Benowitz Neal L, Dains Katherine M, Hall Sharon M, Stewart Susan, Wilson Margaret, Dempsey Delia, Jacob Peyton
Medical Service, San Francisco General Hospital Medical Center, and Department of Medicine, University of California at San Francisco, San Francisco, CA 94143-1220, USA.
Cancer Epidemiol Biomarkers Prev. 2009 Mar;18(3):876-83. doi: 10.1158/1055-9965.EPI-08-0731. Epub 2009 Mar 3.
Mandated reduction of exposure to nicotine and other cigarette toxins has been proposed as a possible national regulatory strategy. However, tapering using lower yield commercial cigarettes may not be effective in reducing nicotine or tar exposure due to compensatory smoking behavior. We examined the effects of gradual reduction of nicotine yield in commercial cigarettes on smoking behavior, with an assessment of nicotine intake and exposure to tobacco smoke toxins.
This 10-week longitudinal study of 20 smokers involved smoking the usual brand followed by different brands with progressively lower machine-determined yields, ranging from 0.9 to 0.1 mg nicotine, each smoked for 1 week. Subjects were followed for 4 weeks after returning to smoking the usual brand (or quitting). Smoking behaviors, biomarkers of tobacco smoke exposure, and cardiovascular effects were measured.
Cotinine and other biomarkers of smoke exposure remained unchanged comparing the usual brand with the 0.4 mg nicotine brands. A 30% to 40% decrease in nicotine, carbon monoxide, and carcinogen exposure comparing 0.1 mg nicotine cigarettes with baseline was observed. Self-efficacy was significantly increased and dependence decreased after tapering.
We confirm prior cross-sectional population and experimental studies showing complete compensation for cigarettes down to the 0.4 mg nicotine range. Nicotine and tobacco toxin exposure were substantially reduced while smoking 0.1 mg nicotine cigarettes. Our data suggest that the degree of nicotine dependence of smokers may be lowered with progressive yield tapering. Gradual tapering of smokers from regular to ultralow nicotine yield commercial cigarettes might facilitate smoking cessation and warrants future research.
强制减少尼古丁及其他香烟毒素的暴露已被提议作为一项可能的国家监管策略。然而，由于补偿性吸烟行为，使用低焦油商业香烟逐渐减量可能无法有效降低尼古丁或焦油暴露。我们研究了商业香烟中尼古丁含量逐渐降低对吸烟行为的影响，并评估了尼古丁摄入量和烟草烟雾毒素暴露情况。
这项针对20名吸烟者的为期10周的纵向研究，让他们先吸常用品牌香烟，然后依次吸机器测定尼古丁含量逐渐降低的不同品牌香烟，尼古丁含量范围从0.9毫克降至0.1毫克，每个品牌吸1周。在受试者恢复吸常用品牌香烟（或戒烟）后，对他们进行4周的跟踪。测量吸烟行为、烟草烟雾暴露生物标志物和心血管效应。
与常用品牌相比，0.4毫克尼古丁含量品牌香烟的可替宁及其他烟雾暴露生物标志物保持不变。与基线相比，0.1毫克尼古丁含量香烟的尼古丁、一氧化碳和致癌物暴露量降低了30%至40%。逐渐减量后，自我效能感显著提高，烟瘾降低。
我们证实了之前的横断面人群研究和实验研究结果，即香烟减量至0.4毫克尼古丁含量范围时会出现完全补偿现象。吸0.1毫克尼古丁含量香烟时，尼古丁和烟草毒素暴露量大幅降低。我们的数据表明，随着尼古丁含量逐渐降低，吸烟者的尼古丁依赖程度可能会降低。吸烟者从常规尼古丁含量香烟逐渐过渡到超低尼古丁含量商业香烟，可能有助于戒烟，值得未来进一步研究。
