Reduced-Nicotine Cigarettes Could Lower Number of Smoking-Related Deaths: Study

Researchers say reduced-nicotine cigarettes could provide substantial public health benefits, especially when paired with nicotine alternatives like gum and patches.

Low-nicotine cigarettes could have a major impact reducing the health risks associated with smoking, according to the findings of a new study, which indicates that individuals who used experimental cigarettes with reduced nicotine levels smoke less overall than individuals who use traditional cigarettes.

Smoking cigarettes exposes a person to dozens of toxic chemicals, such as tar, benzene, formaldehyde, and arsenic. The chemicals are linked to a number of serious health effects, including lung cancer, heart disease, stroke, and chronic obstructive pulmonary disease (COPD).

In findings published this month in the journal The Lancet Regional Health, researchers from the University of Minnesota determined that reduced nicotine cigarettes lower the overall number of cigarettes smoked per day, and increase the number of days individuals go without smoking at all.

“The results of this study demonstrated that substantially reducing the nicotine content in cigarettes decreased smoking behavior and toxicant exposures and increased biochemically verified smoking abstinence,” states lead researchers Dr. Dorothy K. Hatsukami, Professor of Psychiatry and Behavioral Sciences and the Associate Director of Cancer Prevention and Control. “This reduction in cigarette smoking has been observed even in individuals who experience the greatest health inequities and among youth. Therefore, reducing nicotine in cigarettes has the potential to result in substantial public health benefit for all populations who smoke.”

In June 2022, the U.S. Food and Drug Administration (FDA) announced plans to issue a proposed rule for reduced nicotine standards for all cigarettes, as part of an effort to reduce the number of tobacco-related deaths and new nicotine addictions that develop among prior non-smokers. However, no large clinical trial has determined the impact of reduced nicotine cigarettes when other nicotine delivery systems were available.

For this new study, Hatsukami and her team looked at data on 438 current cigarette smokers at six sites across the U.S. The participants were randomized into two groups in an experimental marketplace containing cigarettes with either 0.4 mg or 15.8 mg of nicotine per gram of tobacco and followed for 12 weeks. The average cigarette contains anywhere from 14 to 24 mg of tobacco per cigarette.

Participants also had access to both e-cigarettes and medicinal nicotine, which included products with low doses of nicotine but no other additional toxic chemicals, like nicotine gum or lozenges. The researchers focused on whether using low-nicotine cigarettes, along with the vape systems and alternative nicotine, helped smokers quit.

According to the findings, participants in the 0.4 mg group smoked fewer cigarettes each day by the end of the 12-week study. The low-nicotine group smoked an average of seven cigarettes per day, compared to 13 cigarettes per day in the high-nicotine group.

In addition, smokers in the low-nicotine group also had more smoke-free days. On average, they had 28 smoke-free days, compared to only five smoke-free days among users in the 15.8 mg nicotine group.

The researchers concluded that access to other nicotine alternatives, in addition to low-nicotine cigarettes, offers smokers other options to help cut cravings without high nicotine rates and exposure to other toxic chemicals.

“[R]educing nicotine in cigarettes has the potential to improve individual and public health among people who smoke by reducing consumption,” concluded Hatsukami and her team. “The availability of evidence-based less harmful alternative nicotine delivery systems might be an important component of this standard, along with easy access to smoking cessation resources.”