Neurobehavioral Mechanisms Linking Childhood Adversity to Increased Risk for Smoking

NCT ID: NCT05665465

Last Updated: 2025-04-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

EARLY_PHASE1

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-19

Study Completion Date

2027-03-31

Brief Summary

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The purpose of this study is to evaluate how certain childhood experiences influences brain function and responses to nicotine exposure in a group of nonsmoking young adults. The investigators assess responses to nicotine exposure by giving participants a small amount of nicotine or placebo, and then asking them to answer questionnaires. The investigational drugs used in this study are a nicotine nasal spray (i.e., Nicotrol) and/or a nasal spray placebo (made of common kitchen ingredients, including a very tiny amount of pepper extract also called capsaicin). The investigators assess brain function through function magnetic resonance imaging (fMRI), which is a noninvasive procedure that uses a magnetic field to take pictures of your brain while you are performing certain tasks. This study will help us to learn more about why some childhood experiences (adverse childhood experiences, or ACEs) contribute to increased risk for smoking and other substance use.

Detailed Description

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Individuals with a history of adverse childhood experiences (ACEs) are more likely to smoke cigarettes than those without, but little is known about the factors that account for this increased risk. This study will examine brain function in regions related to reward processing and inhibitory control, along with reactions to initial nicotine exposure to help explain why ACEs lead to increased risk for smoking. In this study, young adult non-smokers ages 18-21 (n=150) with a history of exposure to ACEs ranging from 0 to 4 or more will be enrolled to attend 7 visits including an MRI scan and administration of a nicotine nasal spray. Participants will complete an in-person screening visit, followed by a training visit to provide training for the MRI tasks and to acclimate them to the mock MRI scanner. They will then complete a functional neuroimaging scanning session to examine brain reactivity during a monetary reward task, an inhibitory control task, and during rest. Participants will then attend 3 separate visits in which subjective reactions to a nasal spray containing 0, .5, or 1 mg doses of nicotine will be measured. During a final choice session participants will choose to self-administer nicotine or placebo nasal spray. Breath and urine samples will be collected at each visit to test for recent smoking, alcohol use, or illicit drug use. Plasma samples will be collected at each fixed-dose session to assess nicotine and cotinine levels. All nicotine administration will occur during laboratory sessions, and the study physician will be on site or on call during all visits.

Conditions

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Adverse Childhood Experiences Nicotine Dependence, Cigarettes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

All participants will sample the three doses of nicotine spray in a counter-balanced crossover design.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Placebo

Participants will be administered 2 nasal sprays with a combined nicotine content of 0mg nicotine, 0.1mL

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Participants will be administered placebo nasal spray and provide subjective reactions

0.5mg nicotine

Participants will be administered 2 nasal sprays with a combined nicotine content of 0.5 mg nicotine, 0.1mL

Group Type EXPERIMENTAL

Nicotine nasal spray 0.5 mg

Intervention Type DRUG

Participants will be administered nicotine nasal spray and provide subjective reactions

Placebo

Intervention Type DRUG

Participants will be administered placebo nasal spray and provide subjective reactions

1mg nicotine

Participants will be administered 2 nasal sprays with a combined nicotine content of 1.0 mg nicotine, 0.1mL

Group Type EXPERIMENTAL

Nicotine nasal spray 0.5 mg

Intervention Type DRUG

Participants will be administered nicotine nasal spray and provide subjective reactions

Interventions

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Nicotine nasal spray 0.5 mg

Participants will be administered nicotine nasal spray and provide subjective reactions

Intervention Type DRUG

Placebo

Participants will be administered placebo nasal spray and provide subjective reactions

Intervention Type DRUG

Other Intervention Names

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Nicotrol

Eligibility Criteria

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Inclusion Criteria

1. generally healthy
2. 18-21 years of age
3. never smoked a full cigarette or used an equivalent amount of other nicotine or tobacco products
4. no tobacco exposure in the past 3 years
5. expired air CO level ≤ 3 ppm
6. corroboration of non-smoking status from 2 collateral reporters
7. breath alcohol value = 0.000

Exclusion Criteria

1. use of illegal drugs as measured by urine drug screen
2. reported history of illicit drug use \> 10 times lifetime
3. lifetime history of alcohol use disorder
4. binge drinking \> 5 times per month over the past 3 months
5. history of serious mental illness including bipolar or psychotic disorders
6. significant medical or unstable psychiatric disorders
7. systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg
8. heart rate ≥ 100 bpm
9. use of psychoactive medications (e.g., antidepressants, opioid analgesics, etc.) in the past 6 months
10. presence of conditions that would make fMRI unsafe (e.g., pacemaker)
11. brain abnormality (including but not limited to stroke, brain tumor, and seizure disorder)
12. history of serious traumatic brain injury
13. claustrophobia
14. lack of firm resolve to refrain from cigarette, e-cigarette or other tobacco use in the coming year
15. pregnant, trying to become pregnant, or breastfeeding
16. inability to understand written and/or spoken English language
17. inability to attend all experimental sessions
Minimum Eligible Age

18 Years

Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Maggie Sweitzer, PhD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

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Duke University Medical Center

Durham, North Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Maggie Sweitzer, PhD

Role: CONTACT

919-668-0094

Facility Contacts

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Maggie Sweitzer, PhD

Role: primary

919-668-0094

Other Identifiers

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1R01DA054972-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Pro00110997

Identifier Type: -

Identifier Source: org_study_id

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