Opioids, Low Nicotine Cigarettes, and Chronic Pain Study

This study is looking at how switching to very low nicotine cigarettes (Spectrum NRC 102/103) or normal nicotine cigarettes (Spectrum NRC 600/601) affects craving, withdrawal, and pain. You might be able to join if you are at least 21 years old, smoke cigarettes daily, have chronic non-cancer musculoskeletal pain, and have been on buprenorphine treatment for opioid use disorder for at least 30 days. The study will look at how much nicotine dependence you have, how many cigarettes you smoke each day, and your pain levels. The study is currently unclear about its recruitment status and plans to enroll 60 participants.

Study design
This is an interventional study that plans to enroll 60 participants. It compares two types of cigarettes: very low nicotine and normal nicotine.
What's involved
You would have weekly visits during the 4 weeks of using study cigarettes. Your nicotine dependence, cigarette use, and pain levels will be measured at baseline and throughout the study.
Compensation
Not stated in the trial record.
Follow-up
Your nicotine dependence, cigarette use, and pain levels will be measured weekly during the 4 weeks of study cigarette use.

AI-generated from the public study record. Only the study team can confirm whether you're eligible — confirm details with them before making decisions.

NCT06747871

Opioids, Low Nicotine Cigarettes, and Chronic Pain

Recruiting
NAAges 21+InterventionalBasic science
Duke University
~60 participants
Updated 2026-01-09 on ClinicalTrials.gov
What's tested:Very Low Nicotine Cigarettes (VLNC)Normal Nicotine Cigarettes (NNC)

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Nicotine Dependence as measured by the Fagerstrom Test of Cigarette Dependence (FTCD)
Measured over Baseline and weekly during study cigarette use (4 weeks)
+11 more outcomes measured
Chronic Pain
Tobacco Use
Opioid Substitution Treatment
1 sites across 1 states
North Carolina1
  • Maggie Sweitzer, PhD · PRINCIPAL_INVESTIGATOR · Duke University

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Eligibility criteria

Inclusion

Aged 21+ years who smoke cigarettes daily
Chronic non-cancer musculoskeletal pain secondary to structural changes (e.g., low back pain, osteoarthritis)
Have received stable office-based buprenorphine treatment for opioid use disorder for at least 30 days
Self-report smoking at least 10 cigarettes/day
Expired breath carbon monoxide (CO) level \>8 ppm
Have a smartphone capable of running software for ecological momentary assessment
Open to exploring the possibility of quitting smoking

Exclusion

Pain specifically due to cancer
Other significant health problems
Major surgery within the past 6 months or planned surgery within the timeframe of the study
Current disability litigation
Use of electronic cigarettes or other non-cigarette tobacco products \> 9 of the past 30 days
Current use of nicotine replacement therapy or other cessation treatment
Current daily or near-daily cannabis use
History of psychotic disorder
Acute suicidality or current unstable psychiatric disorder
Positive pregnancy test
Actively seeking smoking cessation treatment
  • Nicotine Dependence as measured by the Fagerstrom Test of Cigarette Dependence (FTCD)Baseline and weekly during study cigarette use (4 weeks)

    The FTCD has a total score of 0 to 10, where a greater score indicates a greater physical dependence on nicotine.

  • Cigarettes per DayBaseline and weekly during study cigarette use (4 weeks)

    Average cigarettes smoked per day during the past week will be calculated using timeline follow-back methods

  • Pain as measured by the Brief Pain Inventory (BPI)Baseline, during abstinence sessions, and at weekly visits during study cigarette use (4 weeks)

    The BPI has an averaged score of 0 to 10, where a greater score indicates greater pain.

  • Mechanical HyperalgesiaWeekly visits 1 and 5 during study cigarette use (4 weeks), and during abstinence sessions

    Mechanical hyperalgesia is a condition that causes increased sensitivity to mechanical stimuli after an injury to the skin. Discriminability and response bias will be assessed using a computerized pressure algometer.

  • Smoking Withdrawal as measured by the Minnesota Withdrawal Scale (MNWS)Baseline, during abstinence sessions, and at weekly visits during study cigarette use (4 weeks)

    The MNWS has a total score range of 0 to 68, where a higher score indicates greater symptoms of withdrawal.

  • Cigarette Craving as measured by the Questionnaire of Smoking Urges-Brief (QSU-B)Baseline, during abstinence sessions, and at weekly visits during study cigarette use (4 weeks)

    The QSU-B has a total score range of 0 to 100, where a higher score indicates greater craving.

  • Cigarette Purchase Task - demand intensityWeekly visits 1 and 5 during study cigarette use (4 weeks), and during abstinence sessions

    Outcomes for the cigarette purchase task will include demand intensity (i.e., consumption at $0) and Omax (i.e., max expenditure at any price point).

  • Cigarette Purchase Task - OmaxWeekly visits 1 and 5 during study cigarette use (4 weeks), and during abstinence sessions

    Outcomes for the cigarette purchase task will include demand intensity (i.e., consumption at $0) and Omax (i.e., max expenditure at any price point).

  • Pain-Smoking Associations as measured by Ecological Momentary Assessment (EMA)Baseline, weeks 1 and 4 of study cigarette use

    EMA (also called experience sampling or daily diary method) involves repeated sampling of people's current experiences (e.g. pain) in real time in their natural environments.

  • Buprenorphine-smoking associations as measured by Ecological Momentary Assessment (EMA) - smoking frequencyBaseline, weeks 1 and 4 of study cigarette use

    Within-person variability in smoking frequency assessed via EMA before and after buprenorphine administration.

  • Buprenorphine-smoking associations as measured by Ecological Momentary Assessment (EMA) - cravingBaseline, weeks 1 and 4 of study cigarette use

    Within-person variability in smoking craving assessed via EMA before and after buprenorphine administration.

  • Opioid Withdrawal as measured by the Short Opioid Withdrawal Scale (SOWS)Baseline, during abstinence sessions, and at weekly visits during study cigarette use (4 weeks)

    The SOWS consists of 16 symptoms rated in intensity by patients on a 5-point scale of intensity as follows: 0-not at all, 1-a little, 2-moderately, 3-quite a bit, 4-extremely. The total score ranges from 0 to 64, where a higher score indicates greater symptoms of withdrawal.