Jason D Robinson1, George Kypriotakis1, Mustafa Al'absi2, Rachel L Denlinger-Apte3, David J Drobes4, Scott J Leischow5, F Joseph McClernon6, Lauren R Pacek6, Herbert H Severson7, Tracy T Smith8, Eric C Donny9, Xianghua Luo10,11, Joni A Jensen10, Lori G Strayer10, Paul M Cinciripini1, Dorothy K Hatsukami10,12. 1. Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX. 2. Department of Family Medicine and BioBehavioral Health, University of Minnesota Medical School, Duluth, MN. 3. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI. 4. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. 5. College of Health Solutions, Arizona State University, Phoenix, AZ. 6. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC. 7. Oregon Research Institute, Eugene, OR. 8. Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC. 9. Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC. 10. Cancer Prevention and Control, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. 11. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN. 12. Department of Psychiatry, University of Minnesota, Minneapolis, MN.
Abstract
INTRODUCTION: Smoking to reduce negative affect has been identified as a key motivational feature of tobacco use. Our recent work suggests that smoking very low nicotine content (VLNC) cigarettes reduces the relationship between negative affect and smoking behavior over a 6-week period. Here, we sought to extend our findings by evaluating whether a gradual or immediate approach to switching to VLNC cigarettes led to a differential reduction in the relationship between affect and smoking behavior over a longer (20-week) period. AIMS AND METHODS: Participants (n = 1250) were adult smokers from 10 US sites randomized to one of three groups: gradual nicotine reduction (15.5, 11.7, 5.2, 2.4, and 0.4 mg of nicotine per gram of tobacco [mg/g]), immediate nicotine reduction (0.4 mg/g), or standard nicotine content cigarettes (15.5 mg/g; control), for 20 weeks. We examined whether the relationship between affect-both negative and positive-and cigarettes per day differed as a function of reduction group. RESULTS: We found that both negative and positive affect were associated with cigarette consumption in the control group, but not in the gradual or immediate reduction groups across the 20 weeks of exposure. CONCLUSIONS: Our results extend previous findings that switching to VLNC cigarettes disrupts the relationship between affect and cigarette consumption by showing that either gradually or immediately reducing cigarette nicotine content achieves this disruption. These findings provide further evidence that switching to VLNC cigarettes reduces nicotine-related reinforcement of cigarette smoking. IMPLICATIONS: These findings support the notion that switching to very low nicotine content cigarettes reduces the association between affect and smoking behavior, and that either a gradual or immediate nicotine reduction approach achieves this reduction. This provides further evidence that switching to very low nicotine content cigarettes weakens reinforcement mechanisms associated with nicotine dependence.
RCT Entities:
INTRODUCTION: Smoking to reduce negative affect has been identified as a key motivational feature of tobacco use. Our recent work suggests that smoking very low nicotine content (VLNC) cigarettes reduces the relationship between negative affect and smoking behavior over a 6-week period. Here, we sought to extend our findings by evaluating whether a gradual or immediate approach to switching to VLNC cigarettes led to a differential reduction in the relationship between affect and smoking behavior over a longer (20-week) period. AIMS AND METHODS: Participants (n = 1250) were adult smokers from 10 US sites randomized to one of three groups: gradual nicotine reduction (15.5, 11.7, 5.2, 2.4, and 0.4 mg of nicotine per gram of tobacco [mg/g]), immediate nicotine reduction (0.4 mg/g), or standard nicotine content cigarettes (15.5 mg/g; control), for 20 weeks. We examined whether the relationship between affect-both negative and positive-and cigarettes per day differed as a function of reduction group. RESULTS: We found that both negative and positive affect were associated with cigarette consumption in the control group, but not in the gradual or immediate reduction groups across the 20 weeks of exposure. CONCLUSIONS: Our results extend previous findings that switching to VLNC cigarettes disrupts the relationship between affect and cigarette consumption by showing that either gradually or immediately reducing cigarette nicotine content achieves this disruption. These findings provide further evidence that switching to VLNC cigarettes reduces nicotine-related reinforcement of cigarette smoking. IMPLICATIONS: These findings support the notion that switching to very low nicotine content cigarettes reduces the association between affect and smoking behavior, and that either a gradual or immediate nicotine reduction approach achieves this reduction. This provides further evidence that switching to very low nicotine content cigarettes weakens reinforcement mechanisms associated with nicotine dependence.
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