Reducing the relative value of cigarettes: Considerations for nicotine and non-nicotine factors

White, Cassidy M.; Hatsukami, Dorothy K.; Donny, Eric C.

doi:10.1016/j.neuropharm.2020.108200

Cited by 12 publications

(9 citation statements)

References 95 publications

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“…Most syntheses that examined a very low nicotine content (VLNC) standard broadly summarised the existing evidence base and outlined evidence gaps,5 28–30 32–37 rather than answering specific research questions. All evidence syntheses on this topic concluded that the policy is likely to result in a notable reduction in cigarette smoking.…”

Section: Resultsmentioning

confidence: 99%

“…Most authors of evidence syntheses on this topic called for more research on the potential individual-level and population-level impacts of the policy,5 29 30 37 39 including on mental and physical health outcomes,37 38 46 51 and/or on priority populations 28 29 32 37 44–46 49. Several noted that the interaction of smoking VLNC cigarettes with alternative nicotine product use remains an evidence gap 35 36 52. Some authors concluded that the remaining gaps in the evidence base should not prevent regulators from progressing policy making on a VLNC standard 36…”

Section: Resultsmentioning

confidence: 99%

“…Potential limitations of the policy include some people reducing cigarettes smoked per day but not achieving cessation, or continuing to use cigarettes for a multitude of reasons other than nicotine addiction, 35 public misperceptions that VLNC cigarettes are harmful 50 and potential (short-term) negative impacts on behavioural and cognitive performance following a rapid reduction in nicotine. 36 51 Canada, 64 Singapore, 55 Solomon Islands 59 3 60…”

Section: Mandatory Very Low Nicotine Content Standardmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Mandatory Very Low Nicotine Content Standardmentioning

confidence: 99%

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Closing the gaps in tobacco endgame evidence: a scoping review

et al. 2022

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“…In contrast, maintaining access to cigarette-like nicotine reinforcement in non-combusted products, such as e-cigarettes, could potentially mitigate withdrawal symptoms and provide a satisfying alternative, while effectively reducing harm to people who smoke. Consequently, the public health impact of reducing nicotine in cigarettes will likely depend on what alternative nicotine products are available to people who smoke ( Hatsukami et al., 2017 ; Abrams & Notely, 2020 ; White, Hatsukami, & Donny, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

A review of the evidence on cigarettes with reduced addictiveness potential

Donny

White

2022

International Journal of Drug Policy

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Background In May 2018, the Secretariat for the World Health Organization Framework Convention on Tobacco Control convened a meeting to discuss the potential for reducing the addictiveness of tobacco products. A central focus was to review research findings on the behavioral effects of reducing the addictiveness of cigarettes. Methods This manuscript reports the results of a review of the behavioral science literature, updated through April 2021, with special attention to both the potential benefits and unintended consequences of reducing nicotine in cigarettes. Results Available evidence suggests that reducing nicotine content in cigarettes to very low levels could benefit public health in three primary ways, by 1) decreasing uptake of regular smoking, 2) decreasing the amount people smoke, and 3) increasing the likelihood of smoking cessation. Current evidence also suggests that reducing nicotine in cigarettes may produce similar benefits across many important subpopulations of people who smoke, including those with psychiatric comorbidities, those who use other substances, those with low socioeconomic status, young people, people who smoke infrequently and people who prefer menthol cigarettes. Cigarette nicotine reduction could also lead to some undesirable outcomes, such as experiencing withdrawal, product manipulation, an illicit market, and harm misperceptions; strategies that may mitigate each are discussed. Conclusion Overall, behavioral research suggests product standards that limit the nicotine content of combusted tobacco products could render cigarettes and similar products less addictive. The availability of legal, non-combusted products that effectively substitute for cigarettes and the dissemination of public health campaigns that clarify misperceptions about the relationship between nicotine, tobacco and disease may facilitate the extent to which a nicotine reduction policy reduces smoking.

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“…Over the years, The Journal of Clinical Pharmacology has been a leader in publishing articles that inform clinicians about the clinical pharmacology of drugs of abuse. These articles are highly regarded and extensively downloaded 1–15 . This supplement extends that commitment to clinician education by bringing articles together in one place that address the major classes of drugs of abuse from a clinical pharmacology perspective.…”

mentioning

confidence: 99%