Department of Psychiatry and Behavioral Sciences, and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
Division of Biostatistics, School of Public Health, and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
Cancer Epidemiol Biomarkers Prev. 2020 Mar;29(3):643-649. doi: 10.1158/1055-9965.EPI-19-0905. Epub 2020 Feb 26.
A mandated reduction in the nicotine content of cigarettes could reduce smoking rate and prevalence. However, one concern is that smokers may compensate by increasing the intensity with which they smoke each cigarette to obtain more nicotine. This study assessed whether smokers engage in compensatory smoking by estimating the mouth-level nicotine intake of low nicotine cigarettes smoked during a clinical trial.
Smokers were randomly assigned to receive cigarettes with one of five nicotine contents for 6 weeks. An additional group received a cigarette with the lowest nicotine content, but an increased tar yield. The obtained mouth-level nicotine intake from discarded cigarette butts for a subset of participants (51-70/group) was estimated using solanesol as described previously. A compensation index was calculated for each group to estimate the proportion of nicotine per cigarette recovered through changes in smoking intensity.
There was no significant increase in smoking intensity for any of the reduced nicotine cigarettes as measured by the compensation index (an estimated 0.4% of the nicotine lost was recovered in the lowest nicotine group; 95% confidence interval, -0.1 to 1.2). There was a significant decrease in smoking intensity for very low nicotine content cigarettes with increased tar yield.
Reductions in nicotine content did not result in compensatory changes in how intensively participants smoked research cigarettes.
Combined with data from clinical trials showing a reduction in cigarettes smoked per day, these data suggest that a reduction in nicotine content is unlikely to result in increased smoke exposure.
香烟尼古丁含量的强制降低可能会降低吸烟率和吸烟率。然而，人们担心的是，吸烟者可能会通过增加每支香烟的吸烟强度来补偿，以获得更多的尼古丁。本研究通过评估吸烟者在临床试验中吸食低尼古丁香烟时是否进行了补偿性吸烟，来估计每支香烟的口腔尼古丁摄入量。
吸烟者被随机分配在 6 周内接受五种尼古丁含量之一的香烟。另外一组接受尼古丁含量最低但焦油产量增加的香烟。从一小部分参与者（每组 51-70 人）丢弃的烟蒂中获得的口腔尼古丁摄入量，使用之前描述的茄尼醇进行估计。为每个组计算了一个补偿指数，以估计通过吸烟强度变化恢复的每支香烟尼古丁的比例。
任何一种低尼古丁香烟的吸烟强度都没有显著增加，这可以通过补偿指数来衡量（估计在最低尼古丁组中，损失的尼古丁中有 0.4%通过吸烟强度的增加得到了恢复；95%置信区间，-0.1 至 1.2）。对于尼古丁含量非常低但焦油含量增加的香烟，吸烟强度显著降低。
尼古丁含量的降低并没有导致参与者吸食研究香烟的强度发生补偿性变化。
这些数据与临床试验数据相结合，表明香烟每天吸烟量的减少，表明尼古丁含量的降低不太可能导致烟雾暴露的增加。
