Adolescent smokers’ response to reducing the nicotine content of cigarettes: Acute effects on withdrawal symptoms and subjective evaluations

Rachel N. Cassidy, Suzanne M. Colby, Jennifer W. Tidey, Kristina M. Jackson, Patricia A. Cioe, Suchitra Krishnan-Sarin, Dorothy K Hatsukami

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Background: Mandating a reduction in the nicotine content of cigarettes to a minimally addictive level could dramatically reduce smoking rates in the US. However, little is known about the effects of reduced nicotine content cigarettes in adolescents. Methods: Following overnight abstinence, adolescent daily smokers (ages 15–19, n = 50) reported on their craving, withdrawal, and positive and negative affect pre- and post- ad lib smoking of one cigarette containing varying nicotine content (15.8, 5.2, 1.3 and 0.4 mg/g of tobacco) in the laboratory and reported their subjective evaluations of each cigarette. Carbon monoxide (CO) boost from pre- to post-cigarette was calculated to determine if lower-nicotine cigarettes led to differential acute changes in toxicant exposure. Results: All four nicotine cigarette types significantly reduced abstinence-induced craving, withdrawal, and negative affect (all p's <.05). Mixed models evaluating the effect of nicotine content, with nicotine dependence level and gender included as covariates, revealed a significant effect of nicotine content on craving and subjective evaluations: higher nicotine content resulted in greater reductions in craving and increases in both positive and negative subjective evaluations. There were no significant effects of nicotine dose on withdrawal symptoms, negative affect, or CO boost. Conclusions: These results suggest that lower nicotine cigarettes might result in reduced abuse liability compared to higher nicotine content cigarettes due to reduced positive subjective effects, while still reducing withdrawal, in adolescents. These results highlight the potential feasibility of this policy approach and support continued research on how a nicotine reduction policy may affect adolescent smoking patterns.

Original languageEnglish (US)
Pages (from-to)153-160
Number of pages8
JournalDrug and alcohol dependence
StatePublished - Jul 1 2018

Bibliographical note

Funding Information:
The study was funded by the National Institutes of Health [grant number K01CA189300 ]. Research reported in this publication was supported by NCI and FDA Center for Tobacco Products (CTP) . The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration. Research cigarettes were supplied by NIDA. Neither NIH nor FDA CTP was involved in the study design, data collection, analysis or interpretation of the data, the writing of the manuscript, or the decision to submit the paper for publication.

Publisher Copyright:
© 2018 Elsevier B.V.


  • Adolescent
  • Nicotine
  • Nicotine reduction
  • Regulatory science
  • Smoking


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