Are Reduced Nicotine Cigarettes Less Addictive in Vulnerable Populations?

Medicaid Policies Impact Use of Smoking Cessation Medications
Medicaid Policies Impact Use of Smoking Cessation Medications
A higher level of addiction is associated with cigarettes that have a higher level of nictone.

A comparison of different strength cigarettes suggests that cigarettes with less nicotine have a lower addiction potential in people with psychiatric disorders and socioeconomically disadvantaged people, according to a study in JAMA Psychiatry.

The researchers assessed the responses of 169 daily smokers from 3 vulnerable populations: individuals with affective disorders (n=56) or opioid dependence (n=60) and socioeconomically disadvantaged women (n=53).  Data for these populations was collected for approximately one year.

Before the study began, all participants abstained from smoking for 6 to 8 hours. They then sampled the research cigarettes in a double-blind protocol. The cigarettes contained varied amounts of nicotine: 0.4, 2.4, 5.2, and 15.8 mg/g. Reducing the nicotine content decreased the reinforcing effects of smoking in all 3 populations.

The highest-nicotine-content cigarettes were often preferred over the 0.4 mg/g nicotine cigarettes. The preference could be reversed, however, by making it more difficult to obtain puffs on the 15.8 mg/g nicotine cigarettes, while maintaining the level of difficulty in the same in the lower-dose cigarettes.

It was also found that the mean estimated rate of cigarette smoking decreased as the price of the 4 doses increased.

The researchers commented that populations like those studied, which are highly vulnerable to tobacco addiction, would benefit from reducing the nicotine content of cigarettes. They conclude that it should be a focus of policy in the United States, where such a reduction is currently under consideration.

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Higgins ST, Heil SH, Sigmon SC, et al. Addiction potential of cigarettes with reduced nicotine content in populations with psychiatric disorders and other vulnerabilities to tobacco addiction [published online August 23, 2017]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.2355