Reduced exposure evaluation of an Electrically Heated Cigarette Smoking System. Part 6: 6-day randomized clinical trial of a menthol cigarette in Japan

Abstract A randomized, controlled, open-label, parallel-group, single-center study to determine biomarkers of exposure to 12 selected harmful and potentially harmful constituents (HPHC) in cigarette smoke, excretion of mutagenic material in urine, and serum Clara cell 16-kDa protein (CC16) in 102 male and female Japanese subjects who smoked Marlboro Ultra Lights Menthol cigarettes (M4J M ; 4 mg tar and 0.3 mg nicotine) at baseline. Subjects were randomized to continue smoking M4J M , or switch to smoking either the Electrically Heated Cigarette Smoking System menthol cigarette (EHCSS-K6 M ; 5 mg tar and 0.3 mg nicotine) or the Lark One menthol cigarette (L a rk1 M ; 1 mg tar and 0.1 mg nicotine), or to no-smoking. The mean decreases from baseline to Day 5/6 were statistically significant ( p  ⩽ 0.05) for exposure to 10 of 12 cigarette smoke HPHC including the primary endpoint (carbon monoxide) and urinary excretion of mutagenic material in the EHCSS-K6 M group (−12.3% to −83.4%). Smaller, but statistically significant reductions ( p  ⩽ 0.05) occurred in the Lark1 M group (−3.3% to −35.2%), with the exception of urinary mutagens. The largest mean reductions (all p  ⩽ 0.05) in exposure to cigarette smoke HPHC and excretion of mutagenic material occurred in the no-smoking group (−1.4% to −93.6%). Serum CC16, an indicator of lung epithelial injury, was not significantly different between groups.