Immediate switch to low levels of nicotine in cigarettes more effective than a gradual reduction

Cigarette butt
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The FDA is considering a regulatory policy to reduce the levels of nicotine in combustible cigarettes to minimally addictive levels. A recently published study in the Journal of the American Medical Association tested how cigarette smokers would react to switching to cigarettes with low levels of nicotine. NIDA scientists worked with 1,250 randomized participants at 10 U.S. sites, which were separated into immediate vs. gradual reduction groups. Participants were asked to record their cigarette use, backed up by urine testing to confirm use. Those in the immediate reduction group showed a greater reduction in smoke exposure, greater reduction in dependence, and more cigarette-free days. These data suggest that regulations requiring an immediate nicotine reduction in cigarettes may result in greater health benefits than a policy of stepped reduction. NIDA and the Food and Drug Administration’s Center for Tobacco Products funded this study. Further support came from the National Cancer Institute and the National Center for Advancing Translational Science, both part of the National Institutes of Health.