Age moderates smokers’ subjective response to very-low nicotine content cigarettes: Evidence from a randomized controlled trial

Rachel N. Cassidy, Jennifer W. Tidey, Qing Cao, Suzanne M. Colby, Francis J. McClernon, Joseph S. Koopmeiners, Dorothy Hatsukami, Eric C. Donny

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Introduction: Reducing the level of nicotine in cigarettes is a regulatory strategy that has the potential to greatly improve public health. If nicotine levels are reduced in all commercially available cigarettes, current smokers might find it easier to quit and young people might be less likely to become dependent. However, it is not yet known whether age moderates subjective or behavioral responses to low-nicotine cigarettes. Methods: Recently, a large, multisite randomized clinical trial was conducted to compare the effects of cigarettes differing in nicotine content (either usual-brand or research cigarettes containing 15.8, 5.2, 2.4, 1.3, or 0.4 mg nicotine/g tobacco) across 6 weeks of exposure. In this secondary analysis, we tested whether age moderated smokers’ subjective (measures of psychological reward, smoking satisfaction) and behavioral (cigarettes smoked per day, smoking topography, and nicotine exposure) responses to cigarettes varying in nicotine content after 2 and 6 weeks of use, while controlling for baseline dependence and demographic factors. Results: Results indicated that younger adults (age 18–24) who smoked cigarettes with 2.4–0.4 mg/g nicotine reported significantly less smoking satisfaction and psychological reward, and smoked fewer cigarettes per day, than older adults (25+ years) after 2 weeks of use. No differences in topography were observed at either time point. After 6 weeks of use, differences had diminished on all measures. Conclusions: The reduced positive effects of reduced-nicotine content cigarettes in young adults suggests that this regulatory policy may reduce smoking reinforcement in this vulnerable population. Implications: As the FDA considers reducing the level of nicotine in cigarettes to make them less addictive, understanding the potential impact of this policy on young people is of crucial importance. We found that young adults had significantly lower positive subjective effects to very-low nicotine content (VLNC) cigarettes and smoked fewer VLNC cigarettes than older adults after 2 weeks of use, indicating that this policy may reduce smoking reinforcement more quickly in young adults.These data add to the growing body of evidence on the potential for this policy to positively affect public health.

Original languageEnglish (US)
Pages (from-to)962-969
Number of pages8
JournalNicotine and Tobacco Research
Issue number7
StatePublished - Jun 21 2019

Bibliographical note

Funding Information:
The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration. Research supported by a grant from the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products (U54DA031659). Manuscript preparation supported by NCI K01CA189300 (PI Cassidy) and NIDA P50DA036114.

Publisher Copyright:
© The Author(s) 2018.


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