Trial reportJAMA network open2018
Association of Reduced Nicotine Content Cigarettes With Smoking Behaviors and Biomarkers of Exposure Among Slow and Fast Nicotine Metabolizers: A Nonrandomized Clinical Trial.
Trial report in JAMA network open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 28 citations in OpenAlex.
- Effects of cigarette package colors and warning labels on marlboro smokers' risk beliefs, product appraisals, and smoking behavior: a randomized trial.BMC public health · 2023Trial
- Effects of pictorial warning labels depicting lesser-known and well-known risks of smoking on viewing patterns, recall, and knowledge of smoking harms.Drug and alcohol dependence · 2023Trial
- The Impact of Gradual and Immediate Nicotine Reduction on Subjective Cigarette Ratings.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2019Trial
- Evaluating the substitutability of fruit versus menthol and tobacco-flavored e-cigarettes on combustible cigarette cessation: Randomized clinical trial protocol.Contemporary clinical trials communications · 2026Article
- Switching from cigarettes to IQOS: the relative importance of IQOS-associated reward, reinforcement and abstinence relief.Tobacco control · 2025Article
- A secondary analysis of the effects of IQOS use on cigarette smoking: Do the effects differ by sex?Drug and alcohol dependence · 2025Article
- Effect of very low nicotine content cigarettes on smoking behavior in Chinese smokers with genotype-stratified nicotine metabolism rates.Frontiers in psychiatry · 2025Article
- The role of IQOS risk perceptions on cigarette smoking behaviours: results from a prospective pilot study.Tobacco control · 2024Article
- Underreporting of non-study cigarette use by study participants confounds the interpretation of results from ambulatory clinical trial of reduced nicotine cigarettes.Harm reduction journal · 2024Article
- Acute nicotine reinforcement requires ability to discriminate the stimulus effects of nicotine.Experimental and clinical psychopharmacology · 2022Review
- Construct validity of the Cigarette Ratings Scale and associations with tobacco use and product feature outcomes.Drug and alcohol dependence · 2022Article
- Shedding 'light' on cigarette pack design: colour differences in product perceptions, use and exposure following the US descriptor ban.Tobacco control · 2022Article
- The "Organic" Descriptor and Its Association With Commercial Cigarette Health Risk Expectancies, Subjective Effects, and Smoking Topography: A Pilot Human Laboratory Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Article
- Responses to reduced nicotine cigarette marketing features: a systematic review.Tobacco control · 2021Article
- Reactions to reduced nicotine content cigarettes in a sample of young adult, low-frequency smokers.Psychopharmacology · 2021Article
- Risk Perceptions of Low Nicotine Cigarettes and Alternative Nicotine Products across Priority Smoking Populations.International journal of environmental research and public health · 2021Article
- Comparing video observation to electronic topography device as a method for measuring cigarette puffing behavior.Drug and alcohol dependence · 2021Article
- Relationships between the Nicotine Metabolite Ratio and a Panel of Exposure and Effect Biomarkers: Findings from Two Studies of U.S. Commercial Cigarette Smokers.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
- The Use of the Nicotine Metabolite Ratio as a Biomarker to Personalize Smoking Cessation Treatment: Current Evidence and Future Directions.Cancer prevention research (Philadelphia, Pa.) · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
importanceThe US Food and Drug Administration (FDA) has announced its intention to reduce the nicotine content in combustible cigarettes but must base regulation on public health benefits. Fast nicotine metabolizers may be at risk for increased smoking following a national nicotine reduction policy. We hypothesized that using reduced nicotine content (RNC) cigarettes would be associated with increases in smoking behaviors and exposure among smokers with a fast-but not slow-nicotine-metabolite ratio (NMR).
objectivesTo examine the association of RNC cigarettes with smoking behaviors and biomarkers of exposure and to compare these associations in fast and slow metabolizers of nicotine based on the NMR. DESIGN SETTING AND
participantsA 35-day, 3-period, within-participant nonrandomized clinical trial was conducted at an academic medical center in Philadelphia, Pennsylvania. A 5-day baseline period using the smokers' preferred brand of cigarettes was followed by 2 consecutive 15-day periods using free investigational RNC cigarettes. A total of 100 daily, non-treatment-seeking, nonmenthol cigarette smokers (59 fast, 41 slow metabolizers) were recruited from December 24, 2013, to December 2, 2015. Data analysis was performed from December 12, 2016, to January 3, 2018.
interventionsTwo 15-day periods using cigarettes containing 5.2 mg (RNC1) and 1.3 mg (RNC2) of nicotine per gram of tobacco. MAIN OUTCOMES AND MEASURES: Smoking behaviors (number of cigarettes per day [CPD], total puff volume) and biomarkers of exposure (carbon monoxide [CO], urine total nicotine equivalents [TNE], and 4-[methylnitrosamino]-1-[3-pyridyl]-1-butanol [NNAL]).
resultsSmokers (73 [73.0%] men; 74 [74.0%] white; mean [SD] age, 43.02 [12.13] years; mean [SD] CPD, 17.31 [5.72]) consumed 2.62 (95% CI, 1.54-3.70) more CPD during the RNC1 period vs their preferred brand during baseline ( CONCLUSIONS AND RELEVANCE: Both RNC cigarettes were associated with decreased puffing and urinary biomarker exposure but not with decreased daily cigarette consumption or CO levels. The NMR did not moderate associations at the nicotine levels tested, suggesting that fast metabolizers may not be at greater risk of increasing use or exposure from these products should the FDA mandate an RNC standard for cigarettes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.