VLN Cigarette: Difference between revisions
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=== 2024: [https://pubmed.ncbi.nlm.nih.gov/38831538/ Perceptions of the Addictiveness of Low-Nicotine Cigarettes Versus Typical Cigarettes and Exposure to Tobacco Industry-Sponsored Corrective Campaign] === | === 2024: [https://pubmed.ncbi.nlm.nih.gov/38831538/ Perceptions of the Addictiveness of Low-Nicotine Cigarettes Versus Typical Cigarettes and Exposure to Tobacco Industry-Sponsored Corrective Campaign] === | ||
*'In the overall population, 4.1% reported that low-nicotine cigarettes were much more addictive than typical cigarettes, 67.5% said they were equally addictive, while 28.4% reported they were slightly/much less addictive." | *'In the overall population, 4.1% reported that low-nicotine cigarettes were much more addictive than typical cigarettes, 67.5% said they were equally addictive, while 28.4% reported they were slightly/much less addictive." | ||
===2024: [https://tobaccocontrol.bmj.com/content/33/3/325 Messaging about very low nicotine cigarettes (VLNCs) to influence policy attitudes, harm perceptions and smoking motivations: a discrete choice experiment]=== | |||
*"Harm and chemical information can be prioritised to ensure VLNCs are not misperceived as less harmful than regular cigarettes. Messages about increased quitting efficacy and reduced addictiveness associated with VLNCs may backfire if presented to those who do not smoke." | |||
===2024: [https://pubmed.ncbi.nlm.nih.gov/38911348/ Reduced nicotine in cigarettes in a marketplace with alternative nicotine systems: randomized clinical trial]=== | |||
*"Nearly two-thirds of participants who were assigned to the VLNC condition and who attained seven-day abstinence from combusted tobacco at the end of the intervention used e-cigarettes." | |||
=== 2023: [https://pubmed.ncbi.nlm.nih.gov/37195268/ E-Cigarette price impacts legal and black-market cigarette purchasing under a hypothetical reduced-nicotine cigarette standard.] === | === 2023: [https://pubmed.ncbi.nlm.nih.gov/37195268/ E-Cigarette price impacts legal and black-market cigarette purchasing under a hypothetical reduced-nicotine cigarette standard.] === | ||
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===2022: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac010/6505261 Educating the public on the health risks of very low nicotine content cigarettes: Results from a U.S.-based convenience sample]=== | ===2022: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac010/6505261 Educating the public on the health risks of very low nicotine content cigarettes: Results from a U.S.-based convenience sample]=== | ||
*Messaging on mortality effects of VLNC cigarettes (i.e., cigarettes with 95% less nicotine are as deadly as current cigarettes) was associated with more accurate perceptions of the health risks of VLNC cigarettes than the control; however, misperceptions remained in one-third of participants. | *Messaging on mortality effects of VLNC cigarettes (i.e., cigarettes with 95% less nicotine are as deadly as current cigarettes) was associated with more accurate perceptions of the health risks of VLNC cigarettes than the control; however, misperceptions remained in one-third of participants. | ||
===2022: [https://pmc.ncbi.nlm.nih.gov/articles/PMC9629593/ The effects of reduced nicotine content cigarettes on biomarkers of nicotine and toxicant exposure, smoking behavior and psychiatric symptoms in smokers with mood or anxiety disorders: A double-blind randomized trial]=== | |||
*"Reducing nicotine content in cigarettes to very low levels reduces some toxicant exposures and cigarette addiction and increases smoking cessation in smokers with mood and/or anxiety disorders, without worsening mental health." | |||
===2021: [https://pubmed.ncbi.nlm.nih.gov/34958368/ Predicting Non-Adherence With Very Low Nicotine Content Cigarettes Among Adults With Serious Mental Illness Who Smoke]=== | |||
*"Results offer preliminary insight into potential barriers to adherence in SMI populations. Adherence might be enhanced by supplementing VLNC cigarettes with alternative sources of non-combusted nicotine, paired with educational campaigns to encourage quitting or switching to less harmful products. Future studies should replicate these analyses in a larger sample of individuals with SMI who smoke." | |||
===2021: [https://pubmed.ncbi.nlm.nih.gov/33249498/ Switching to Progressively Reduced Nicotine Content Cigarettes in Smokers With Low Socioeconomic Status: A Double-Blind Randomized Clinical Trial]=== | ===2021: [https://pubmed.ncbi.nlm.nih.gov/33249498/ Switching to Progressively Reduced Nicotine Content Cigarettes in Smokers With Low Socioeconomic Status: A Double-Blind Randomized Clinical Trial]=== | ||
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*17 people completed the study. | *17 people completed the study. | ||
