Bottom Line: The optimal approach for reducing nicotine to minimally or nonaddictive levels in all cigarettes sold in the United States has not been determined. In this randomized clinical trial of 1,250 smokers, compared with gradual nicotine reduction, immediate reduction to 0.4 mg of nicotine per gram of tobacco cigarettes was associated with lower toxicant exposure across time, smoking fewer cigarettes per day, greater reduction in dependence and more cigarette-free days. However, the immediate reduction in nicotine caused greater withdrawal symptoms and higher study dropout rates. There was no significant difference between gradual reduction and the control group in decreases in biomarkers of smoke exposure across time. A limitation of the study was its duration of 20 weeks; the long-term effect of reduced nicotine content cigarettes is uncertain.
Authors: Dorothy K. Hatsukami, Ph.D., University of Minnesota, Minneapolis, and coauthors
Visual Abstract: This is the link to the abstract when the embargo lifts.
-- A video abstract that summarizes the results of this study is available for download or to embed on your website. Download the video as a high-quality MP4 file by clicking on this link and then right-clicking and selecting "save video as." In addition, you may copy and paste the html code below to embed the video on your website.
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-- The JAMA article, "Drugs for Tobacco Dependence," is available on the For The Media website.
Previously published related articles:
-- From JAMA Psychiatry, Nondaily Smokers' Changes in Cigarette Consumption With Very Low-Nicotine-Content Cigarettes
-- From JAMA, Will the FDA's New Tobacco Strategy Be a Game Changer?
-- From JAMA Network Open, Association of Reduced Nicotine Content Cigarettes With Smoking Behaviors and Biomarkers of Exposure Among Slow and Fast Nicotine Metabolizers
To Learn More: The full study is available on the For The Media website.
(doi:10.1001/jama.2018.11473)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Journal
JAMA