Reduced Nicotine Content Cigarettes and Nicotine Patch – Follow-up Study

April 19, 2013

University of Minnesota Masonic Cancer Center

Hatsukami et al. – June 2013, Cancer Epidemiology, Biomarkers & Prevention. 22:1015-1024

Key Takeaways

  • VLNC cigarettes produced significantly better results than FDA-approved nicotine lozenges; even those smokers who ultimately didn’t quit ended up reducing their cigarette consumption from 19 cigarettes per day to 12 cigarettes per day
  • Very Low Nicotine Content cigarettes were associated with greater relief of withdrawal than the nicotine lozenge
  • Funded by the National Institutes of Health (NIH), (grant id: R01 DA025598 and U54DA031659)


  • Background: Reduced nicotine content (RNC) cigarettes have led to smoking fewer cigarettes, withdrawal relief, and facilitation of cessation. The aim of this study is to examine the effects RNC cigarettes with and without nicotine patch and patch alone on smoking behavior, toxicant exposure, withdrawal discomfort, and as an exploratory analysis, on long-term abstinence.
  • Methods: This study involved a randomized, parallel arm design and six weeks of: (i) 0.05-0.09 mg nicotine yield cigarettes (N = 79); (ii) 21 mg nicotine patch (N = 80), or (iii) 0.05-0.09 nicotine yield cigarettes with 21 mg nicotine patch (N = 76); all groups received six weeks of additional behavioral treatment with follow-ups up to six months.
  • Results: Combination approach led to lower rates of smoking assigned cigarettes and hence lower carbon monoxide levels than RNC cigarettes alone. In addition, the combination approach was associated with less withdrawal severity when switching from usual brand to assigned product, and less smoking of usual brand cigarettes during treatment, but not after treatment compared with the other approaches.
  • Conclusion: Combining very low nicotine content cigarettes with nicotine patch may improve the acute effects resulting from switching to either of these products alone.
  • Impact: These findings may have implications for smoking cessation treatment or a policy measure to reduce nicotine content in cigarettes.