*Although replication with larger samples and longer access is needed, results indicate nicotine reduction to ≤2.3 mg/g in cigarettes would attenuate reinforcement. This choice procedure may efficiently inform future clinical trials to assess relative reinforcing effects of smoking reduced nicotine cigarettes. | *Although replication with larger samples and longer access is needed, results indicate nicotine reduction to ≤2.3 mg/g in cigarettes would attenuate reinforcement. This choice procedure may efficiently inform future clinical trials to assess relative reinforcing effects of smoking reduced nicotine cigarettes. | ||
===2020: [https://www.mdpi.com/1660-4601/17/19/7047 Comparison between Gradual Reduced Nicotine Content and Usual Nicotine Content Groups on Subjective Cigarette Ratings in a Randomized Double-Blind Trial]=== | |||
*"Findings from our study revealed that consistent significant differences between the RNC and the UNC treatment groups started to occur at visit 6 with 1.4 mg nicotine/cigarette. The most consistent differences occurred at visits 8 and 9 when the RNC group was smoking VLNC cigarettes (0.2 mg nicotine/cigarette). The study indicates that even with reduced nicotine, cigarettes still provide some pleasurable and reinforcing effects. Subjects using RNC stated they were less likely to purchase RNC cigarettes, which would facilitate the goal of a nicotine reduction policy, but also points to the need to reduce access to black market high nicotine cigarettes. Understanding the impact of nicotine reduction on subjective effects through cigarette evaluation and liking scales would provide valuable information and possible direction to the FDA on implementing a nicotine reduction policy for cigarettes." | |||
===2020: [https://www.ingentaconnect.com/contentone/psp/hbpr/2020/00000007/00000006/art00004 Measuring Support for Requiring Reduced Nicotine Cigarettes: Issues with Questions, Answers, and Respondents]=== | |||
*"Survey design, including question type and the response order, resulted in a substantial difference in participant responses. Better and multiple questions may be needed before drawing conclusions about mandatory reduced nicotine cigarettes support, especially among smokers." | |||
===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939783/ Misperceptions of Nicotine and Nicotine Reduction: The Importance of Public Education to Maximize the Benefits of a Nicotine Reduction Standard]=== | ===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939783/ Misperceptions of Nicotine and Nicotine Reduction: The Importance of Public Education to Maximize the Benefits of a Nicotine Reduction Standard]=== | ||
*Recent population-level data highlight that 49%–80% of US adults incorrectly believe that nicotine is responsible for most of the cancer caused by smoking | *Recent population-level data highlight that 49%–80% of US adults incorrectly believe that nicotine is responsible for most of the cancer caused by smoking | ||
*Nearly half (47%) of adult smokers believe that continued smoking of VLNC cigarettes is less likely to cause cancer than smoking their current cigarettes.This misperception is more common among smokers who are age 55+ (57%) and Black (57%). | *Nearly half (47%) of adult smokers believe that continued smoking of VLNC cigarettes is less likely to cause cancer than smoking their current cigarettes.This misperception is more common among smokers who are age 55+ (57%) and Black (57%). | ||
===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939779/ Reducing Nicotine Without Misleading the Public: Descriptions of Cigarette Nicotine Level and Accuracy of Perceptions About Nicotine Content, Addictiveness, and Risk]=== | |||
*"Stating that 95% of nicotine would be removed more accurately conveyed the nicotine content and addictiveness of VLNC cigarettes. However, descriptions that better conveyed nicotine content and addictiveness misled people about cancer risk." | |||
===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939759/ The Role of Compensation in Nicotine Reduction]=== | |||
*"The available research on switching from NNCs to VLNCs shows minimal evidence of compensatory smoking such that smokers do not smoke more cigarettes per day and are not exposed to higher levels of tobacco combustion toxicants. Furthermore, mathematical estimations based on the nicotine availability in VLNCs compared with NNC cigarettes with consideration of potential increases in bioavailability that could occur with intensive smoking suggest that substantial compensation would be impossible. It is much more likely that smokers who are unable to tolerate the extent of proposed nicotine reduction would switch to other sources of nicotine, rather than try to compensate by smoking more VLNC cigarettes more intensively." | |||
