Nicotine reduction revisited: science and future directions

Abstract

Regulation of nicotine levels in cigarettes and other tobacco products is now possible with the passage of the Family Smoking Prevention and Tobacco Control Act (FSPTCA) in 2009 giving the U.S. Food and Drug Administration authority to regulate tobacco products, and with Articles 9-11 of the World Health Organization Framework Convention on Tobacco Control.[1-2] Both regulatory approaches allow establishing product standards for tobacco constituents, including nicotine. The FSPTCA does not allow nicotine levels to be decreased to zero, although FDA has the authority to reduce nicotine yields to very low, presumably non-addicting levels. The proposal to reduce levels of nicotine to a level that is non-addicting was originally suggested in 1994.[3] Reduction of nicotine in tobacco products could potentially have a profound impact on reducing tobacco-related morbidity and mortality. To examine this issue, two meetings were convened in the United States with non-tobacco-industry scientists of varied disciplines, tobacco control policy-makers and representatives of government agencies. This article provides an overview of the current science in the area of reduced nicotine content cigarettes and key conclusions and recommendations for research and policy that emerged from the deliberations of the meeting members.

Impact of Tobacco Regulation on Animal Research: New Perspectives and Opportunities

“…Benowitz and Henningfield (1994) originally recommended a reduction in nicotine levels of all cigarettes over the course of 10-15 years, although recent studies have demonstrated that immediate reduction is also successful in decreasing smoking and even dependence (Donny, Houtsmuller, & Stitzer, 2007;Hatsukami et al, 2010). While arguments could be made for either reduction strategy, the rate of reduction may substantially impact the level to which nicotine content would need to be reduced.…”

“…Hatsukami et al, 2010). That is, some individuals may not stop smoking as a direct result of nicotine reduction, possibly because the nicotine content in cigarettes remains above their individual threshold for reinforcement.…”

“…The demand for this information places responsibility on nicotine and tobacco scientists with a wide range of expertise to answer critical questions related to the FSPTCA and WHO FCTC (Hatsukami et al, 2010).…”

Effects of Monoamine Oxidase Inhibition on the Reinforcing Properties of Low-Dose Nicotine

“…Reducing the nicotine content in cigarettes to a non-addictive level has been suggested as a potential strategy for improving public health because it may decrease the prevalence of smoking (Benowitz and Henningfield, 1994;Hatsukami et al, 2010). A recently completed clinical trial on nicotine reduction showed that individuals who smoked very low nicotine content cigarettes for 6 weeks smoked fewer cigarettes and scored lower on measures of nicotine dependence compared with individuals who smoked cigarettes with a normal nicotine content .…”

Review of hookah tobacco smoking among college students: policy implications and research recommendations

“…Large-scale research is needed to validate this instrument in the population of US college students. This research will enable the FDA to develop empirically derived standards for performance and quality control for hookah tobacco manufacturers with the goal of tobacco harm reduction (107), especially since the FDA is not authorized to ban tobacco products.…”