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. 2022 Mar 26;24(5):728-735.
doi: 10.1093/ntr/ntab227.

Blood Nicotine Predicts the Behavioral Economic Abuse Liability of Reduced-Nicotine Cigarettes

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Blood Nicotine Predicts the Behavioral Economic Abuse Liability of Reduced-Nicotine Cigarettes

Brent A Kaplan et al. Nicotine Tob Res. .

Abstract

Background: Cigarette smoking continues to be a major health concern and remains the leading preventable cause of death in the US. Recent efforts have been made to determine the potential health and policy benefits of reducing nicotine in combustible cigarettes. The degree to which changes in blood nicotine relate to measures of the abuse liability of reduced-nicotine cigarettes is unknown. The current study examined the relation between blood nicotine and behavioral economic demand measures of cigarettes differing in nicotine content.

Methods: Using a within-subject design, participants smoked a single cigarette during each experimental session. Cigarettes included the participant's usual-brand cigarette and SPECTRUM investigational cigarette differing in nicotine level (mg of nicotine to g of tobacco; 15.8 mg/g, 5.2 mg/g, 2.4 mg/g, 1.3 mg/g, and 0.4 mg/g). During each session, blood was collected at multiple timepoints and behavioral economic demand was assessed. Nonlinear mixed-effects models were used to estimate differences in derived intensity (Q0) and change in elasticity (α).

Results: Measures of blood nicotine decreased in an orderly fashion related to nicotine level and significantly predicted change in elasticity (α), but not derived intensity. No differences in demand parameters between the usual brand and 15.8mg/g cigarettes were observed. However, α was significantly higher (lower valuation) for 0.4mg/g than 15.8mg/g cigarettes.

Conclusions: The lowest nicotine level (0.4mg/g) corresponded with the lowest abuse liability (α) compared to the full-strength control (15.8mg/g), with the 1.3mg/g level also resulting in low abuse liability.

Implications: This is the first study examining the relative contributions of nicotine content in cigarettes and blood nicotine levels on the behavioral economic demand abuse liability of cigarettes ranging in nicotine content. Our results suggest blood nicotine and nicotine content both predict behavioral economic demand abuse liability. In addition, our results suggest a nicotine content of 1.3mg/g or lower may be effective at reducing cigarette uptake among first-time (naïve) smokers. Our results largely conform to previous findings suggesting a very low nicotine content cigarette maintains lower abuse liability than full-strength cigarettes.

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Figures

Figure 1.
Figure 1.
Area under the change in blood nicotine curve. Each dot represents a single participant. The horizontal line within the box represents the median, the length of the box represents the interquartile range, and the whiskers extend to 1.5 times the interquartile range.
Figure 2.
Figure 2.
Predictions from the nonlinear mixed-effects model across the different cigarettes examined in the Cigarette Purchase Task.

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