Department of Psychiatry, Vermont Center on Behavior and Health, Burlington, VT.
Department of Psychological Science, University of Vermont, Burlington, VT.
Nicotine Tob Res. 2019 Dec 23;21(Suppl 1):S81-S87. doi: 10.1093/ntr/ntz145.
The Food and Drug Administration (FDA) has proposed reducing nicotine with very low nicotine content (VLNC) cigarettes. In contrast, reducing nicotine by reducing number of cigarettes per day (CPD) is common. Our prior findings demonstrate that VLNC cigarettes decreased dependence more and were more acceptable than reducing CPD. This secondary analysis explored which reduction strategy increased quit attempts (QA), self-efficacy, or intention to quit more.
This is a secondary analysis of 68 adult daily smokers not ready to quit randomized to smoke VLNC cigarettes versus reduce CPD over 5 weeks. All participants smoked study cigarettes with nicotine yield similar to most commercial cigarettes ad lib for 1 week (baseline). Participants were then randomized to gradually reduce to 70%, 35%, 15%, and 3% of baseline nicotine over 4 weeks by either (1) transitioning to lower nicotine VLNC cigarettes or (2) reducing the number of full nicotine CPD. All participants received nicotine patches to aid reduction. We assessed (1) QAs using nightly and weekly self-reports, (2) Velicer's Self-Efficacy to Quit measure weekly, and (3) the Intention-to-Quit Ladder nightly.
More CPD (41%) than VLNC (17%) participants made any QA (odds ratio = 3.4, 95% confidence interval = 1.1, 10.5). There was no difference in QAs ≥24 h. Self-efficacy increased for VLNC but not CPD participants (interaction: F = 3.7, p < .01). The condition by time interaction for intention-to-quit was not significant.
Reducing number of CPD increased QAs more than reducing nicotine via switching to VLNC cigarettes. The lack of difference in longer QAs suggests replication tests are needed.
Reducing the frequency of smoking behavior (ie, CPD) could be a more effective strategy to increase QAs than reducing the magnitude of nicotine in each cigarette (ie, VLNC) per se.
美国食品和药物管理局（FDA）提出降低极低尼古丁含量（VLNC）香烟中的尼古丁。相比之下，减少每天吸烟的支数（CPD）是很常见的。我们之前的研究结果表明，VLNC 香烟降低了依赖性，且比减少 CPD 更受吸烟者的欢迎。本二次分析旨在探讨哪种减少策略可以更有效地增加戒烟尝试（QA）、自我效能感或戒烟意愿。
这是一项对 68 名尚未准备好戒烟的成年每日吸烟者的二次分析，这些吸烟者被随机分配在 5 周内吸食 VLNC 香烟或减少 CPD。所有参与者在前 1 周内自由吸食与大多数商业香烟尼古丁含量相似的研究香烟（基线）。然后，参与者被随机分配在 4 周内逐渐减少到基线尼古丁的 70%、35%、15%和 3%，方法是（1）过渡到尼古丁含量较低的 VLNC 香烟，或（2）减少全尼古丁 CPD 的支数。所有参与者都接受尼古丁贴片以帮助减少吸烟。我们评估了（1）通过每晚和每周的自我报告来评估 QA，（2）每周评估 Velicer 的戒烟自我效能感测量，以及（3）每晚评估戒烟意愿阶梯。
与 VLNC（17%）相比，更多的 CPD（41%）参与者进行了任何 QA（优势比=3.4，95%置信区间=1.1，10.5）。VLNC 和 CPD 参与者之间 24 小时以上的 QA 没有差异。VLNC 参与者的自我效能感增加，但 CPD 参与者没有（交互作用：F=3.7，p<0.01）。戒烟意愿的条件与时间的交互作用不显著。
与转换为 VLNC 香烟减少尼古丁相比，减少 CPD 的数量可以更有效地增加 QA。较长 QA 没有差异表明需要进行复制测试。
减少吸烟行为的频率（即 CPD）可能比减少每支香烟的尼古丁含量（即 VLNC）本身更能有效地增加 QA。
