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Lower nicotine cigarettes may hinder addiction in at-risk groups

Cigarettes with lower nicotine content may decrease addiction potential among individuals highly vulnerable to tobacco addiction.

“A regulatory question fundamental to protecting public health is whether the nicotine content of cigarettes can be set below a threshold dose necessary to produce or sustain addiction. This would allow current smokers to make more rational choices about continuing to smoke while lowering addiction risk among those newly introduced to smoking,” Stephen T. Higgins, PhD, of University of Vermont Tobacco Center of Regulatory Science, Burlington, and colleagues wrote.

To assess effects of cigarettes with reduced nicotine content among smokers with psychiatric disorders and other vulnerabilities to tobacco addiction, researchers conducted a multisite, double-blind, within-participant assessment of acute response to research cigarettes among 169 daily smokers. Cigarettes included 0.4 mg/g, 2.3 mg/g, 5.2 mg/g, and 15.8 mg/g of tobacco, ranging from below a hypothesized addiction threshold to levels comparable to commercial cigarettes. The study cohort included 56 smokers with affective disorders, 60 with opioid dependence, and 53 socioeconomically disadvantaged women. After brief smoking abstinence, participants were exposed to cigarettes with varying nicotine doses over 14 outpatient sessions that were 2- to 4-hours each. Mean age was 35.6 years.

Reducing nicotine content of cigarettes decreased associated reinforcing effects of smoking among all participants.

In concurrent choice testing, the lowest dose, 0.4 mg/g, was chosen significantly less than the 15.8 mg/g dose (30% vs. 70%; P < .001).

The 0.4 mg/g dose also generated lower demand in the Cigarette Purchase Task (P < .001).

Preference for higher vs. lower nicotine content cigarettes could be influenced by increasing the response cost necessary to obtain higher doses (61% vs. 39%; P < .001), according to researchers.

All doses decreased Minnesota Nicotine Withdrawal Scale total scores (P < .001 for all).
owever, Withdrawal symptoms were greater at higher doses (P = .002).

“Our results suggest that a national regulatory policy reducing the nicotine content of cigarettes may reduce the addiction potential of cigarettes and that those effects would extend to populations that are highly vulnerable to tobacco addiction,” the researchers wrote. “In addition, the results suggest how regulatory policies could potentially shift preferences from more to less-harmful tobacco products. Studies of extended exposure to reduced nicotine content cigarettes and studies in populations with other psychiatric conditions are warranted.” – by Amanda Oldt

Disclosure: Higgins reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.