Large reductions in nicotine content could dramatically reduce reinforcement from and dependence on cigarettes. In this article, we summarise the potential benefits of reducing nicotine in combusted tobacco and address some of the common concerns. We focus specifically on New Zealand because it may be ideally situated to implement such a policy. The available data suggest that, in current smokers, very low nicotine content (VLNC) cigarettes decrease nicotine exposure, decrease cigarette dependence, reduce the number of cigarettes smoked per day and increase the likelihood of contemplating, making and succeeding at a quit attempt. New smokers would almost certainly be exposed to far less nicotine as a result of smoking VLNC cigarettes and, consequently, would probably be less likely to become chronic, dependent, smokers. Many of the concerns about reducing nicotine including compensatory smoking, an exacerbation of psychiatric symptoms, the perception that VLNC cigarettes are less harmful, and the potential for a black market are either not supported by the available data, likely mitigated by other factors including the availability of nicotinecontaining e-cigarettes, or unlikely to offset the potential benefit to public health. Although not all concerns have been addressed or can be a priori, the magnitude of the potential benefits and the growing evidence of relatively few potential harms should make nicotine reduction one of the centrepieces for discussion of how to rapidly advance tobacco control. Policies that aim to render the most toxic tobacco products less addictive could help New Zealand attain their goal of becoming smokefree by 2025.
|Original language||English (US)|
|State||Published - 2017|
Bibliographical noteFunding Information:
Acknowledgements ECD was supported by the University of Pittsburgh while
writing this manuscript as a Visiting Professor at the University of Auckland. DH was supported by the Forster Family Chair in Cancer Prevention. ECD and DH receive research funding from the US National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products to assess the potential impact of reducing the nicotine content of cigarettes in the USA.
Funding Contributions from all authors were supported by their respective institutions.
Copyright 2017 Elsevier B.V., All rights reserved.