“I actually finally feel like the cigarettes aren't controlling me.” – Interviews with participants smoking very low nicotine content cigarettes during a residential study

Rachel L. Denlinger-Apte, Cassidy M. White, Eric C. Donny, Dorothy K. Hatsukami, Neal L. Benowitz, Matthew J. Carpenter, Tracy T. Smith

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The U.S. Food and Drug Administration (FDA) is considering a low-nicotine product standard for cigarettes. The purpose of this qualitative study was to explore participants’ experiences after 72 hours of exclusively smoking very low nicotine content (VLNC) cigarettes. Methods: We conducted a residential study during which participants who smoked cigarettes (N = 16) stayed in a smoking-friendly hotel for 5 days/4 nights. Participants only had access to VLNC cigarettes and were told the cigarettes had 97% less nicotine compared to conventional cigarettes. We conducted individual interviews with participants to assess their initial expectations about VLNC cigarettes, subjective experiences when smoking VLNC cigarettes, opinions regarding a low-nicotine product standard, and predicted use behavior if only VLNC cigarettes were available. Interviews were transcribed verbatim and analyzed using thematic analysis methods. Results: Several participants expected, prior to trying VLNC cigarettes, to compensate for the reduced nicotine levels by smoking more cigarettes but were surprised when they did not increase their smoking. A subset of participants reported experiencing minor withdrawal symptoms, such as irritability and fatigue. Several participants reported feeling less dependent after exclusively smoking VLNC cigarettes. Most participants said they would smoke VLNC cigarettes if they were the only cigarettes available to purchase. Some also said that smoking VLNC cigarettes could help people taper down or quit smoking. Conclusions: Health communication strategies are needed to inform people who smoke about what to expect from a low-nicotine product standard for cigarettes in order to maximize the public health impact of the policy and increase support.

Original languageEnglish (US)
Article number108465
JournalDrug and alcohol dependence
Volume219
DOIs
StatePublished - Feb 1 2021

Bibliographical note

Funding Information:
Research supported by grants from the National Institute on Drug Abuse (NIDA), National Cancer Institute (NCI) and Food and Drug Administration (FDA) Center for Tobacco Products (R03DA045197, K01DA047433 ? Smith; R36DA045183, R03CA252767 ? Denlinger-Apte; T32CA122061 ? Avis, Foley; U54DA031659 ? Donny). Research also supported in part by the Qualitative and Patient-Reported Outcomes Shared Resource of the Wake Forest Baptist Comprehensive Cancer Center's NCI Cancer Center Support Grant P30CA012197 and the Wake Forest Clinical and Translational Science Institute's NCATS Grant UL1TR001420. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH or FDA.

Funding Information:
Research supported by grants from the National Institute on Drug Abuse (NIDA) , National Cancer Institute (NCI) and Food and Drug Administration (FDA) Center for Tobacco Products (R03DA045197, K01DA047433 – Smith; R36DA045183, R03CA252767 – Denlinger-Apte; T32CA122061 – Avis, Foley; U54DA031659 – Donny). Research also supported in part by the Qualitative and Patient-Reported Outcomes Shared Resource of the Wake Forest Baptist Comprehensive Cancer Center’s NCI Cancer Center Support Grant P30CA012197 and the Wake Forest Clinical and Translational Science Institute’s NCATS Grant UL1TR001420 . The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH or FDA.

Publisher Copyright:
© 2020 Elsevier B.V.

Keywords

  • Nicotine
  • Policy
  • Smoking

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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