Nicotine Reduction: Strategic Research Plan

Abstract

background: Reducing nicotine content in cigarettes and other combustible products to levels that are not reinforcing or addictive has the potential to substantially reduce tobacco-related morbidity and mortality. The authority to reduce nicotine levels as a regulatory measure is provided in the U.S. Family Smoking Prevention and Tobacco Control Act and is consistent with the general regulatory powers envisioned under the relevant articles of the World Health Organization's Framework Convention on Tobacco Control. Many experts have considered reducing nicotine in cigarettes to be a feasible national policy approach, but more research is necessary.

Effects of 6-Week Use of Reduced-Nicotine Content Cigarettes in Smokers With and Without Elevated Depressive Symptoms

“…Due to the over-representation of depressive symptoms and related mental health conditions among current smokers, understanding how these smokers respond to RNC cigarettes is essential to consider when determining how to best implement a nicotine reduction policy. 30,31 The current study is a secondary analysis of the recent large clinical trial of RNC cigarettes 21 and aimed to examine how baseline depressive symptom severity affected responses to RNC cigarettes. Based on the poorer responses of smokers with elevated depressive symptoms to smoking cessation treatments, we hypothesized that participants with elevated depressive symptoms who were assigned to RNC cigarette use during the study would be less likely than those with lower depressive symptoms to experience reductions in cigarettes per day, nicotine exposure, nicotine dependence, and cigarette craving, would be less compliant with RNC cigarettes, and would be less likely to make a quit attempt after the study.…”

Let actual markets help assess the worth of optional very-low-nicotine cigarettes before deciding on mandatory regulations

“…[2,3]). The strategy proposes that, for the good of public health, the only cigarettes that should be sold legally must contain such low levels of nicotine in the tobacco that they would not create or support addiction.…”

“…The nicotine-reduction strategy should be part of a comprehensive tobacco/nicotine control system [2,3,6]. Accompanying regulations and policies that minimize use of the most dangerous tobacco products (combustibles) are seen as important for the strategy [3,5,8,9,14], but these supporting steps should be taken as soon as possible, and without mandatory low-nicotine cigarettes.…”

“…Accompanying regulations and policies that minimize use of the most dangerous tobacco products (combustibles) are seen as important for the strategy [3,5,8,9,14], but these supporting steps should be taken as soon as possible, and without mandatory low-nicotine cigarettes. The proponents of the low-nicotine-cigarette strategy argue that public education is needed to inform consumers of differential product risks and the risks of cigarettes and other combustibles.…”

Nicotine Dependence, Nicotine Metabolism, and the Extent of Compensation in Response to Reduced Nicotine Content Cigarettes

“…1 A number of other papers have discussed the proposal and the research needed to support this type of regulatory intervention, and provided initial data to support this approach. [2][3][4][5] Research priorities of the FDA for tobacco regulation include studying how a reduction in nicotine or reduced nicotine content cigarettes (RNC) may result in reduced nicotine dependence and how this decrease could be influenced by individual differences. 6 In response to reduced nicotine delivery from cigarettes, smokers may compensate by smoking more cigarettes and/or smoking more intensely.…”