Reduced-nicotine cigarettes 'do not lead to increased smoking intensity'

Researchers have previously been concerned that cigarettes with reduced levels of nicotine could lead to smokers increasing the intensity of their habit in order to satisfy their nicotine cravings. A new study of the prolonged use of reduced-nicotine cigarettes suggests that this may not be the case.

Nicotine is the main addictive component in tobacco smoke, responsible for both the rewarding feeling that cigarettes give smokers and the feelings of withdrawal that arise when the habit is stopped. Nicotine is also considered to be one of the most difficult substances to give up.

The authors of a new study, published in Cancer Epidemiology, Biomarkers & Prevention, state that previous research has found that smokers aim to "achieve a desired nicotine dose and will adjust their smoking behavior to maintain this dose across products."

If smokers are using reduced-nicotine cigarettes, the fear is that they would begin to smoke more in order to achieve their desired nicotine dose, and so increase their exposure to the other harmful components of cigarettes, such as tar and carbon monoxide.

With their recent study, the authors aimed to examine the changes in smoking behavior that arose with the smoking of reduced-nicotine cigarettes, and whether compensatory smoking occurred as a result. They also set out to investigate whether reduced-nicotine cigarettes affected smokers' exposure to nicotine and nicotine withdrawal symptoms.

Changing the habit

The researchers recruited participants for their study using newspaper advertisements in the Kitchener-Waterloo area of Ontario, Canada. The participants were aged between 18-65 years, smoked at least five cigarettes a day and had no intention to stop smoking within the next month. In total, 72 participants were recruited and completed the study.

Nicotine is highly addictive and is primarily responsible for the maintenance of cigarette smoking. In 1994, Benowitz and Henningfield proposed the idea of federal regulation of the nicotine content of cigarettes such that the nicotine content of cigarettes would be reduced over time, resulting in lower intake of nicotine and a lower level of nicotine dependence. When nicotine levels get very low, cigarettes would be much less addictive. As a result, fewer young people who experiment with cigarettes would become addicted adult smokers and previously addicted smokers would find it easier to quit smoking when they attempt to do so. The regulatory authority to promulgate such a public health strategy was provided by the Family Smoking Prevention and Tobacco Control Act. Although it precludes ‘reducing nicotine to zero’, the act does not prohibit the Food and Drug Administration from setting standards for cigarette nicotine content that would prevent them from being capable of causing addiction.

After filling out smoking history and demographic data surveys, the participants smoked their normal brand of cigarettes for 1 week. For each of the following 3 weeks, the participants had to smoke different types of Quest reduced-nicotine cigarettes. Urine and breath samples were taken from the participants at the end of each week.