ASPO Abstracts

Correlates of support for a nicotine reduction policy among smokers enrolled in a 20-week trial of very low nicotine content cigarettes

Authors: Denlinger-Apte, RL; Koopmeiners JS; Tidey JW; Luo X; Smith TT; Pacek LR; McClernon FJ; Jenson J; Colby SM; Severson H; Donny EC; Hatsukami DK

Category: Behavioral Science & Health Communication
Conference Year: 2020

Abstract Body:
Study Purpose: The Food and Drug Administration (FDA) recently announced a policy proposal to limit the amount of nicotine in cigarettes to a minimally-addictive level. Within the first year of implementation, an estimated 5 million smokers may quit smoking. In surveys, smokers are generally supportive of such a policy, although most likely have minimal exposure to very low nicotine content (VLNC) cigarettes. Little is known about the extent of support for a nicotine reduction policy among smokers with prolonged exposure to VLNC cigarettes and if the nicotine reduction approach influences support. Methods: Daily smokers (N=1250) were randomly assigned to an immediate nicotine reduction condition (0.4 mg/g nicotine cigarettes; VLNC), a gradual nicotine reduction condition (15.5 to 0.4 mg/g nicotine cigarettes; monthly nicotine dose changes), or a control condition (15.5 mg/g nicotine cigarettes) for 20 weeks. Participants were asked if they would "support or oppose a law that reduced the amount of nicotine in cigarettes, to make cigarettes less addictive." Logistic regression analyses assessed if policy support was affected by study condition, gender, race, age, education level, menthol status, and interest in quitting as well as cigarette dependence, satisfaction, perceived risk, withdrawal, and craving scores. Results: At week 20 (N=957 completers), 578 participants supported the policy (60.4%), 167 opposed (17.4%), and 212 responded "Don't know" (22.2%). Across conditions, support was greater among those interested in quitting (OR=3.3, 95% CI=2.4, 4.4), older participants (OR= 1.01, 95% CI=1, 1.03) and those with increased cigarette risk perceptions (OR=1.05, 95% CI=1, 1.1). Support was lower among males (OR=0.51, 95% CI=0.38, 0.69) and those with greater dependence scores (OR=0.92, 95% CI=0.86, 0.98). Study condition was not associated with support. Conclusions: The majority of participants supported the policy and prolonged exposure to VLNC cigarettes did not affect support. Notably, smokers interested in quitting were more likely to support the policy. Health communication campaigns highlighting the potential health benefits of cigarette nicotine reduction (i.e. increased quitting) could be advantageous if the FDA moves forward with policy implementation.

Keywords: Cigarette smoking; Tobacco policy