Progressively reducing the nicotine content of cigarettes may not lead smokers to quit

The US Family Smoking Prevention and Tobacco Control Act, passed in 2009, permits the U.S. Food and Drug Administration (FDA) to set standards for cigarette nicotine content. The FDA is accordingly supporting research into how very low nicotine content (VLNC) cigarettes might function as a regulatory measure to make cigarettes non-addictive, reduce smoke exposure, and improve public health, even among people who don’t want to quit smoking.

New research published today in the scientific journal Addiction shows that simply reducing the nicotine content of cigarettes may not be enough to eliminate smoking dependence.

In this two-year study involving 135 smokers, those in the test group smoked five levels of progressively lower nicotine content cigarettes over the course of one year, the lowest nicotine content cigarette being smoked for 7 months. Participants in the control group smoked their usual brand of cigarettes for 12 months. All subjects were then followed for another 12 months after returning to their own cigarettes or quitting. The idea being tested was that progressively reducing nicotine intake from cigarettes would make smokers less dependent and more likely to quit.

During the 12-month follow-up, the lower levels of cotinine (a nicotine derivative found in plasma that provides an accurate record of the nicotine intake from smoking in recent days) in test group subjects returned to levels similar to smokers in the control group, suggesting that they had returned to their former levels of smoking. Quitting among test group members remained low: at 24 months the percent of smokers in the test group who quit smoking was not significantly higher than that of the control group.

Lead author Dr Neal Benowitz explains “We don’t know that very low nicotine cigarettes will not’ work to reduce nicotine dependence and enhance quitting, but progressively reducing nicotine content of cigarettes in the way we did, without other means of supporting smokers, did not produce the desired results.”


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