Investigating tobacco withdrawal in response to reduced nicotine cigarettes among smokers with opioid use disorder and other vulnerabilities.

Streck, Joanna M.; Sigmon, Stacey C.; Priest, Jeffrey S.; Bergeria, Cecilia L.; Davis, Danielle R.; Hughes, John R.; Villanti, Andrea C.; Tidey, Jennifer W.; Heil, Sarah H.; Gaalema, Diann E.; Stitzer, Maxine L.; Higgins, Stephen T.

doi:10.1037/pha0000350

Cited by 6 publications

(12 citation statements)

References 45 publications

(60 reference statements)

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“…Prior research has shown that elevated depression symptoms associated with greater cigarette withdrawal during a past quit attempt reported retrospectively (Tsoh et al, 2003), measured across 3 days of biochemically verified abstinence (Pomerleau et al, 2005), and in response to reduced nicotine cigarettes (Streck et al, 2020). The current study extends these findings by suggesting that people with elevated depression symptoms who smoke may experience elevated withdrawal during periods of both abstinence and non-abstinence.…”

Section: Discussionsupporting

confidence: 67%

“…One laboratory-based study in people with elevated baseline depression symptoms who smoke, found that smoking research cigarettes with varying levels of nicotine following cigarette abstinence associated with greater cigarette withdrawal (Streck et al, 2020). However, this study did not report an effect of depression symptom level on withdrawal when participants smoked their usual brand cigarettes or during periods of non-abstinence (Streck et al, 2020) so these effects may be specific to DEPRESSION, SMOKING, LAB STUDY smoking cigarettes with reduced nicotine levels during abstinence. Another laboratory-based study reported people with elevated depression symptoms who smoke (vs. low depression symptoms) experienced more intense cigarette withdrawal across 3 days of biochemically verified abstinence (Pomerleau et al, 2005), but did not assess withdrawal during nonabstinence.…”

Section: Introductionmentioning

confidence: 64%

“…However, other studies did not find significant associations of general baseline depression symptoms and cigarette withdrawal during a cessation attempt (Copeland et al, 2009;Schnoll et al, 2013). One laboratory-based study in people with elevated baseline depression symptoms who smoke, found that smoking research cigarettes with varying levels of nicotine following cigarette abstinence associated with greater cigarette withdrawal (Streck et al, 2020). However, this study did not report an effect of depression symptom level on withdrawal when participants smoked their usual brand cigarettes or during periods of non-abstinence (Streck et al, 2020) so these effects may be specific to DEPRESSION, SMOKING, LAB STUDY smoking cigarettes with reduced nicotine levels during abstinence.…”

Section: Introductionmentioning

confidence: 99%

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Association of depression symptom level with smoking urges, cigarette withdrawal, and smoking reinstatement: A preliminary laboratory study

Tucker

Bello

Weinberger

et al. 2022

Drug and Alcohol Dependence

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Background: Cigarette smoking urges, withdrawal, and smoking reinstatement may be especially relevant to people with elevated depression symptoms who smoke. This laboratory study aimed to assess relations between depression symptom level and smoking urges for reward and relief, cigarette withdrawal, and smoking reinstatement in people who smoke cigarettes daily during acute abstinence and while smoking as usual. Methods: Participants with low (n=51) or elevated (n=29) baseline depression symptoms underwent two counterbalanced laboratory sessions (i.e., abstinent, non-abstinent). At each session, they completed subjective measures of smoking urges for reward and relief, and withdrawal. They also completed a laboratory smoking reinstatement task measuring whether they would delay smoking and the number of cigarettes smoked. Results: The elevated depression symptom group reported significantly higher withdrawal (p=.01) and smoked more cigarettes than the low depression symptoms group during the smoking reinstatement task self-administration period at the abstinent session (p=.04).Smoking urges for reward and relief were not significantly different by depression symptom group. There were no significant interactions of depression and abstinence with any outcomes. Conclusions:As outcomes were measured at both an abstinent and non-abstinent session, findings identify factors for people with elevated depression symptoms who smoke which may drive smoking behavior and impede smoking cessation efforts. This study provides evidence that people with elevated depression symptoms who smoke may need additional/more 3 DEPRESSION, SMOKING, LAB STUDY pharmacological or behavioral smoking cessation aids targeted at reducing withdrawal and number of cigarettes smoked.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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Association of depression symptom level with smoking urges, cigarette withdrawal, and smoking reinstatement: A preliminary laboratory study

