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Effects of Very Low Nicotine Content Cigarettes on Smoking Behavior and Biomarkers of Exposure in Menthol and Non-menthol Smokers.
IntroductionBecause 30% of cigarettes sold in the United States are characterized as menthol cigarettes, it is important to understand how menthol preference may affect the impact of a nicotine reduction policy.MethodsIn a recent trial, non-treatment-seeking smokers were randomly assigned to receive very low nicotine cigarettes (VLNC; 0.4 mg nicotine/g tobacco) or normal nicotine cigarettes (NNC; 15.5 mg/g) for 20 weeks. On the basis of preference, participants received menthol or non-menthol cigarettes. We conducted multivariable regression analyses to examine whether menthol preference moderated the effects of nicotine content on cigarettes per day (CPD), breath carbon monoxide (CO), urinary total nicotine equivalents (TNE), urinary 2-cyanoethylmercapturic acid (CEMA), and abstinence.ResultsAt baseline, menthol smokers (n = 346) reported smoking fewer CPD (14.9 vs. 19.2) and had lower TNE (52.8 vs. 71.6 nmol/mg) and CO (17.7 vs. 20.5 ppm) levels than non-menthol smokers (n = 406; ps < .05). At week 20, significant interactions indicated that menthol smokers had smaller treatment effects than non-menthol smokers for CPD (-6.4 vs. -9.3), TNE (ratio of geometric means, 0.22 vs. 0.10) and CEMA (ratio, 0.56 vs. 0.37; ps < .05), and trended toward a smaller treatment effect for CO (-4.5 vs. -7.3 ppm; p = .06). Odds ratios for abstinence at week 20 were 1.88 (95% confidence interval [CI] = 0.8 to 4.4) for menthol and 9.11 (95% CI = 3.3 to 25.2) for non-menthol VLNC smokers (p = .02) relative to the NNC condition.ConclusionsAlthough menthol smokers experienced reductions in smoking, toxicant exposure, and increases in quitting when using VLNC cigarettes, the magnitude of change was smaller than that observed for non-menthol smokers.ImplicationsResults of this analysis suggest that smokers of menthol cigarettes may respond to a nicotine reduction policy with smaller reductions in smoking rates and toxicant exposure than would smokers of non-menthol cigarettes
Efeito dos aditivos do tabaco na iniciação e manutenção do tabagismo
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Detecting longitudinal patterns of daily smoking following drastic cigarette reduction
To enhance prolonged smoking cessation or reduction, a better understanding of the process of change is needed. This study examines daily smoking rates following the end of an intensive smoking reduction program originally designed to evaluate the relationship of tobacco biomarkers with reduced levels of smoking. A novel pattern-oriented approach called time series-based typology is used to detect homogeneous smoking patterns in time-intensively (i.e., 40 occasions) observed smokers (n = 57), who were predominantly Caucasian (94.7%), male (52.6%), and on average 47.9 years old (SD = 11.3). The majority of the smokers exhibited a change in their daily smoking behavior over the course of 40 days with 47.4% increasing and 40.4% decreasing the number of cigarettes smoked per day, which is contrary to the results a group level approach would have found. Very few smokers (12.3%) maintained their average smoking rate, and exhibited an externally controlled smoking pattern. Trajectory type could be predicted by temporally proximal motivation and self-efficacy variables ((F(4, 106) =3.46, p = .011, η2 = .115), underscoring their importance in maintaining reduced smoking rates. Time series-based typology demonstrated good sensitivity to the identification of meaningfully different trajectories
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