Addiction Potential of Cigarettes With Reduced Nicotine Content in Populations With Psychiatric Disorders and Other Vulnerabilities to Tobacco Addiction
Addiction Potential of Cigarettes With Reduced Nicotine Content in Populations With Psychiatric Disorders and Other Vulnerabilities to Tobacco Addiction
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DOI：
10.1001/jamapsychiatry.2017.2355
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发表时间：
2017-10-01
期刊：
影响因子：
25.8
通讯作者：
Tursi, Lauren
中科院分区：
文献类型：
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作者：
Higgins, Stephen T.;Heil, Sarah H.;Tursi, Lauren
重要性一项国家政策正在考虑减少香烟的尼古丁含量，以降低尼古丁成瘾的可能性，在美国，目的探讨吸烟者如何与精神疾病和其他脆弱的烟草成瘾的反应，香烟与减少尼古丁含量。参与者对尼古丁含量范围从低于假设成瘾阈值到代表商业香烟的研究香烟的急性反应的内部评估在3个学术研究中心进行的研究（0.4、2.3、5.2和15.8mg/g烟草）包括来自以下3个弱势人群的169名每日吸烟者：情感障碍（n = 56）或阿片类药物依赖（n = 60）和社会经济弱势女性（n = 53）。数据收集自2015年3月23日至2016年4月25日。干预在短暂戒烟后，参与者在14个2- 4小时的门诊时间内暴露于不同尼古丁剂量的香烟。主要结果和测量使用同时选择测试，香烟购买任务（CPT）和主观效果的有效测量来评估吸烟者的成瘾潜力。结果在分析的169名每日吸烟者中（120名女性[71.0%]和49名男性[29.0%];平均[SD]年龄为35.6 [11.4]岁），降低香烟中的尼古丁含量降低了所有3个人群中吸烟的相对增强效应。在人群中，在同时选择测试中，选择0.4 mg/g剂量的显著低于15.8 mg/g剂量（平均值[SEM] 30% [0.04%] vs 70% [ 0.04%]; Cohen d = 0.40; P
IMPORTANCE A national policy is under consideration to reduce the nicotine content of cigarettes to lower nicotine addiction potential in the United States.OBJECTIVE To examine how smokers with psychiatric disorders and other vulnerabilities to tobacco addiction respond to cigarettes with reduced nicotine content.DESIGN, SETTING, AND PARTICIPANTS A multisite, double-blind, within-participant assessment of acute response to research cigarettes with nicotine content ranging from levels below a hypothesized addiction threshold to those representative of commercial cigarettes (0.4, 2.3, 5.2, and 15.8mg/g of tobacco) at 3 academic sites included 169 daily smokers from the following 3 vulnerable populations: individuals with affective disorders (n = 56) or opioid dependence (n = 60) and socioeconomically disadvantaged women (n = 53). Data were collected from March 23, 2015, through April 25, 2016.INTERVENTIONS After a brief smoking abstinence, participants were exposed to the cigarettes with varying nicotine doses across fourteen 2- to 4-hour outpatient sessions.MAIN OUTCOMES AND MEASURES Addiction potential of the cigaretteswas assessed using concurrent choice testing, the Cigarette Purchase Task (CPT), and validated measures of subjective effects, such as the Minnesota Nicotine Withdrawal Scale.RESULTS Among the 169 daily smokers included in the analysis (120 women [71.0%] and 49 men [29.0%]; mean [SD] age, 35.6 [11.4] years), reducing the nicotine content of cigarettes decreased the relative reinforcing effects of smoking in all 3 populations. Across populations, the 0.4-mg/g dose was chosen significantly less than the 15.8-mg/g dose in concurrent choice testing (mean [SEM] 30% [0.04%] vs 70% [ 0.04%]; Cohen d = 0.40; P