Summary
Introduction:
This article presents the results of a randomized controlled trial examining the impact of reducing nicotine content in cigarettes on adolescent smoking and nicotine exposure. The study aimed to determine the effects of very low nicotine content (VLNC) cigarettes on adolescent smokers' cigarette use, respiratory symptoms, and biomarkers of nicotine exposure. This summary will highlight the key aspects of the study design, major findings, and main message.
Key Points:
* Double-blind, two-arm, randomized controlled trial with 66 adolescent daily smokers aged 15-19 years.
* Participants were randomized to use either VLNC (0.4 mg/g) or normal nicotine content (NNC, 15.8 mg/g) research cigarettes for 3 weeks following a 1-week baseline.
* Primary outcome was average total cigarettes smoked per day (CPD) at week 3, including both study and non-study cigarettes.
* Adolescent participants assigned to VLNC use for 3 weeks smoked 2.4 fewer CPD on average than the NNC group.
* VLNC cigarettes were associated with lower levels of craving reduction compared to NNC cigarettes.
* No group differences were found for secondary outcomes, such as respiratory symptoms and biomarkers of nicotine exposure.
* High rates of incomplete adherence to VLNC cigarettes were observed, suggesting that youth may seek alternative sources of nicotine.
Main Message:
The study demonstrates that a VLNC policy would reduce cigarette smoking in adolescents who smoke. However, high rates of incomplete adherence to VLNC cigarettes suggest that alternative strategies, such as assisting youth in transitioning away from smoking, should be considered when implementing a nicotine reduction policy. Additionally, the absence of significant differences in respiratory symptoms and biomarkers of nicotine exposure indicates that such a policy would not result in increased harm to adolescent smokers.
Citation
Cassidy RN, Tidey JW, Jackson KM, et al. The Impact of Reducing Nicotine Content on Adolescent Cigarette Smoking and Nicotine Exposure: Results From a Randomized Controlled Trial. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2023;25(5):918-927. doi:10.1093/ntr/ntac279
