Transient compensatory smoking in response to placebo cigarettes

MacQueen, David; Heckman, Bryan W.; Blank, Melissa D.; Rensburg, Kate Janse Van; Evans, David; Drobes, David J.

doi:10.1007/s00213-012-2685-1

Cited by 28 publications

(31 citation statements)

References 38 publications

(51 reference statements)

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“…Although smokers may attempt to compensate when they first try VLNC cigarettes, numerous studies have shown that most smokers do not compensate after the first few cigarettes5 34 35 and that biomarkers of smoke exposure do not increase when participants are switched to VLNC cigarettes 4 5 8 9 16 17. One limitation of clinical trials suggesting little or no compensation is that smokers could easily purchase normal nicotine cigarettes, although an inpatient study in which participants could only use VLNC cigarettes also demonstrated a reduction in smoke exposure 8.…”

Section: Common Questionsmentioning

confidence: 99%

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%

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

et al. 2016

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“…An inpatient study in which smokers switched from "regular" to de-nicotinized cigarettes resulted in a decline in CPD that over the 11-day study period and a significant reduction in puff number per cigarette (38). In addition, a 2-day study found an initial increase in puff behavior, which dissipated after several smoking bouts (56). Two studies have examined changes in smoking behavior measured for a single cigarette, one of which found no differences in puff number (12), the other found significantly lower puffing intensity for all 3 Quest brands compared with usual brand smoking (36).…”

Section: Smoking Behaviormentioning

confidence: 99%

Reduced Nicotine Cigarettes: Smoking Behavior and Biomarkers of Exposure among Smokers Not Intending to Quit

Hammond

O’Connor

2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: The U.S. FDA has the authority to limit the nicotine content of cigarettes; however, there are concerns that reduced nicotine cigarettes will be smoked more intensely and, therefore, will increase exposure to toxic chemicals in smoke. This study examined changes in consumer behavior and exposure in response to cigarettes with substantially reduced nicotine content.Methods: Seventy-two adult smokers completed an unblinded trial of reduced nicotine cigarettes. Participants completed a 7-day baseline period during which they smoked their usual cigarette brand, followed by consecutive 7-day periods smoking cigarettes with progressively lower nicotine levels (0.6, 0.3, and 0.05 mg emission Quest cigarettes). Nicotine dependence and withdrawal, smoking behavior, and biomarkers of exposure were assessed for each 7-day period.Results: Significant reductions in nicotine intake were observed between usual brand smoking ($1.2 mg nicotine) and the 0.3 and 0.05 mg nicotine emission cigarettes, but not the 0.6 mg cigarette. The findings provide little evidence of compensatory smoking of Quest cigarettes, with no increases in exhaled breath carbon monoxide levels, smoking intensity, or levels of 1-hydroxypyrene across study periods. No significant differences were observed for smoking urges or measures of nicotine dependence.Conclusions: The study adds to the evidence that cigarettes with markedly reduced nicotine content are not associated with increased smoking intensity or exposure to smoke toxicants.Impact: The findings add to the evidence base on reduced nicotine content cigarettes and have the potential to inform FDA policy on nicotine levels. Cancer Epidemiol Biomarkers Prev; 23(10); 2032-40. Ó2014 AACR.

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“…In the only study published to date, adolescents (N=35) tended to engage in compensatory smoking when given VLNC (0.06 mg nicotine yield, 17.9 mg tar) cigarettes acutely, increasing the number of puffs compared to a high nicotine (1.14 mg nicotine yield, 15.9 mg tar) cigarette (Kassel et al, 2007). This effect has also been observed in adult, daily smokers, but tends to dissipate with repeated use (Macqueen et al, 2012). …”

Section: Resultsmentioning

confidence: 65%

Reduced nicotine product standards for combustible tobacco: Building an empirical basis for effective regulation

Donny

Hatsukami

Benowitz

et al. 2014

Preventive Medicine

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Introduction Both the Tobacco Control Act in the U.S. and Article 9 of the Framework Convention on Tobacco Control enable governments to directly address the addictiveness of combustible tobacco by reducing nicotine through product standards. Although nicotine may have some harmful effects, the detrimental health effects of smoked tobacco are primarily due to non-nicotine constituents. Hence, the health effects of nicotine reduction would likely be determined by changes in behavior that result in changes in smoke exposure. Methods Herein, we review the current evidence on nicotine reduction and discuss some of the challenges in establishing the empirical basis for regulatory decisions. Results To date, research suggests that very low nicotine content cigarettes produce a desirable set of outcomes, including reduced exposure to nicotine, reduced smoking, and reduced dependence, without significant safety concerns. However, much is still unknown, including the effects of gradual versus abrupt changes in nicotine content, effects in vulnerable populations, and impact on youth. Discussion A coordinated effort must be made to provide the best possible scientific basis for regulatory decisions. The outcome of this effort may provide the foundation for a novel approach to tobacco control that dramatically reduces the devastating health consequences of smoked tobacco.

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Transient compensatory smoking in response to placebo cigarettes

Cited by 28 publications

References 38 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

Reduced Nicotine Cigarettes: Smoking Behavior and Biomarkers of Exposure among Smokers Not Intending to Quit

Reduced nicotine product standards for combustible tobacco: Building an empirical basis for effective regulation

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