Department of Psychology, Ryerson University, Toronto, ON, Canada.
Masonic Cancer Center, University of Minnesota, Duluth, MN, USA.
Nicotine Tob Res. 2021 Jun 8;23(7):1168-1175. doi: 10.1093/ntr/ntaa236.
A nicotine product standard reducing the nicotine content in cigarettes could improve public health by reducing smoking. This study evaluated the potential unintended consequences of a reduced nicotine product standard by examining its effects on (1) smoking behaviors based on drinking history; (2) drinking behavior; and (3) daily associations between smoking and drinking.
Adults who smoke daily (n = 752) in the United States were randomly assigned to smoke very low nicotine content (VLNC) cigarettes versus normal nicotine content (NNC; control) cigarettes for 20 weeks. Linear mixed models determined if baseline drinking moderated the effects of VLNC versus NNC cigarettes on Week 20 smoking outcomes. Time-varying effect models estimated the daily association between smoking VLNC cigarettes and drinking outcomes.
Higher baseline alcohol use (vs no use or lower use) was associated with a smaller effect of VLNC on Week 20 urinary total nicotine equivalents (ps < .05). No additional moderation was supported (ps > .05). In the subsample who drank (n = 415), in the VLNC versus NNC condition, daily alcohol use was significantly reduced from Weeks 17 to 20 and odds of binge drinking were significantly reduced from Weeks 9 to 17. By Week 7, in the VLNC cigarette condition (n = 272), smoking no longer predicted alcohol use but remained associated with binge drinking.
We did not support negative unintended consequences of a nicotine product standard. Nicotine reduction in cigarettes generally affected smoking behavior for individuals who do not drink or drink light-to-moderate amounts in similar ways. Extended VLNC cigarette use may improve public health by reducing drinking behavior.
There was no evidence that a VLNC product standard would result in unintended consequences based on drinking history or when considering alcohol outcomes. Specifically, we found that a very low nicotine standard in cigarettes generally reduces smoking outcomes for those who do not drink and those who drink light-to-moderate amounts. Furthermore, an added public health benefit of a very low nicotine standard for cigarettes could be a reduction in alcohol use and binge drinking over time. Finally, smoking VLNC cigarettes may result in a decoupling of the daily associations between smoking and drinking.
降低香烟中的尼古丁含量可减少吸烟，从而改善公共健康。本研究通过考察尼古丁含量降低对（1）基于饮酒史的吸烟行为；（2）饮酒行为；以及（3）吸烟和饮酒之间的日常关联的影响，评估了减少尼古丁产品标准的潜在非预期后果。
美国每天吸烟的成年人（n=752）被随机分配在 20 周内吸食极低尼古丁含量（VLNC）香烟与正常尼古丁含量（NNC；对照）香烟。线性混合模型确定基线饮酒是否调节 VLNC 与 NNC 香烟对第 20 周吸烟结果的影响。时变效应模型估计了吸食 VLNC 香烟与饮酒结果之间的每日关联。
较高的基线酒精使用（vs 无使用或低使用）与 VLNC 对第 20 周尿总尼古丁当量的影响较小有关（p<.05）。未支持更多的调节作用（p>.05）。在饮酒的亚样本中（n=415），VLNC 与 NNC 条件下，从第 17 周到第 20 周，每日饮酒量显著减少，从第 9 周到第 17 周，狂饮的几率显著降低。到第 7 周，VLNC 香烟条件下（n=272），吸烟不再预测饮酒，但仍与狂饮有关。
我们没有支持尼古丁产品标准的负面意外后果。一般来说，香烟中的尼古丁减少会以类似的方式影响不饮酒或轻中度饮酒的个体的吸烟行为。延长 VLNC 香烟的使用可能会通过减少饮酒行为来改善公共健康。
没有证据表明，根据饮酒史或考虑酒精结果，VLNC 产品标准会产生意外后果。具体来说，我们发现，对于不饮酒和轻中度饮酒的人，香烟中的极低尼古丁标准通常会降低吸烟结果。此外，随着时间的推移，香烟中极低尼古丁标准的另一个公共健康益处可能是减少酒精使用和狂饮。最后，吸食 VLNC 香烟可能会导致吸烟和饮酒之间的日常关联脱钩。
