Reducing the Nicotine Content of Cigarettes: Effects in Smokers With Mental Health Conditions and Socioeconomic Disadvantages

Tidey, Jennifer W.; Muscat, Joshua E.; Foulds, Jonathan; Evins, A. Eden; Gaalema, Diann E.; Denlinger-Apte, Rachel L.

doi:10.1093/ntr/ntz118

Cited by 7 publications

(9 citation statements)

References 17 publications

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“…[38][39][40][41] One traditional review reported the majority of smoking participants supported a VLNC standard in three surveys (in USA and NZ), while two surveys in the USA reported fewer than half supported the policy. 5 Other topics explored by syntheses on this topic included policy implementation feasibility, 42 43 the impact on use of other nicotine products or other drugs 28 including alcohol 44 and the potential impacts on people experiencing mental illness, 28 45-47 socioeconomic disadvantage, 47 pregnant women, 28 women of childbearing age 48 and Indigenous peoples, 49 with authors of all these syntheses recommending a VLNC standard to achieve a tobacco endgame.…”

Section: Mandatory Very Low Nicotine Content Standardmentioning

confidence: 99%

Closing the gaps in tobacco endgame evidence: a scoping review

et al. 2022

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ObjectiveTobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities.Data sourcesGuided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) for evidence syntheses published in English since 1990 on 12 policies, and Google for publications from key national and international organisations. Reference lists of included publications were hand searched.Study selectionTwo reviewers independently screened titles and abstracts. Inclusion criteria were broad to capture policy impacts (including unintended), feasibility, public and stakeholder acceptability and other aspects of policy implementation.Data extractionWe report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.Data synthesisEight policies have progressed to evidence synthesis stage (49 publications): mandatory very low nicotine content (VLNC) standard (n=26); product standards to substantially reduce consumer appeal or remove the most toxic products from the market (n=1); moving consumers to reduced risk products (n=8); tobacco-free generation (n=4); ending sales (n=2); sinking lid (n=2); tax increases (n=7); and restrictions on tobacco retailers (n=10). Based on published evidence syntheses, the evidence base was most developed for a VLNC standard, with a wide range of evidence synthesised.ConclusionsVLNC cigarettes have attracted the most attention, in terms of synthesised evidence. Additional focus on policies that reduce the availability of tobacco is warranted given these measures are being implemented in some jurisdictions.

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Section: Mandatory Very Low Nicotine Content Standardmentioning

confidence: 99%

Closing the gaps in tobacco endgame evidence: a scoping review

et al. 2022

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“…Clinical trials have shown that daily smokers assigned to very low nicotine cigarettes show decreases in the number of cigarettes smoked, exposure to toxicants and carcinogens and dependence, and increases in quit attempts [75][76][77] and cessation 76,78,79 compared to those who smoke normal nicotine cigarettes. Reductions in smoking and dependence have been observed in non-daily smokers 80,81 , young adults 82,83 , menthol smokers 84 , and those with depressed mood 85 or serious mental illness 86,87 . Reductions in the reinforcing effects of cigarettes has been observed in laboratory studies among youth 88 and in populations likely to experience health disparities such as persons of lower socioeconomic status, with a diagnosis of substance use disorder, and who experience mental health disorders 89 .…”

Section: Moving Forward In Tobacco Harm Reductionmentioning

confidence: 99%

Tobacco harm reduction: Past history, current controversies and a proposed approach for the future

Hatsukami

Carroll

2020

Preventive Medicine

107

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“…Whereas high‐dependence (vs. low‐dependence) participants self‐administered more cigarettes irrespective of study condition, dependence level did not moderate responses to VLNC. Our findings contribute to a growing body of research documenting that desirable VLNC effects extend to vulnerable smokers, including individuals with concurrent mental health conditions and socio‐economic disadvantage 50 . It is hoped that findings from this and other research will contribute to a more nuanced understanding of the safety and efficacy of reducing cigarette nicotine content as a strategy to promote smoking cessation and improve public health.…”

Section: Discussionmentioning

confidence: 57%

Acute effects of a very low nicotine content cigarette on laboratory smoking lapse: Impacts of nicotine metabolism and nicotine dependence

2020

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Reducing cigarette nicotine content to nonaddictive levels facilitates smoking cessation; however, very low nicotine content cigarettes (VLNCs) may not be equally effective across heterogeneous smokers. We evaluated the impact of acute VLNC smoking versus control (sham puffs) on craving, withdrawal and smoking lapse behaviour and whether genetically influenced differences in nicotine metabolism and individual differences in nicotine dependence moderate observed effects. Thirty‐three overnight‐abstinent smokers (15 slow vs. 17 normal nicotine metabolizers; 17 low vs. 16 high nicotine dependence) smoked a 0.05‐mg nicotine VLNC during one session and took sham VLNC puffs during another session, in a counterbalanced order. Craving and withdrawal were assessed before and after smoking and sham puffing. Next, participants completed the McKee Smoking Lapse Task, which measures ability to resist smoking and quantity of ad libitum smoking. VLNC (vs. sham) reduced craving and withdrawal, increased ability to resist smoking and reduced ad libitum smoking. VLNC‐induced reduction in craving for positive reinforcement was greater in slow (vs. normal) metabolizers. Nicotine metabolism did not moderate any other VLNC responses. High‐dependence (vs. low‐dependence) participants engaged in greater ad lib smoking across VLNC and sham conditions. Nicotine dependence did not moderate VLNC responses. VLNC reduced craving, withdrawal and smoking lapse behaviour. Individual differences in nicotine metabolism and dependence had a minimal impact on VLNC responses; however, VLNCs were less effective at reducing craving for positive reinforcement among normal (vs. slow) metabolizers. These findings suggest that desirable VLNC effects may extend across heterogeneous groups of smokers.

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Reducing the Nicotine Content of Cigarettes: Effects in Smokers With Mental Health Conditions and Socioeconomic Disadvantages

Cited by 7 publications

References 17 publications

Closing the gaps in tobacco endgame evidence: a scoping review

Closing the gaps in tobacco endgame evidence: a scoping review

Tobacco harm reduction: Past history, current controversies and a proposed approach for the future

Acute effects of a very low nicotine content cigarette on laboratory smoking lapse: Impacts of nicotine metabolism and nicotine dependence

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