Trial reportNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2021
Switching to Progressively Reduced Nicotine Content Cigarettes in Smokers With Low Socioeconomic Status: A Double-Blind Randomized Clinical Trial.
Trial report in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Compensatory Smoking With Very Low Nicotine Content Cigarettes: A Systematic Review and Meta-Analysis.JAMA network open · 2026Pooled it
- Secondary analysis of a randomized clinical trial of very low nicotine cigarettes: Outcomes across social and demographic groups.Preventive medicine · 2025Trial
- Racial Differences in Nicotine Reduction: Pooled Results from Two Double-Blind Randomized Controlled Trials.Journal of racial and ethnic health disparities · 2025Trial
- Smoking abstinence and cessation-related outcomes one month after an immediate versus gradual reduction in nicotine content of cigarettes.Preventive medicine · 2022Trial
- Potential effects of nicotine content in cigarettes on use of other substances.Preventive medicine · 2022Trial
- E-Liquid Flavor Availability Significantly Affects Cigarette and E-Liquid Purchasing in an Experimental Marketplace Simulating a Low Nicotine Product Standard.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Continuous Nicotine Monitors for Personal Nicotine Pharmacokinetics: A Receptor-Aware Research Agenda.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Review
- Simulating early steps in nicotine dependence: Pharmacokinetics, activation, and chaperoning of nicotinic receptors.Molecular pharmacology · 2025Article
- Evaluating the human abuse potential of concurrent use of electronic cigarettes and low nicotine cigarettes among adults who smoke.Experimental and clinical psychopharmacology · 2025Article
- Perceptions and Interest in Lung Cancer Screening by Smoking Status: A Cross-Sectional Study of HINTS 6 (2022).Healthcare (Basel, Switzerland) · 2024Article
- Dietary Patterns among Smokers and Non-Smokers: Findings from the National Health and Nutritional Examination Survey (NHANES) 2017-2018.Nutrients · 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
- Disparities in Healthcare and HBV Vaccination by Smoking Status: Findings from the National Health and Nutrition Examination Survey (NHANES) 2017-2018.Healthcare (Basel, Switzerland) · 2023Article
- Qualitative reactions to a low nicotine product standard for cigarettes from adolescents and young adults living in the United States who smoke.Preventive medicine reports · 2023Article
- Electronic Cigarette Users' Reactions and Responses to a Hypothetical Nicotine Concentration Reduction in Electronic Cigarette Liquids.Substance use & misuse · 2023Article
- Reducing Misperceptions About Very Low Nicotine Content Cigarettes: Insights From Adults Who Smoke.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Article
- Effect of menthol on nicotine reduction: Pooled results from two double-blind randomized controlled trials.Brain research bulletin · 2022Review
- A review of the evidence on cigarettes with reduced addictiveness potential.The International journal on drug policy · 2022Review
- Risk Perceptions of Low Nicotine Cigarettes and Alternative Nicotine Products across Priority Smoking Populations.International journal of environmental research and public health · 2021Article
- Reducing the Nicotine Content of Cigarettes: Effects in Smokers With Mental Health Conditions and Socioeconomic Disadvantages.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
Abstract
introductionThe Food and Drug Administration issued an advanced notice of proposed rulemaking for setting a product standard for nicotine levels in cigarettes, with an emphasis on minimally or non-addicting very low nicotine content (VLNC).
methodsA 33 week, two-arm, double-blind randomized trial conducted in Hershey, Pennsylvania, USA and Washington, DC, USA included adult daily cigarette smokers (≥5 cigarettes per day) with less than a college degree, and who had no plans to quit within the next six months. Participants were randomized to either reduced nicotine content (RNC) study cigarettes tapered every three weeks to a final VLNC (0.2 mg/cigarette) for six weeks or to usual nicotine content (UNC) study cigarettes (11.6 mg/cigarette). Outcomes included acceptability of study cigarettes measured by attrition (primary outcome), compliance, reduction in cigarette dependence and tobacco biomarkers, and post-intervention cessation.
resultsThe RNC (n = 122) versus UNC (n = 123) group had higher attrition (adjusted Hazard Ratio 3.4; 95% confidence interval [CI] 1.99 to 5.81). At the end of the intervention, cotinine levels were 50% lower in the RNC group (mean group difference -137 ng/mL; 95% CI -172, -102). The RNC group smoked fewer CPD (-4.1; 95% CI -6.44, -1.75) and had lower carbon monoxide levels (-4.0 ppm; 95% CI -7.7, -0.4). Forty seven percent (29/62) of the RNC group were biochemically-confirmed compliant with smoking VLNC cigarettes (mean cotinine = 8.9 ng/ml). At three month follow-up, only compliant VLNC smokers quit with an assisted quit attempt (N = 6/22, 27%).
conclusionsThis study supports a VLNC standard in cigarettes. IMPLICATIONS: Differential dropout and noncompliance indicate some smokers had difficulty transitioning to cigarettes with reduced nicotine. These smokers will benefit from supplemental nicotine in medicinal or noncombustible tobacco products if a nicotine reduction standard is established. Other smokers successfully transitioned to very low nicotine content cigarettes exclusively and substantially reduced their exposure to nicotine.
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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.