VLN Cigarette: Difference between revisions

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===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.] ===

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*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.

===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]===

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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]===

*"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]===

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===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.

==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==

===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.

==Discussion links BLOGs, Articles, Videos, etc==

~~==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://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]===

@@ Line 21: / Line 21: @@
 ===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.] ===
@@ Line 71: / Line 74: @@
 *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.
+===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]===
@@ Line 90: / Line 96: @@
 ===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."
+===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]===
@@ Line 143: / Line 152: @@
 ===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.
+==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==
 ===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.
+==Discussion links BLOGs, Articles, Videos, etc==
-==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://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]===