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Reducing nicotine exposure results in weight gain in smokers randomized to very low nicotine content cigarettes.

November 17, 2016

Department of Psychology, University of Pittsburgh

.Ìý– November 2016, Tobacco Control. DOI: 10.1136/tobaccocontrol-2016-053301

Key Takeaways

 
  • Weight gain at week 6 was negatively correlated with nicotine exposure in the 2 lowest nicotine content cigarette conditions
 
  • The study indicates that weight gain is a likely consequence of reduced exposure to nicotine
 
  • Funded by the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products (grant id:Ìý U54DA031659)
 

Abstract

 
  • Background:ÌýThe Food and Drug Administration can reduce the nicotine content in cigarettes to very low levels. This potential regulatory action is hypothesised to improve public health by reducing smoking, but may have unintended consequences related to weight gain.
 
  • Methods:ÌýWeight gain was evaluated from a double-blind, parallel, randomised clinical trial of 839 participants assigned to smoke 1 of 6 investigational cigarettes with nicotine content ranging from 0.4 to 15.8 mg/g or their own usual brand for 6 weeks. Additional analyses evaluated weight gain in the lowest nicotine content cigarette groups (0.4 and 0.4 mg/g, high tar) to examine the effect of study product in compliant participants as assessed by urinary biomarkers. Differences in outcomes due to gender were also explored.
 
  • Findings:ÌýThere were no significant differences in weight gain when comparing the reduced nicotine conditions with the 15.8 mg/g control group across all treatment groups and weeks. However, weight gain at week 6 was negatively correlated with nicotine exposure in the 2 lowest nicotine content cigarette conditions. Within the 2 lowest nicotine content cigarette conditions, male and female smokers biochemically verified to be compliant on study product gained significantly more weight than non-compliant smokers and control groups.
 
  • Conclusions:ÌýThe effect of random assignment to investigational cigarettes with reduced nicotine on weight gain was likely obscured by non-compliance with study product. Men and women who were compliant in the lowest nicotine content cigarette conditions gained 1.2 kg over 6 weeks, indicating weight gain is a likely consequence of reduced exposure to nicotine.
  Trial registration number:Ìý, Post-results.