Randomized Trial of Low-Nicotine Cigarettes and Transdermal Nicotine

Smith, Tracy T.; Koopmeiners, Joseph S.; Tessier, Katelyn M.; Davis, Esa M.; Conklin, Cynthia A.; Denlinger-Apte, Rachel L.; Lane, Tonya; Murphy, Sharon E.; Tidey, Jennifer W.; Hatsukami, Dorothy K.; Donny, Eric C.

doi:10.1016/j.amepre.2019.05.010

Cited by 33 publications

(29 citation statements)

References 23 publications

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“…1 , 2 , 3 , 4 , 5 , 6 Studies in the general population of smokers demonstrate that reducing nicotine content in cigarettes to very low levels decreases smoking rate and dependence severity with minimal compensatory smoking (ie, smoking adjustments to sustain desired nicotine blood levels). 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 Overrepresentation of smoking among populations with psychiatric conditions and socioeconomic disadvantage requires examination of how these high-risk populations respond to reduced nicotine–content cigarettes. 1 , 2 , 3 , 4 , 5 , 6 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 …”

Section: Introductionmentioning

confidence: 99%

Changes in Cigarette Consumption With Reduced Nicotine Content Cigarettes Among Smokers With Psychiatric Conditions or Socioeconomic Disadvantage

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Changes in Cigarette Consumption With Reduced Nicotine Content Cigarettes Among Smokers With Psychiatric Conditions or Socioeconomic Disadvantage

et al. 2020

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“…Since nicotine is the primary reinforcing constituent in cigarettes that contributes to establishing and maintaining smoking behavior, drastically reducing the allowable nicotine content could prevent adolescents from becoming dependent on cigarettes and help people who currently smoke cigarettes to quit or cut down [ 10 , 11 ]. Indeed, results from clinical trials consistently report reductions in smoking behavior, toxicant exposure, and nicotine dependence among adult smokers who switched to low nicotine content (LNC) cigarettes [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Such trials also report minimal evidence of the following potential unintended consequences: compensatory smoking behavior due to decreased nicotine levels, exacerbation of psychiatric symptoms, or increases in alcohol or cannabis use among adults smoking LNC cigarettes [ 12 , 16 , 17 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Perceptions of Low Nicotine Cigarettes and Alternative Nicotine Products across Priority Smoking Populations

Denlinger-Apte

Pacek

Ross

et al. 2021

IJERPH

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Background: As the U.S. Food and Drug Administration considers a low nicotine product standard for cigarettes, it is important to examine how people who smoke, especially individuals from priority populations disproportionately affected by smoking, perceive low nicotine content (LNC) cigarettes and their relative risk perceptions of alternative nicotine delivery system (ANDS) products, including e-cigarettes and snus, and medicinal nicotine. Methods: Data are from Wave 4 (2016–2017) of the adult Population Assessment of Tobacco Use and Health (PATH) Study. We examined respondents’ absolute risk perceptions about nicotine, LNC cigarettes, ANDS products and medicinal nicotine; their relative risk perceptions of LNC cigarettes and ANDS products compared to conventional cigarettes; and their relative risk perceptions of medicinal nicotine compared to ANDS products. Results: The majority of respondents across priority smoking populations indicated snus, e-cigarettes, and LNC cigarettes were ‘about the same’ level of harmfulness or addictiveness as conventional cigarettes. The majority of respondents indicated e-cigarettes to be ‘about the same’ harmfulness as medicinal nicotine. Conclusions: Our study indicates that adults who smoke cigarettes generally have misperceptions about the harms of nicotine and the relative risks of ANDS products and such misperceptions exist regardless of their racial/ethnic identity, sexual orientation, and gender identity.

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“…Evidence from clinical trials investigating nicotine reduction is encouraging. Several studies show that assignment to very low nicotine content (VLNC) cigarettes reduces the number of cigarettes smoked per day (CPD) and nicotine dependence and increases attempts to quit smoking (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Exclusive Use of Very Low Nicotine Cigarettes on Compensatory Smoking: An Inpatient Crossover Clinical Trial

Smith

Koopmeiners

White

et al. 2020

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: The FDA is considering a mandated reduction in the nicotine content of cigarettes. Clinical trials have been limited by non-study cigarette use (noncompliance), which could mask compensation. The goal of this study was to assess whether compensation occurs when smokers provided with very low nicotine cigarettes cannot access normal nicotine cigarettes.Methods: In a within-subjects, crossover design, current smokers (n ¼ 16) were confined to a hotel for two 4-night hotel stays during which they were only able to access the research cigarettes provided. The hotel stays offered normal nicotine cigarettes or very low nicotine content (VLNC) cigarettes, in an unblinded design, available for "purchase" via a study bank.Results: In the context of complete compliance with the study cigarettes (n ¼ 16), there was not a significant increase during the VLNC condition for cigarettes smoked per day, expired carbon monoxide, or N-acetyl-S-(cyanoethyl)-L-cysteine (cyanoethyl-MA, metabolite of acrylonitrile). There was a significant nicotine Â time interaction on urine N-acetyl-S-(3-hydroxypropyl)-L-cysteine (hydroxypropyl-MA, metabolite of acrolein), driven by an increase in the VLNC condition during the first 24 hours. By the end of the VLNC condition, there was no evidence of compensation across any measure of smoking or smoke exposure.Conclusions: Among current smokers who exclusively used VLNC cigarettes for 4 days, there was no significant compensatory smoking behavior.Impact: These data, combined with the larger body of work, suggest that a mandated reduction in nicotine content is unlikely to result in an increase in smoking behavior to obtain more nicotine.

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Randomized Trial of Low-Nicotine Cigarettes and Transdermal Nicotine

Cited by 33 publications

References 23 publications

Changes in Cigarette Consumption With Reduced Nicotine Content Cigarettes Among Smokers With Psychiatric Conditions or Socioeconomic Disadvantage

Changes in Cigarette Consumption With Reduced Nicotine Content Cigarettes Among Smokers With Psychiatric Conditions or Socioeconomic Disadvantage

Risk Perceptions of Low Nicotine Cigarettes and Alternative Nicotine Products across Priority Smoking Populations

The Impact of Exclusive Use of Very Low Nicotine Cigarettes on Compensatory Smoking: An Inpatient Crossover Clinical Trial

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