Published: 16:51 BST, 22 August 2014 Updated: 01:30 BST, 23 August 2014
Fears smokers opting for reduced-nicotine cigarettes would merely smoke more to get their hit are unfounded, say scientists.
Past studies have raised concerns that cigarettes with lower levels of nicotine could lead to people increasing the intensity of their habit to satisfy their cravings.
But a new study by a team at the University of Waterloo in Canada has suggested the fears may not have been realised.
Nicotine is the main addictive ingredient in cigarettes, giving smokers the highs they crave and the withdrawals that can blight an attempt to quit.
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A new study by scientists at the University of Waterloo in Canada, found cigarettes with lower levels of nicotine do not prompt smokers to smoke more to achieve their fix
The researchers involved in the new study said past studies have raised 'concerns that reduced nicotine cigarettes will be smoked more intensely and, therefore, will increase exposure to toxic chemicals in smoke'.
Seventy-two adult smokers completed an unblinded trial of reduced nicotine cigarettes.
After filling out smoking history surveys, the participants spent seven days smoking their usual choice of cigarette.
That was followed by three consecutive weeks smoking different types of Quest, reduced nicotine level cigarettes.
Each week the levels of nicotine reduced, from 0.6mg in week two to week four when the participants smoked Quest 3 - with a nicotine emission of 0.05mg.
A regular cigarette has a nicotine emission level of around 1.2mg.
The scientists found that the smokers taking part did not change the number of cigarettes they smoked or the number of inhalations they took during each of the four weeks.
The study authors, said: 'The findings provide little evidence of compensatory smoking of Quest cigarettes - those with lower nicotine levels -, with no increases in exhaled breath carbon monoxide levels and smoking intensity.
A study of 72 adult smokers found 'little evidence of compensatory' smoking during a four-week experiment where smokers started with their usual brand, before smoking special low nicotine cigarettes for three weeks
'No significant differences were observed for smoking urges or measures of nicotine dependence.
'The study adds to the evidence that cigarettes with markedly reduced nicotine content are not associated with increased smoking intensity or exposure to smoke toxicants.'
David Hammond, one of the study's authors, mentions that the FDA now has a mandate 'to reduce nicotine levels in cigarettes to negligible amounts', Medical Today News reported.
He said: 'Our study suggests that smokers are unable or unwilling to compensate when there is markedly less nicotine in the cigarette and when the experience of smoking is far less rewarding.
'Our study may help regulators anticipate the possible consequences of mandatory nicotine reductions in cigarettes.'
The study was published in Cancer Epidemiology, Biomarkers and Prevention.
In late July 2017, the FDA released a sweeping plan to regulate tobacco and nicotine products. According to the FDA, the plan “will serve as a multi-year roadmap to better protect kids and significantly reduce tobacco-related disease and death.”
Part of this plan is to reduce the nicotine concentrations in cigarettes to non-addictive levels.
The FDA has its sights trained on the much larger issue of nicotine addiction.
According to FDA Commissioner Scott Gottlieb, MD:
'Because nicotine lives at the core of both the problem and the solution to the question of addiction, addressing the addictive levels of nicotine in combustible cigarettes must be part of the FDA’s strategy for addressing the devastating, addiction crisis that is threatening American families. Our approach to nicotine must be accompanied by a firm foundation of rules and standards for newly-regulated products. To be successful all of these steps must be done in concert and not in isolation.'
Essentially, the FDA is trying to move people away from combustible tobacco products like cigarettes in favor of non-combustible alternatives like e-cigarettes. Although nicotine is addictive, cigarette smoke is full of disease-causing particles which lead to lung cancer, heart disease, COPD, and more. The calculus is that by lowering the nicotine levels in cigarettes, people who are dependent on nicotine won’t want to smoke cigarettes anymore and use e-cigarettes instead.
In reality, it could be years before the FDA actually lowers nicotine concentrations in cigarettes. Predictably, this move by the FDA will be met by strong resistance by the powerful tobacco lobbies. The FDA’s endgame to phase out cigarettes would serve as a major blow to beleaguered tobacco manufacturers.
Another part of the FDA’s plan is to develop a foundation “of rules and standards for newly-regulated products.” To do this, it’s delaying by either three or four years the regulation of e-cigarettes, cigars, cigarillos, and hookah (i.e., water pipe). Originally, the FDA was supposed to have already started regulating these products if not for a delay by the Trump administration.
This move to delay the regulation of e-cigarettes, cigars, cigarillos, and hookah has dismayed many public health experts. These products are made to appeal to kids and come in kid-friendly flavors, such as mint and apple, as well as kid-friendly packaging. Lots of underage kids who are new users purchase tobacco and nicotine products.
Other public health experts are excited that the FDA is linking its policies on e-cigarettes and cigarettes and is following through with the Family Smoking Prevention and Tobacco Control Act, or Tobacco Control Act, which grants the FDA the authority to regulate tobacco products. Specifically, the law finds that “nicotine is an addictive drug” and vests the FDA “with the authority to regulate the levels of tar, nicotine, and other harmful components of tobacco products.”
The Tobacco Control Act was signed into June 22, 2009 by Barack Obama. The law mandates the FDA with the authority to regulate the manufacture, distribution, and marketing of tobacco products to protect public health. In May 2016, the provisions of this law were expanded to cover e-cigarettes and vape pens as well as cigars, pipe tobacco, gels, hookah tobacco, and future tobacco products.
In order for the FDA’s plan to work, and for e-cigarettes to emerge as a safer alternative to cigarettes, the e-cigarettes themselves must be able to consistently deliver enough nicotine to sustain dependence. However, research shows that e-cigarettes vary widely in the amount of nicotine they deliver.
In a 2013 study titled “Nicotine Levels in Electronic Cigarettes,” Goniewicz and co-authors tested 16 popular electronic cigarette brands. They found that the amount of nicotine in vapor varies widely between 0.5 mg to 15.4 mg. (Cigarettes contain between 6 mg and 12 mg of nicotine.)
Furthermore, in electronic cigarettes tested, the amount of nicotine delivered in 15 puffs by an effective device—not all devices are effective—was less than that of a cigarette. Instead, it took between 150 and 180 puffs to deliver the nicotine using e-cigarettes. Keep in mind that it takes about 15 puffs to smoke a cigarette. In other words, it takes a lot of puffs to get the nicotine out of an e-cigarette.
The FDA plans to lower the nicotine concentrations in cigarettes to phase cigarettes out in favor of e-cigarettes, which don’t involve disease-causing smoke particles. This move should substantially reduce tobacco-related disease and death.
However, this change could take several years and will likely be met by steep opposition from tobacco lobbies. Furthermore, in order to take enough time to set the foundation for this grand plan, the FDA is postponing regulation of e-cigarettes, cigars, cigarillos, and hookah. Many of these products appeal to kids and pose a threat to public health. Finally, current e-cigarettes don’t consistently deliver nicotine to users, which compromises their efficacy.
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