===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056339/ Public misperception that very low nicotine cigarettes are less carcinogenic]=== | ===2019: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056339/ Public misperception that very low nicotine cigarettes are less carcinogenic]=== | ||
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===2019: [https://academic.oup.com/ntr/article/21/Supplement_1/S38/5684952 Effects of 6-Week Use of Very Low Nicotine Content Cigarettes in Smokers With Serious Mental Illness]=== | ===2019: [https://academic.oup.com/ntr/article/21/Supplement_1/S38/5684952 Effects of 6-Week Use of Very Low Nicotine Content Cigarettes in Smokers With Serious Mental Illness]=== | ||
*"These results suggest that a reduced-nicotine standard for cigarettes would reduce smoking among smokers with SMI. However, the lack of effect on total nicotine exposure indicates VLNC noncompliance, suggesting that smokers with SMI may respond to a reduced-nicotine standard by substituting alternative forms of nicotine." | *"These results suggest that a reduced-nicotine standard for cigarettes would reduce smoking among smokers with SMI. However, the lack of effect on total nicotine exposure indicates VLNC noncompliance, suggesting that smokers with SMI may respond to a reduced-nicotine standard by substituting alternative forms of nicotine." | ||
===2019: [https://pmc.ncbi.nlm.nih.gov/articles/PMC7297107/ Pharmacokinetic Profile of Spectrum Reduced Nicotine Cigarettes]=== | |||
*"Additional dose–response relationships have been detected on the number of cigarettes smoked per day when low and high nicotine Spectrum cigarettes are available. For example, after 7 days of smoking Spectrum cigarettes, individuals given the low-nicotine content cigarettes significantly reduced the number of experimental cigarettes smoked compared to those given the high-nicotine content research cigarettes." | |||
===2018: [https://pubmed.ncbi.nlm.nih.gov/29902305/ Nondaily Smokers' Changes in Cigarette Consumption With Very Low-Nicotine-Content Cigarettes: A Randomized Double-blind Clinical Trial]=== | ===2018: [https://pubmed.ncbi.nlm.nih.gov/29902305/ Nondaily Smokers' Changes in Cigarette Consumption With Very Low-Nicotine-Content Cigarettes: A Randomized Double-blind Clinical Trial]=== | ||
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===2018: [https://jamanetwork.com/journals/jama/article-abstract/2698925 Effect of Immediate vs Gradual Reduction in Nicotine Content of Cigarettes on Biomarkers of Smoke Exposure]=== | ===2018: [https://jamanetwork.com/journals/jama/article-abstract/2698925 Effect of Immediate vs Gradual Reduction in Nicotine Content of Cigarettes on Biomarkers of Smoke Exposure]=== | ||
*In this study, compared with gradual nicotine reduction, immediate reduction was associated with lower toxicant exposure across time, smoking fewer CPD (cigarettes per day), greater reduction in dependence, and more cigarette-free days. However, the immediate reduction in nicotine caused greater withdrawal symptoms, greater use of nonstudy cigarettes, and higher drop-out rates. | *In this study, compared with gradual nicotine reduction, immediate reduction was associated with lower toxicant exposure across time, smoking fewer CPD (cigarettes per day), greater reduction in dependence, and more cigarette-free days. However, the immediate reduction in nicotine caused greater withdrawal symptoms, greater use of nonstudy cigarettes, and higher drop-out rates. | ||
===2018: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986583/ Effects of reduced nicotine content cigarettes on individual withdrawal symptoms over time and during abstinence]=== | |||
*"Thus, a reduced-nicotine standard for cigarettes produced a relatively mild and temporary increase in withdrawal among non-treatment seeking smokers." | |||
===2017: [https://www.sciencedirect.com/science/article/abs/pii/S0091743516304510 U.S. adults' addiction and harm beliefs about nicotine and low nicotine cigarettes]=== | ===2017: [https://www.sciencedirect.com/science/article/abs/pii/S0091743516304510 U.S. adults' addiction and harm beliefs about nicotine and low nicotine cigarettes]=== | ||
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===2017: [https://pubmed.ncbi.nlm.nih.gov/28214392/ Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior]=== | ===2017: [https://pubmed.ncbi.nlm.nih.gov/28214392/ Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior]=== | ||
*Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use. | *Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use. | ||
===2016: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328980/ U.S. adults' addiction and harm beliefs about nicotine and low nicotine cigarettes]=== | |||