Tucker

Bello

Weinberger

et al. 2022

Drug and Alcohol Dependence

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“…Similar analyses on marijuana use suggest that switching to low nicotine cigarettes is likely to benefit people regardless of marijuana use status and is unlikely to alter the prevalence or frequency of cannabis use ( Pacek et al., 2016 ). Finally, nicotine reduction clinical trials enrolling people who use opioids found that this smoking population also experienced lower smoking rates and decreased nicotine dependence severity after using low nicotine cigarettes, relative to normal nicotine cigarettes ( Higgins et al., 2017 , Higgins et al., 2020 ; Streck et al., 2020 ). Overall, evidence does not support that nicotine reduction affects people who use other drugs uniquely, nor that nicotine reduction leads to the compensatory use of other substances.…”

Section: Resultsmentioning

confidence: 99%

A review of the evidence on cigarettes with reduced addictiveness potential

Donny

White

2022

International Journal of Drug Policy

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Background In May 2018, the Secretariat for the World Health Organization Framework Convention on Tobacco Control convened a meeting to discuss the potential for reducing the addictiveness of tobacco products. A central focus was to review research findings on the behavioral effects of reducing the addictiveness of cigarettes. Methods This manuscript reports the results of a review of the behavioral science literature, updated through April 2021, with special attention to both the potential benefits and unintended consequences of reducing nicotine in cigarettes. Results Available evidence suggests that reducing nicotine content in cigarettes to very low levels could benefit public health in three primary ways, by 1) decreasing uptake of regular smoking, 2) decreasing the amount people smoke, and 3) increasing the likelihood of smoking cessation. Current evidence also suggests that reducing nicotine in cigarettes may produce similar benefits across many important subpopulations of people who smoke, including those with psychiatric comorbidities, those who use other substances, those with low socioeconomic status, young people, people who smoke infrequently and people who prefer menthol cigarettes. Cigarette nicotine reduction could also lead to some undesirable outcomes, such as experiencing withdrawal, product manipulation, an illicit market, and harm misperceptions; strategies that may mitigate each are discussed. Conclusion Overall, behavioral research suggests product standards that limit the nicotine content of combusted tobacco products could render cigarettes and similar products less addictive. The availability of legal, non-combusted products that effectively substitute for cigarettes and the dissemination of public health campaigns that clarify misperceptions about the relationship between nicotine, tobacco and disease may facilitate the extent to which a nicotine reduction policy reduces smoking.

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“…One study focused on perceptions of five endgame policies (mandating a VLNC standard for tobacco products, setting product standards (removing additives from tobacco), reduced risk products, tobacco tax increases and restrictions on the number of tobacco retailers) among people on a low income in Aotearoa (New Zealand),43 while the remaining 17 studies described the impacts of mandating VLNC for smoked tobacco products to make them non-addictive or minimally addictive among participants based in the USA. The authors of 14 of these 17 studies are affiliated with the same research centre (the Center for Alcohol and Addiction Studies at Brown University in the USA) 44–55…”

Section: Resultsmentioning

confidence: 99%

Tobacco endgame and priority populations: a scoping review

et al. 2023

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AimTo summarise the research literature on the impacts or perceptions of policies to end tobacco use at a population level (ie, tobacco endgame policies) among people from eight priority population groups (experiencing mental illness, substance use disorders, HIV, homelessness, unemployment or low incomes, who identify as lesbian, gay, bisexual, transgender, queer or intersex (LGBTQI+) or who have experienced incarceration).MethodsGuided by JBI Scoping Review Methodology, we searched six databases for original research examining the impacts or perceptions of 12 tobacco endgame policies among eight priority populations published since 2000. We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.ResultsOf the 18 included studies, one described perceptions of five endgame policies among people on low incomes in Aotearoa (New Zealand), and 17 focused on the effectiveness or impacts of a very low nicotine content (VLNC) cigarette standard among people experiencing mental illness (n=14), substance use disorders (n=8), low incomes (n=6), unemployment (n=1) or who identify as LGBTQI+ (n=1) in the USA. These studies provide evidence that VLNC cigarettes can reduce tobacco smoking, cigarette cravings, nicotine withdrawal and nicotine dependence among these populations.ConclusionsMost of the tobacco endgame literature related to these priority populations focuses on VLNC cigarettes. Identified research gaps include the effectiveness of endgame policies for reducing smoking, impacts (both expected and unexpected) and policy perceptions among these priority populations.

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Investigating tobacco withdrawal in response to reduced nicotine cigarettes among smokers with opioid use disorder and other vulnerabilities.

Cited by 6 publications

References 45 publications

Association of depression symptom level with smoking urges, cigarette withdrawal, and smoking reinstatement: A preliminary laboratory study

Association of depression symptom level with smoking urges, cigarette withdrawal, and smoking reinstatement: A preliminary laboratory study

A review of the evidence on cigarettes with reduced addictiveness potential

Tobacco endgame and priority populations: a scoping review

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