Evaluation of a reduced nicotine product standard: Moderating effects of and impact on cannabis use

Lauren R. Pacek, Ryan Vandrey, Sarah S. Dermody, Rachel L. Denlinger-Apte, Andrine Lemieux, Jennifer W. Tidey, F. Joseph McClernon, Ananta S Bangdiwala, David J. Drobes, Mustafa N al'Absi, Andrew A. Strasser, Joe Koopmeiners, Dorothy K Hatsukami, Eric C. Donny

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Introduction The Family Smoking Prevention and Tobacco Control Act authorized the FDA to reduce the nicotine content in cigarettes. Research is needed to guide proposed regulations, including evaluation of consequences to public health. This study evaluated how a reduced nicotine product standard might be moderated by and impact cannabis use. Methods Secondary analysis of a controlled clinical trial examining the effects of nicotine content in cigarettes in adult daily smokers. Linear regression assessed whether baseline cannabis use moderated behavioral, subjective, or physiological effects of smoking very low nicotine content (VLNC) versus normal nicotine content (NNC) cigarettes. Repeated measures analysis of associations between nicotine condition and prevalence and frequency of cannabis use was completed using generalized estimating equations (GEE). Results Cannabis use did not moderate most of the following effects of VLNC cigarettes: Among cannabis users and non-users, smokers randomized to VLNC cigarettes reported lower nicotine dependence, cigarettes per day, biomarkers of nicotine exposure, and craving compared to smokers randomized to NNC cigarettes. Non-cannabis using smokers randomized to VLNC cigarettes also reported lower smoking dependence motives and had lower tobacco-specific nitrosamine exposure and total puff volume versus smokers randomized to NNC cigarettes. For cannabis users, smokers randomized to VLNC cigarettes reported decreased positive affect. VLNC cigarette use did not impact the prevalence or frequency of cannabis use. Discussion Findings provide evidence that nicotine reduction in cigarettes could have beneficial effects on cigarette smoking regardless of cannabis use. Results suggest that transitioning to VLNC cigarettes is unlikely to alter current rates of cannabis use.

Original languageEnglish (US)
Pages (from-to)228-232
Number of pages5
JournalDrug and alcohol dependence
StatePublished - 2016

Bibliographical note

Funding Information:
Research reported in this publication was supported by the National Institute on Drug Abuse and FDA Center for Tobacco Products (U54 DA031659) . Salary support for LRP during the preparation of this paper was provided by T32DA0079209 and T32AI007329 . 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. Portions of these data were presented at the College on Problems of Drug Dependence 2015 and Tobacco Centers of Regulatory Science 2015 annual meetings.

Publisher Copyright:
© 2016 Elsevier Ireland Ltd


  • Cannabis
  • Cigarette
  • Co-use
  • Comorbidity
  • Marijuana
  • Nicotine
  • Smoking


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