University of Minnesota Medical School Researchers Study Best Approach Towards Reducing Tobacco Dependence

Cigarette smoking is the leading cause of preventable disease and death in the United States, accounting for more than 480,000 deaths every year.

University of Minnesota Medical School researchers have studied whether a gradual reduction or a targeted immediate reduction in nicotine in cigarettes is the best approach towards reducing tobacco dependence. This supports a recent advanced notice of a proposed regulation from the U.S. Food and Drug Administration issued this March, that would reduce nicotine in all cigarettes and possibly other burned tobacco products sold in the U.S. to minimally addictive levels. Although reducing nicotine in cigarettes does not make the cigarette safer, because nicotine an addictive chemical, the reduction would reduce the progression towards tobacco dependence and also make it easier for smokers to quit.

“This publication provides a promising piece of evidence indicating that stopping cigarette smoking immediately is helpful in reducing their exposure to cancer causing chemicals,” said Mustafa al'Absi, PhD, Professor, Family Medicine & BioBehavioral Health, University of Minnesota Medical School, Duluth Campus.

The clinical trial involved 1,250 smokers across 10 academic institutions. Researchers found that immediate nicotine reduction is likely to result in more rapid positive public health effects. They also discovered smokers in the immediate reduction group experienced significantly less exposure to toxic cigarette smoke chemicals and reported smoking fewer cigarettes per day, less dependence on cigarettes and greater number of days that they were smoke-free compared to the other two groups.

“The results strongly support the benefits of rapidly reducing nicotine in all cigarettes, primarily because this approach helped smokers, who initially had no immediate intentions to quit, experience smoke-free days,” said lead investigator Dr. Dorothy Hatsukami, professor of psychiatry at the University of Minnesota Medical School and Masonic Cancer Center member. “This is good news because the majority of smokers want to quit smoking, but only a small percentage of smokers are successful.”

At the same time, immediate nicotine reduction is likely to be more difficult for smokers. Smokers in the immediate reduction group experienced more severe withdrawal symptoms during the first week after switching to very low nicotine content cigarettes. They were also more likely to drop out of the study and smoke non-study cigarettes.

“Our study demonstrates that a targeted date for drastically reducing nicotine in cigarettes, a product that kills about half of its consumers, is an approach that can benefit public health,” said Hatsukami. “Future research should examine what type of nicotine products smokers will seek in a world with reduced nicotine cigarettes and the consequent potential health effects.”

The study, recently published in JAMA, was funded by a grant from the National Institute on Drug Abuse and the Food and Drug Administration and was conducted at the following institutions: University of Pennsylvania (Philadelphia, Pennsylvania), Johns Hopkins University (Baltimore, Maryland), Duke University (Raleigh/Durham, North Carolina), Moffitt Cancer Center (Tampa, Florida), University of Minnesota (Minneapolis [lead site] and Duluth, Minnesota), University of Texas MD Anderson Cancer Center (Houston, Texas); Mayo Clinic (Scottsdale, Arizona); University of California (San Francisco, California) and Oregon Research Institute (Eugene, Oregon).

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