After a major review of scientific information, six leading tobacco research and policy experts have concluded that a nicotine reduction strategy should be an urgent research priority because of its potential to profoundly reduce the death and disease from tobacco use.
Their findings were published in the journal Tobacco Control.
According to this new report, reducing the amount of nicotine in cigarettes to non-addictive levels could have a significant public health impact on prevention and smoking cessation. Over time, the move could dramatically reduce the number of annual deaths related to cigarette smoking by decreasing adolescent experimentation with cigarettes preventing a progression to addiction, and by reducing dependence on tobacco among currently addicted smokers of all ages.
Dorothy Hatsukami, Ph.D., University of Minnesota Medical School, and Mitch Zeller, J.D., Pinney Associates in Bethesda, MD, led the overall effort as co-chairs of the National Cancer Institute's Tobacco Harm Reduction Network. They convened several meetings of researchers, policy makers, tobacco control advocates and government representatives that explored the science base for a nicotine reduction strategy.
Currently, about 44 million (or 20 percent) of adults in the United States smoke cigarettes. Other research cited by the authors had found that reducing nicotine to non-addictive levels could potentially reduce smoking prevalence to about 5 percent.
"Nicotine addiction sustains tobacco use. Quitting tobacco can be as difficult to overcome as heroin or cocaine addiction," said Hatsukami, director of the University of Minnesota's Tobacco Use Research Center and the Masonic Cancer Center's Cancer Control and Prevention Research Program "Reducing the nicotine in cigarettes to a level that is non-addicting could have a profound impact on reducing death and disability related to cigarettes and improving overall public health."
Hatsukami adds that studies to date have found that substantial reduction in nicotine in cigarettes does not lead to smokers smoking more lower-nicotine cigarettes because it is harder to compensate for very low nicotine intake.
"In addition, studies have shown a significantly lower number of cigarettes are smoked when low-nicotine cigarettes are used, resulting in eventual abstinence in a considerable number of smokers," she said.
"Imagine a world where the only cigarettes that kids could experiment with would neither create nor sustain addiction," Zeller said. "The public health impact of this would be enormous if we can prevent youthful experimentation from progressing to regular smoking, addiction, and the resulting premature disease and death later. Reducing the nicotine content in cigarettes may be a very effective way to accomplish this major impact," he added.
Hatsukami, Zeller, and their colleagues recommend engaging scientific, research and government agencies to conduct the necessary research and set priorities and goals as the next step toward determining the feasibility of a nicotine reduction approach.
This study was funded by the National Cancer Institute, National Institute on Drug Abuse and the American Legacy Foundation. Other authors of this paper include Drs. Kenneth Perkins (University of Pittsburgh), Mark LeSage (Minneapolis Medical Research Foundation and University Minnesota), David Ashley (formerly at the Centers for Disease Control and Prevention, now at the Food and Drug Administration), Jack Heningfield (Pinney Associates), Neal Benowitz (University of California, San Francisco), Cathy Backinger (National Cancer Institute).
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