Evaluating New Nicotine Standards for Cigarettes

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PROJECT SUMMARY On December 9, 2021, the New Zealand Government launched the Smokefree Aotearoa 2025 Action Plan, outlining a strategy to reduce smoking prevalence to less than 5% for all populations in New Zealand by 2025. The plan includes a commitment to only having low-level nicotine smoked tobacco products for sale. A low nicotine product standard has also been proposed as a cornerstone of the United States Food and Drug Administration’s Comprehensive Plan for Tobacco and Nicotine Regulation. Previous research has demonstrated that when tobacco users switch to very low nicotine content cigarettes there is a reduction in cigarettes per day, dependence and biomarkers of smoke exposure, plus an increase in quit attempts and smoking cessation; and relatively few unintended consequences. However, to date, no country has implemented a low nicotine product standard; therefore, the real world impact of regulation has not been evaluated. We propose to conduct an exploratory sequential mixed methods study in New Zealand adults who smoke tobacco cigarettes to assess product perceptions, concerns for individual health and well-being, need for support services, and behavioral intentions in response to a pending mandated reduction of nicotine in all smoked tobacco products. The survey will also include items from a wide range of domains including tobacco use behaviors; tobacco dependence; attitudes, beliefs, and norms; other health behaviors; significant health conditions and associated risk factors; mental health indicators; and smoking cessation history. Biosamples will be banked in a biorepository located at the University of Auckland for future analysis of changes in objective measures of exposure to tobacco smoke. The proposed research focuses on populations with high smoking prevalence (oversampling important ethnic groups: Maori, Pacific Islanders), including: 1) Individuals with self-reported anxiety, depression and other mental health concerns; 2) Young adult women (age 18-24 years) living in socioeconomically deprived areas of New Zealand who are at a much greater risk of smoking during pregnancy; and 3) Individuals who report heavy alcohol and/or cannabis use.