Randomized Trial of Reduced-Nicotine Standards for Cigarettes

Goldstein, Jeffery A.; Goldstein, Lila K S

doi:10.1056/nejmc1513886

Cited by 4 publications

(2 citation statements)

References 240 publications

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“…1–6 Evidence suggests that ECs are primarily being used as a means to reduce and/or stop smoking cigarettes, 7 but concerns suggest that EC availability and promotion may renormalize smoking, encourage dual use, or undermine smoking cessation. VLNCs may lead to less consumption of harmful toxicants because of reduced nicotine dependence allowing for less smoking and higher rates of smoking cessation, 8–10 however, similar products (Quest) have not fared well in markets that also sold C-FMCs. The extent of switching from cigarettes to alternative products depends on the availability and appeal of other products.…”

Section: Introductionmentioning

confidence: 99%

A Novel Method for Evaluating the Acceptability of Substitutes for Cigarettes: The Experimental Tobacco Marketplace

et al. 2017

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Objectives: The current study tests the substitutability of nicotine replacement therapy (NRT), electronic cigarettes (ECs), and very low nicotine cigarettes (VLNCs) in the context of an online experimental tobacco marketplace (ETM) that was designed to mimic the choices of smokers under 4 policy scenarios. Methods: Dutch cigarette smokers (N = 840) completed an online survey in July 2015. The ETM was comprised of conventional cigarettes, VLNCs, ECs (disposable/cartridge/tank systems), and NRT (lozenges/patches/tabs). All participants completed a scenario in which conventional cigarettes were banned. To test additional policy scenarios participants were randomized to one of 3 experiments: 1) no VLNCs, 2) all products available, or 3) no ECs. Hypothetical weekly purchases were made when the cost for conventional cigarettes was ½ market price (MP), MP, 2x MP, and 4x MP. Substitutability was measured by the change in estimated consumption as cigarette prices increased. Results: Tank and cartridge ECs and VLNCs were stronger cigarette substitutes than disposable ECs and NRT products. Substitution of ECs and NRT for cigarettes was dampened when VLNCs were available. Conclusions: The ETM offers a method to predict how smokers might respond to policies that alter the availability of potentially substitutable products available in the marketplace.

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Section: Introductionmentioning

confidence: 99%

A Novel Method for Evaluating the Acceptability of Substitutes for Cigarettes: The Experimental Tobacco Marketplace

et al. 2017

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“…A larger randomized double-blind study ( n = 840) found that individuals who used lower nicotine cigarettes did not have increased CO expiration or puff volume, suggesting that there was minimal compensation observed. They conclude that the study that reduced cigarettes can reduce nicotine exposure and dependence [107,108]. …”

Section: Approaches To Tobacco Harm Reductionmentioning

confidence: 99%

Innovative approaches to support smoking cessation for individuals with mental illness and co-occurring substance use disorders

Das

Prochaska

2017

Expert Review of Respiratory Medicine

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Introduction Tobacco remains the leading preventable cause of death in the US, accounting for over 520,000 deaths annually. While the smoking prevalence has declined over the past 50 years, those with mental illness and addictive disorders continue to smoke at high levels and with significant tobacco-related health problems. Areas covered This review highlights the epidemiology, contributing factors, and evidence-base for intervening upon tobacco use in those with mental illness and addictive disorders. Historically under-prioritized, a growing body of literature supports treating tobacco within mental health and addiction treatment settings. Critically, treating tobacco use appears to support, and not harm, mental health recovery and sobriety. This review also summarizes novel, emerging approaches to mitigate the harms of cigarette smoking. Expert commentary People with mental illness and addictive disorders have a high prevalence of tobacco use with serious health harms. Treating tobacco use is essential. Evidence-based strategies include individual treatments that are stage-matched to readiness to quit and combine cessation medications with behavioral therapies, supported by smoke-free policies in treatment settings and residential environments. Emerging approaches, with a focus on harm reduction, are electronic nicotine delivery systems and tobacco regulatory efforts to reduce the nicotine content in cigarettes, thereby reducing their addiction potential.

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