Washington: According to new research, a study examining the effects of nicotine reduction among the most vulnerable smokers supports the recent FDA recommendation to reduce nicotine to non-addictive levels.
Research focuses on the relationship between behavior and health, particularly among disadvantaged populations, a group that is “overrepresented” among smokers, according to the study’s authors.
In their latest study, the research team, led by Stephen Higgins, Ph.D., a professor of psychiatry and director of VCBH, examined the potential for addiction of nicotine-reduced cigarettes in three vulnerable populations of smokers – people with Psychiatric disorders, affective disorders, opioid use disorders) and women with socioeconomic disadvantages.
Higgins shared that “evidence in relatively healthy and socially stable smokers indicates that reducing the nicotine content of cigarettes reduces their addictiveness and if that effect is felt in populations highly vulnerable to tobacco addiction.”
The double-blind, multi-site study is “the first large, controlled study to examine the dose-dependent effects of nicotine-reduced cigarettes on the effects of reinforcement, subjective effects, and topography of smokers from vulnerable populations,” Authors of the study.
The study was conducted between March 2015 and April 2016 and included 169 daily smokers, including 120 women and 49 men. Participating centers included UVM, Brown University, Johns Hopkins University School of Medicine and the University of Kansas.
A total of 56 of the participants were diagnosed with affective disorders, 60 with opioid dependence and 53 were women with socioeconomic disadvantages. Each study participant completed 14 sessions of 2 to 4 hours, refraining from smoking for 6 to 8 hours before each of the sessions, which were organized in 3 phases.
Phase 1 included sessions 1 through 5 and included a sampling of research cigarettes in double-blind conditions, starting with the participant’s regular brand cigarette in session 1 and then smoking 1 identical-looking research cigarette but with Variable doses of nicotine in sessions 2 to 5.
Participants had to use a plastic cigarette holder when smoking cigarette research, in order to measure the topography of smoking, the number of inhalations, the length, and speed of each breath.
The Phase 2 (6-11) sessions provided participants with the opportunity to select the cigarette they preferred to smoke among 6 different dose combinations and used a computer program, which recorded which of the two cigarettes they preferred for that session and whether Wanted to or not to continue smoking that selection after two puffs or abstain.
Phase 3 (Sessions 12-14) followed the same protocol, but only measured the highest and lowest doses of nicotine.
While participants tended to prefer higher nicotine dose content research cigarettes, researchers found that low dose nicotine cigarettes could serve as economic substitutes for commercial grade nicotine cigarettes Of the highest dose when the cost of the latter was higher.
Among the limitations of the study is its brief exposure to research cigarettes. The authors report that field trials of prolonged exposure with these vulnerable populations to determine viability under “naturalistic smoking conditions” is underway.
“This study provides a very encouraging indication that reducing the nicotine content of cigarettes would help the vulnerable population. We need more research, but this is very encouraging news with tremendous potential for improving public health in the US” , Said Higgins.
The study was published in the journal JAMA Psychiatry.