*"Incorrectly believing that nicotine causes cancer could discourage smokers from switching to safer nicotine-containing alternatives, and could lead nonsmokers to experiment with low nicotine tobacco products, believing that cancer risk would be reduced. Findings underscore the need to educate the public on the health effects of nicotine and LNCs, and can help public health practitioners determine which subgroups should be prioritized in targeted educational efforts." | |||
===2015: [https://cebp.aacrjournals.org/content/24/2/331 Biochemical Estimation of Noncompliance with Smoking of Very Low Nicotine Content Cigarettes]=== | ===2015: [https://cebp.aacrjournals.org/content/24/2/331 Biochemical Estimation of Noncompliance with Smoking of Very Low Nicotine Content Cigarettes]=== | ||
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===2009: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2573966/ Toxicological Analysis of Low-Nicotine and Nicotine-Free Cigarettes]=== | ===2009: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2573966/ Toxicological Analysis of Low-Nicotine and Nicotine-Free Cigarettes]=== | ||
*In summary, a toxicological analysis does not indicate that low-nicotine and nicotine-free Quest® cigarettes have less adverse toxicological effects in the laboratory than conventional cigarettes. This should draw the attention of the consumers and policy makers. A more comprehensive evaluation in smokers is expected for these new products. | *In summary, a toxicological analysis does not indicate that low-nicotine and nicotine-free Quest® cigarettes have less adverse toxicological effects in the laboratory than conventional cigarettes. This should draw the attention of the consumers and policy makers. A more comprehensive evaluation in smokers is expected for these new products. | ||
==Letters to the FDA CTP in Support or Opposition== | |||
===2025: [https://www.convenience.org/Media/Daily/2025/September/15/2-NACS-Sends-Letter-Opposing-FDA-Proposal_GR NACS Sends Letter Opposing FDA Proposal on Reduced Nicotine]=== | |||
==Statements, Official Comments, Testimony== | ==Statements, Official Comments, Testimony== | ||
===2018: [https://www.iowaattorneygeneral.gov/media/cms/Reduced_Nicotine_ANPRM_Response_180_5BB91F8E318CC.pdf ANPRM comment by Iowa AG, Tom Miller, and leading public health experts]=== | ===2018: [https://www.iowaattorneygeneral.gov/media/cms/Reduced_Nicotine_ANPRM_Response_180_5BB91F8E318CC.pdf ANPRM comment by Iowa AG, Tom Miller, and leading public health experts]=== | ||
*However, we all agree that there is one important requirement common to each of the perspectives above: that is the availability of low-risk non-combustible alternative tobacco or nicotine products that are sufficiently satisfying alternatives to cigarettes that smokers who choose to continue to use nicotine would be willing to switch to them. | *However, we all agree that there is one important requirement common to each of the perspectives above: that is the availability of low-risk non-combustible alternative tobacco or nicotine products that are sufficiently satisfying alternatives to cigarettes that smokers who choose to continue to use nicotine would be willing to switch to them. | ||
==Discussion links BLOGs, Articles, Videos, etc== | |||
===2022: [https://www.medpagetoday.com/opinion/second-opinions/99972 Can We Smoke Out Cancer?]=== | |||
===2022: [https://tobaccoreporter.com/2022/06/21/policy-masterstroke-or-political-quagmire/ Policy masterstroke or political quagmire?]=== | ===2022: [https://tobaccoreporter.com/2022/06/21/policy-masterstroke-or-political-quagmire/ Policy masterstroke or political quagmire?]=== | ||
===2022: [https://theconversation.com/the-us-governments-call-for-deep-nicotine-reduction-in-cigarettes-could-save-millions-of-lives-an-expert-who-studies-tobacco-addiction-explains-186704 The US government’s call for deep nicotine reduction in cigarettes could save millions of lives – an expert who studies tobacco addiction explains]=== | |||
===2022: [https://jamanetwork.com/journals/jama/article-abstract/2788548 First Modified-Risk Combusted Cigarettes Are Authorized]=== | |||
===2021: [https://clivebates.com/twenty-reasons-to-be-sceptical-about-rules-lowering-nicotine-levels-in-cigarettes-and-what-to-do-instead/ Twenty reasons to be sceptical about rules lowering nicotine levels in cigarettes – and what to do instead]=== | |||
===2021: [https://clivebates.com/fda-spreads-confusion-about-nicotine-and-smoking/ FDA spreads confusion about nicotine and smoking]=== | ===2021: [https://clivebates.com/fda-spreads-confusion-about-nicotine-and-smoking/ FDA spreads confusion about nicotine and smoking]=== | ||
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==Suggestions to add to this page== | ==Suggestions to add to this page== | ||
===[https://www.xxiicentury.com/vln-clinical-studies/published-clinical-studies-on-very-low-nicotine-content-vlnc-cigarettes Studies on 22nd Century website]=== | ===[https://www.xxiicentury.com/vln-clinical-studies/published-clinical-studies-on-very-low-nicotine-content-vlnc-cigarettes Studies on 22nd Century website]=== | ||