarette smoking. Read more about this study

Who is it for?
Ages 21 years and olderHealthy volunteers can take part
Conditions the study is for
Cigarette Smoking-Related Carcinoma
What is being tested?
Carbon Monoxide Measurement, Nicotine Lozenge and Oral Nicotine Pouch
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,000 participants
Where
1 siteUnited States
Study dates
13 Jun 2025to 31 Dec 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Read and speak English
  • 21 years or older
  • Smoke ≥ 5 cigarettes per day for the past year
  • Willing to use Oral Nicotine Pouches (ONP) or Nicotine Replacement Therapy (NRT)
  • Live in a rural Appalachian County
  • Have a smartphone and/or willing to use a smartphone for study purposes (smartphones may be provided to participants for study purposes only)
  • Willing to blow air into a handheld study device
  • If capable of becoming pregnant, verbal confirmation of not being pregnant based on urine pregnancy test results

Who cannot join

  • Report currently using smoking cessation medications, NRT, or actively seeking treatment for smoking cessation
  • Use of ONPs in past 3 months
  • Use of Nicotine Replacement Therapies in past 3 months
  • Use of other tobacco products > 10 days/month
  • Unstable or significant medical condition
  • Unstable or significant psychiatric conditions (past and stable conditions will be allowed)
Show all 9Show fewer
  • History of cardiac event or distress within the past 3 months
  • Live in same household as another study participant.
  • Currently pregnant, planning to become pregnant within 6 months, or breastfeeding

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

The Ohio State University Comprehensive Cancer Center contact

800-293-5066

OSUCCCClinicaltrials@osumc.edu

United States1 site, 1 recruiting
  • Ohio State University Comprehensive Cancer Center

    Columbus, Ohio, 43210

    Brittney L. Keller-Hamilton, PhD, MPH, 614-366-9652

    Brittney L. Keller-Hamilton

    Recruiting

Other trials in United States

About this study

Official title: Testing Oral Nicotine Pouches to Reduce Smoking-Related Cancer in Rural Appalachia

This clinical trial compares the use of oral nicotine pouches to nicotine replacement therapy, consisting of nicotine patches and lozenges, to reduce cigarette use in smokers living in rural Appalachia. The lung and oral cancers that plague Appalachia are fueled by cigarette smoking. Oral nicotine pouches which contain nicotine but no tobacco leaf, present a new opportunity to reduce cancer risk among Appalachian adults who smoke. Oral nicotine pouches and nicotine replacement therapy may work well to reduce cigarette use for smokers in rural Appalachia.

Read the detailed description

PRIMARY OBJECTIVES:

  1. Evaluate short-term changes in cigarette smoking patterns, including switching, abstinence from cigarettes, and frequency of smoking between oral nicotine patches (ONPs) and NRT.

II. Compare product appeal, craving, withdrawal relief, and perceived cigarette dependence between ONPs and NRT.

III. Examine sustained changes in tobacco use behaviors, including abstinence from cigarettes, purchase of ONPs/NRT, and continued use of ONPs/NRT.

OUTLINE: Participants are randomized to 1 of 2 arms.

ARM I:

SAMPLING PHASE: Participants receive 2 concentrations of three different flavors of oral nicotine pouches. Participants use the products ad libitum, starting with the lowest concentration, to determine their preferred concentration and flavor, over 2 weeks.

SWITCH PHASE: Participants receive their preferred oral nicotine pouches and use them in place of cigarettes for 12 weeks.

Participants complete surveys and have their carbon monoxide levels measured at various points throughout the study.

OBSERVATION PHASE: After completion of the intervention, participants complete a final follow-up survey, along with a carbon monoxide measure, 14 weeks after the intervention ends.

ARM II:

SAMPLING PHASE: Participants receive 2 different strengths of nicotine replacement therapy patches and 2 different strengths and 3 different flavors of nicotine replacement therapy lozenges. Participants use the products ad libitum, starting with the lowest concentration, to determine their preferred concentration and flavor, over 2 weeks.

SWITCH PHASE: Participants receive their preferred nicotine patches and lozenges and use them in place of cigarettes for 12 weeks.

Participants complete surveys and have their carbon monoxide levels measured at various points throughout the study.

OBSERVATION PHASE: After completion of intervention, participants complete a final follow-up survey, along with a carbon monoxide measure, 14 weeks after the intervention ends.

Being tested
Carbon Monoxide Measurement, Nicotine Lozenge, Oral Nicotine Pouch, Nicotine Patch, Survey Administration

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Carbon Monoxide MeasurementOther

    Also called Carbon Monoxide, Covita iCOquit

    Undergo carbon monoxide measurement

  • Nicotine LozengeOther

    Also called Rugby, Nicotine Replacement Therapy

    Use nicotine lozenge

  • Oral Nicotine PouchOther

    Also called ZYN

    Use oral nicotine pouch

  • Nicotine PatchOther

    Also called Rugby, Nicotine Skin Patch, Nicotine Transdermal Patch, Nicotine Replacement Therapy

