Smoking topography characteristics during a six-week trial of very low nicotine content cigarettes in smokers with serious mental illness.

INTRODUCTION: A nicotine reduction policy could have major benefits for smokers with serious mental illness (SMI). However, potential unintended consequences, such as compensatory smoking, should be considered to ensure that such a policy does not negatively affect this population. The purpose of this secondary analysis was to examine the impact of smoking very low nicotine content (VLNC) cigarettes for six weeks on smoking topography characteristics, indicators of compensatory smoking, among smokers with SMI.
METHODS: After a baseline usual brand smoking phase, smokers with SMI (N=58) were randomly assigned under double-blind conditions to receive either VLNC (0.4 mg nicotine/g tobacco) or normal nicotine content (NNC; 15.8 mg/g) research cigarettes for six weeks. During two study visits scheduled six weeks apart, participants smoked either their usual brand (baseline) or assigned study cigarettes (post-randomization) through a handheld smoking topography device. Univariate ANOVA compared smoking topography indices with cigarette condition (VLNC vs NNC) as the between-subjects factor with corresponding baseline topography results included as co-variates.
RESULTS: At Week 6, participants in the VLNC condition smoked fewer puffs per cigarette and had shorter inter-puff intervals compared to participants in the NNC condition (p's < 0.05). There were no differences between research cigarette conditions at Week 6 for cigarette volume, puff volume, puff duration, peak flow rate, or carbon monoxide boost.
CONCLUSIONS: Findings are consistent with acute VLNC cigarette topography studies and indicate that a nicotine reduction policy is unlikely to lead to compensation among smokers with SMI.

RCT Entities:   Population Interventions Outcomes