Aims: To assess the impact of a reduction in the nicotine content of cigarettes on estimated consumption of reduced nicotine cigarettes and usual brand cigarettes at a variety of hypothetical prices. Design: Double-blind study with participants assigned randomly to receive cigarettes for 6 weeks that were either usual brand or an investigational cigarette with one of five nicotine contents. Setting: Ten sites across the United States. Participants: A total of 839 eligible adult smokers randomized from 2013 to 2014. Intervention and comparator: Participants received their usual brand or an investigational cigarette with one of five nicotine contents: 15.8 (primary control), 5.2, 2.4, 1.3, or 0.4 mg/g. Measurements: The Cigarette Purchase Task was completed at baseline and at the week 6 post-randomization visit. Findings: Compared with normal nicotine content controls, the lowest nicotine content (0.4 mg/g) reduced the number of study cigarettes participants estimated they would smoke at a range of prices [mean reduction relative to 15.8 mg/g at a price of $4.00/pack: 9.50, 95% confidence interval (CI) = 6.81,12.19]. The lowest nicotine content also reduced the maximum amount of money allocated to study cigarettes and the price at which participants reported they would stop buying study cigarettes [median reduction relative to 15.8 mg/g, 95% CI = $8.21 (4.27,12.15) per day and $0.44 (0.17,0.71) per cigarette, respectively]. A reduction in nicotine content to the lowest level also reduced the maximum amount of money allocated to usual brand cigarettes (median reduction relative to 15.8 mg/g: $4.39 per day, 95% CI = 1.88,6.90). Conclusions: In current smokers, a reduction in nicotine content may reduce cigarette consumption, reduce the reinforcement value of cigarettes and increase cessation if reduced nicotine content cigarettes were the only cigarette available for purchase.
Bibliographical noteFunding Information:
The research reported in this publication was supported by the National Institute on Drug Abuse and FDA Center for Tobacco Products (CTP) (U54 DA031659). 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. T.S. was supported by the National Cancer Institute (T32 CA186783). The authors would like to thank all the individuals who were instrumental in conducting the clinical trial, including Rachel L. Denlinger-Apte, Neal L. Benowitz, Ryan G. Vandrey, Mustafa al'Absi, Steven G. Carmella, Paul M. Cinciripini, David J. Drobes, Steve Hecht, Joni Jensen, Joseph Koopmeiners, Tonya Lane, F. Joseph McClernon, Sharon Murphy, Jason D. Robinson, Maxine L. Stitzer, Andrew A. Strasser, Hilary Tindle and all the students, fellows and staff involved in the Center for the Evaluation of Nicotine in Cigarettes.
© 2016 Society for the Study of Addiction
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- End game
- harm reduction
- public policy