Impact of reduced nicotine content on behavioral economic measures of cigarette reinforcement in adolescents who smoke cigarettes.

Background: Public health officials in the U.S. and New Zealand are considering a reduced nicotine standard for cigarettes to reduce their addictive potential. This study's aim was to evaluate the effects of nicotine reduction on the reinforcing efficacy of cigarettes in adolescents who smoke, which has implications for this policy's potential for success.
Methods: Adolescents who smoked cigarettes daily (n = 66; mean age: 18.6) participated in a randomized clinical trial assessing effects of assignment to very low nicotine content (VLNC; 0.4 mg/g nicotine) or normal nicotine content (NNC; 15.8 mg/g nicotine) cigarettes. Hypothetical cigarette purchase tasks were completed at baseline and the end of Week 3 and demand curves fit to the data. Linear regressions estimated effects of nicotine content on demand for study cigarettes at baseline and Week 3 and associations between baseline demand for cigarette consumption at Week 3.
Results: An extra sum of squares F-test of fitted demand curves indicated that demand (α) was more elastic among VLNC participants at baseline and Week 3 (F(2, 1016)= 35.72, p < 0.001). Adjusted linear regressions indicated demand was more elastic (ß= 1.45, p < 0.01) and maximum expenditure (O _max ) lower (ß= -1.42, p-0.03) among VLNC participants at Week 3. More elastic demand for study cigarettes at baseline predicted lower consumption of cigarettes at Week 3 (p's < 0.01).
Conclusions: A nicotine reduction policy may reduce the reinforcing value of combustible cigarettes among adolescents. Future work should investigate likely responses to such a policy among youth with other vulnerabilities and evaluate the potential for substitution to other nicotine containing products.
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