Predicted Impact of Nicotine Reduction on Smokers with Affective Disorders

Gaalema, Diann E.; Miller, Mollie E.; Tidey, Jennifer W.

doi:10.18001/trs.1.2.5

Cited by 13 publications

(18 citation statements)

References 114 publications

(106 reference statements)

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“…VLNC cigarettes are unlikely to pose a significant threat to smokers with psychiatric disorders 37 38. Smokers with psychiatric disorders commonly quit smoking with standard treatments and experience little deterioration or even improvements in their psychiatric symptoms 37 38.…”

Section: Common Questionsmentioning

confidence: 99%

“…Smokers with psychiatric disorders commonly quit smoking with standard treatments and experience little deterioration or even improvements in their psychiatric symptoms 37 38. Initial studies of smokers with elevated baseline symptoms of depression (Center for Epidemiological Studies—Depression Scale, CES-D, ≥16) or schizophrenia suggest that use of VLNC cigarettes does not exacerbate their symptoms 39 40.…”

Section: Common Questionsmentioning

confidence: 99%

“…For example, participants with elevated baseline symptoms of depression (CES-D ≥16) displayed similar reductions in nicotine exposure, cigarettes per day and dependence as participants with fewer symptoms of depression 39. Nevertheless, given the potential concerns the use of VLNC cigarettes might present in smokers with psychiatric comorbidities,21 37 research is underway and likely to provide more definitive evidence within the next few years, including studies of smokers with affective disorders, schizophrenia, attention deficit hyperactivity disorder and current opioid abuse (see online supplementary materials). If enacted, the impact of a policy reducing the nicotine content of cigarettes can be closely monitored, particularly in comorbid populations, through postregulation surveillance.…”

Section: Common Questionsmentioning

confidence: 99%

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Reducing the nicotine content of combusted tobacco products sold in New Zealand

et al. 2016

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Large reductions in nicotine content could dramatically reduce reinforcement from and dependence on cigarettes. In this article, we summarise the potential benefits of reducing nicotine in combusted tobacco and address some of the common concerns. We focus specifically on New Zealand because it may be ideally situated to implement such a policy. The available data suggest that, in current smokers, very low nicotine content (VLNC) cigarettes decrease nicotine exposure, decrease cigarette dependence, reduce the number of cigarettes smoked per day and increase the likelihood of contemplating, making and succeeding at a quit attempt. New smokers would almost certainly be exposed to far less nicotine as a result of smoking VLNC cigarettes and, consequently, would probably be less likely to become chronic, dependent, smokers. Many of the concerns about reducing nicotine including compensatory smoking, an exacerbation of psychiatric symptoms, the perception that VLNC cigarettes are less harmful, and the potential for a black market are either not supported by the available data, likely mitigated by other factors including the availability of nicotine-containing e-cigarettes, or unlikely to offset the potential benefit to public health. Although not all concerns have been addressed or can be a priori, the magnitude of the potential benefits and the growing evidence of relatively few potential harms should make nicotine reduction one of the centrepieces for discussion of how to rapidly advance tobacco control. Policies that aim to render the most toxic tobacco products less addictive could help New Zealand attain their goal of becoming smokefree by 2025.

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Section: Common Questionsmentioning

confidence: 99%

Section: Common Questionsmentioning

confidence: 99%

Section: Common Questionsmentioning

confidence: 99%

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Reducing the nicotine content of combusted tobacco products sold in New Zealand

et al. 2016

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“…26 Unlike "light" cigarettes, RNC cigarettes are associated with minimal compensation, 21 but smokers with elevated depressive symptoms may be more likely to attempt to compensate for the reduction in nicotine. Likewise, RNC cigarette studies have shown few effects on mood to date, 27 but no large-scale studies of RNC cigarettes have focused on smokers with elevated depressive symptoms. These smokers might also increase their alcohol or other drug intake in an attempt to cope with negative affect during nicotine withdrawal.…”

Section: Introductionmentioning

confidence: 99%

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

Tidey

Pacek

Koopmeiners

et al. 2016

NICTOB

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Background: The FDA recently acquired regulatory authority over tobacco products, leading to renewed interest in whether reducing the nicotine content of cigarettes would reduce tobacco dependence in the United States. Given the association between depressive symptoms and cigarette smoking, it is important to consider whether smokers with elevated depressive symptoms experience unique benefits or negative consequences of nicotine reduction. Methods: In this secondary analysis of a randomized clinical trial that examined the effects of cigarettes varying in nicotine content over a 6-week period in non-treatment-seeking smokers, we used linear regression to examine whether baseline depressive symptom severity (scores on the Center for Epidemiologic Studies Depression Scale [CES-D]) moderated the effects of reduced-nicotine content (RNC) cigarettes, relative to normal-nicotine content (NNC) cigarettes, on smoking rates, depressive symptom severity, and related subjective and physiological measures. Results: Of the 717 participants included in this analysis, 109 (15.2%) had CES-D scores ≥ 16, indicative of possible clinical depression. Relative to NNC cigarettes, RNC cigarettes reduced smoking rates, nicotine dependence, and cigarette craving, and these effects were not significantly moderated by baseline CES-D score. A significant interaction between baseline CES-D score and cigarette condition on week 6 CES-D score was observed (p < .05); among those with CES-D scores ≥ 16 at baseline, those assigned to RNC cigarettes had lower week 6 CES-D scores than those assigned to NNC cigarettes. Among those in the lowest nicotine content conditions, biochemically confirmed

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“…60 Few experimental studies have made a direct assessment of whether smokers with and without serious mental illness differ in their sensitivity to cigarette reinforcement. Tidey et al 61,62 examined how responses for cigarette puffs among people with schizophrenia were affected by varying the response requirement for puffs and the opportunity to obtain an alternative (monetary) reinforcer, using the same experimental procedure and equipment as a study that had compared these factors in heavy smokers without psychiatric illness.…”

Section: Resultsmentioning

confidence: 99%

Behavioral Economic Laboratory Research in Tobacco Regulatory Science

Tidey¹,

Cassidy²,

Miller³

et al. 2016

tobacco reg sci

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Objectives Research that can provide a scientific foundation for the United States Food and Drug Administration (FDA) tobacco policy decisions is needed to inform tobacco regulatory policy. One factor that affects the impact of a tobacco product on public health is its intensity of use, which is determined, in part, by its abuse liability or reinforcing efficacy. Behavioral economic tasks have considerable utility for assessing the reinforcing efficacy of current and emerging tobacco products. Methods This paper provides a narrative review of several behavioral economic laboratory tasks and identifies important applications to tobacco regulatory science. Results Behavioral economic laboratory assessments, including operant self-administration, choice tasks and purchase tasks, can be used generate behavioral economic data on the effect of price and other constraints on tobacco product consumption. These tasks could provide an expedited simulation of the effects of various tobacco control policies across populations of interest to the FDA. Conclusions Tobacco regulatory research questions that can be addressed with behavioral economic tasks include assessments of the impact of product characteristics on product demand, assessments of the abuse liability of novel and potential modified risk tobacco products (MRTPs), and assessments of the impact of conventional and novel products in vulnerable populations.

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Predicted Impact of Nicotine Reduction on Smokers with Affective Disorders

Cited by 13 publications

References 114 publications

Reducing the nicotine content of combusted tobacco products sold in New Zealand

Reducing the nicotine content of combusted tobacco products sold in New Zealand

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

Behavioral Economic Laboratory Research in Tobacco Regulatory Science

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