Response to varying the nicotine content of cigarettes in vulnerable populations: an initial experimental examination of acute effects

Key Takeaways

• There was no evidence of compensatory smoking with VLNC cigarettes in these vulnerable populations and there were significant reductions in nicotine withdrawal and cravings with VLNC cigarettes

• These initial results in more vulnerable populations of smokers are encouraging regarding the feasibility of a national policy to reduce the nicotine content of cigarettes to very low levels without substantial adverse effects

• Funded by a Tobacco Centers of Regulatory Science (TCORS) award (P50DA036114) from the National Institute on Drug Abuse and Food and Drug Administration

Abstract

• Rationale: The purpose of this study was to begin researching the effects of very low nicotine content cigarettes in smokers especially vulnerable to dependence to assess their potential as a less dependence-producing alternative to current commercial cigarettes.

• Methods: Participants were 26 adult, daily cigarette smokers from one of three populations: economically disadvantaged women of reproductive age (n = 9), opioid-dependent individuals (n = 11), and individuals with affective disorders (n = 6). Participants completed fourteen 2-4-h experimental sessions in a within-subjects research design. Sessions were conducted following brief smoking abstinence. Four research cigarettes varying in nicotine content (0.4, 2.4, 5.2, and 15.8 mg/g) were studied under double-blind conditions, assessing smoking topography, subjective effects, and relative reinforcing effects of varying doses in concurrent choice tests. Results were collapsed across vulnerable populations and analyzed using repeated measures ANOVA.

• Results: No significant differences between doses were discernible in smoking topography. All doses were equi-effective at reducing nicotine withdrawal. Ratings of satisfaction from smoking were lower at the 0.4 compared to 15.8 mg/g dose. Participants preferred the 15.8 mg/g dose over the 0.4 and 2.4 but not the 5.2 mg/g doses in concurrent choice testing; no differences between the two lowest doses were noted.

• Conclusions: All cigarettes effectively reduced nicotine withdrawal with no differences in smoking topography, suggesting minimal compensatory smoking. Dependence potential was lowest at the 0.4 mg/g dose. These initial results are promising regarding the feasibility of lowering nicotine content in cigarettes to very low levels in vulnerable populations without untoward effects.