    Use nicotine patch

  • Survey AdministrationOther

    measurements; data gathering

  • Check-in Phone CallsOther

    Check-in phone calls to study participants

Study groups in NCT06763536
Study groupRoleWhat they receive
Arm I (oral nicotine pouch)ExperimentalSAMPLING PHASE: Participants receive 2 concentrations of three different flavors of oral nicotine pouches. Participants use the products ad libitum, starting with the lowest concentration, to determine their preferred concentration and flavor, over 2 weeks. SWITCH PHASE: Participants receive their preferred oral nicotine pouches and use them in place of cigarettes for 12 weeks. Participants complete surveys and have their carbon monoxide levels measured at various points throughout the study. OBSERVATION PHASE: After completion of the intervention, participants complete a final follow-up survey, along with a carbon monoxide measure, 14 weeks after the intervention ends.
Receives: Other: Carbon Monoxide Measurement; Other: Oral Nicotine Pouch; Other: Survey Administration; Other: Check-in Phone Calls
Arm II (nicotine replacement therapy)Active comparatorSAMPLING PHASE: Participants receive 2 different strengths of nicotine replacement therapy patches and 2 different strengths and 3 different flavors of nicotine replacement therapy lozenges. Participants use the products ad libitum, starting with the lowest concentration, to determine their preferred concentration and flavor, over 2 weeks. SWITCH PHASE: Participants receive their preferred nicotine patches and lozenges and use them in place of cigarettes for 12 weeks. Participants complete surveys and have their carbon monoxide levels measured at various points throughout the study. OBSERVATION PHASE: After completion of intervention, participants complete a final follow-up survey, along with a carbon monoxide measure, 14 weeks after the intervention ends.
Receives: Other: Carbon Monoxide Measurement; Other: Nicotine Lozenge; Other: Nicotine Patch; Other: Survey Administration; Other: Check-in Phone Calls

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Biochemically verified 7-day point prevalence abstinence from cigarettes

    Statistical analyses will be performed using SAS 9.4. P-values less than 0.05 will be considered statistically significant. Will be presented as frequencies and proportions and compared with chi-squared tests.

    Measured: At the end of the 12- week switch phase

  2. Complete switching rate (Aim 1)

    Will be compared between arms using logistic regression analysis, adjusting for baseline variables as needed.

    Measured: At the end of the 12-week switch phase

  3. Abstinence from cigarettes (Aim 1)

    Will be compared between arms using logistic regression analysis, adjusting for baseline variables as needed.

    Measured: At the end of the 12-week switch phase

  4. Cigarettes smoked per day (Aim 1)

    If needed, will apply a normalizing transformation to the number of cigarettes smoked per day (e.g., taking the logarithm) before proceeding with the analysis as a means of removing the effects of potential outliers. Will compare cigarettes smoked per day between the two arms using linear regression analysis. The model will adjust for cigarettes smoked per day at baseline and other baseline variables if they are imbalanced.

    Measured: At the end of the 12-week switch phase

  5. Differences in product appeal (Aim 2)

    Will be adjusted for potential confounders including baseline variables such as age, gender, number of cigarettes smoked per day, and/or randomization stratification factors as necessary; normalizing transformations will be employed if needed.

    Measured: From baseline to the end of the 12 week switch phase

  6. Cigarette craving (Aim 2)

    Will be evaluated with linear regression models adjusting for appropriate confounders.

    Measured: Up to the end of the 12 week switch phase

  7. Withdrawal symptoms (Aim 2)

    Will be evaluated with linear regression models adjusting for appropriate confounders.

    Measured: Up to the end of the 12 week switch phase

  8. Change in nicotine dependence among participants who completely switched to their assigned study product (Aim 2)

    Using linear regression analysis, adjusting for baseline nicotine dependence.

    Measured: From baseline to the end of the 12 weeks switch phase

  9. Abstinence from cigarettes (Aim 3)

    Will be compared between arms using logistic regression analysis and will be evaluated with a logistic regression model.

    Measured: Up to the end of the 14 week observation phase

  10. Number of days the study products are used (Aim 3)

    Linear regression analysis will be used to compare the number of days the products are used. A normalizing transformation will be employed if needed and appropriate baseline characteristics will be adjusted for.

    Measured: Up to the end of the 14 week observation phase

  11. Purchase and continued use of the study products (Aim 3)

    Will be compared between the arms with logistic regression analysis, adjusting for all appropriate confounders.

    Measured: Up to the end of the 14 week observation phase

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Jan 2025
  2. Study start13 Jun 2025
  3. Primary completion31 Dec 2028 (estimated)
  4. Study completion31 Dec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06763536
Sponsor's protocol ID
2024C0064
Other IDs
NCI-2024-09181, R01CA289551-01
Acronym
ARISE
Status last verified
Jun 2026
First submitted
2 Jan 2025
Last updated
30 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Wermert A, Brasky TM, Newton AM, Hinton A, Curran H, Ferketich AK, Carpenter MJ, Shields PG, Tomko P, Wagener TL, Keller-Hamilton B. Testing oral nicotine pouches versus nicotine replacement therapy for cigarette harm reduction in Appalachia: The ARISE study protocol. PLoS One. 2025 Dec 23;20(12):e0338503. doi: 10.1371/journal.pone.0338503. eCollection 2025.

    PubMed 41433314

Questions about this trial

What is this clinical trial studying?

A study testing Carbon Monoxide Measurement, Nicotine Lozenge and Oral Nicotine Pouch in people with Cigarette Smoking-Related Carcinoma, run by Ohio State University Comprehensive Cancer Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 30 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact The Ohio State University Comprehensive Cancer Center (800-293-5066, OSUCCCClinicaltrials@osumc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Biochemically verified 7-day point prevalence abstinence from cigarettes (time frame: At the end of the 12- week switch phase). The study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06763536, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jun 2026.

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