Nicotine Dependence Clinical Trial
Official title:
Safety of Nicotine Reduction Strategy
This is a 2-year study involving the progressive reduction in the nicotine content of cigarettes. The investigators believe that at the end of the study smokers of cigarettes with progressively reduced nicotine content will be "weaned" from nicotine. At the end of the study, the result will be a decreased level of nicotine dependence. When smokers are again free to choose any smoking behavior, they will smoke fewer cigarettes and/or have a greater interest in quitting compared to a control group that smokes their usual cigarettes.
This is a 2-year, randomized, two-arm study involving a 6-month period of progressive
reduction in the nicotine content of cigarettes. During the first year (tapering/maintenance
phases), subjects will smoke progressively reduced nicotine content (RNC) cigarettes over a
period of six months, and then remain on the lowest nicotine content cigarette for an
additional six months. Comparisons will be made with a control group in which subjects will
smoke their usual normal nicotine yield cigarettes. There will be a one year follow-up phase
during which subjects will be monitored and will be free to resume smoking a commercial
cigarette of their choice, or to quit.
We hypothesize that smokers of cigarettes with progressively reduced nicotine content will
experience a reduction in nicotine intake without compensatory oversmoking. This will serve
to "wean" them from nicotine and result in a decreased level of nicotine dependence. Once
this has occurred, subjects will then be able to maintain their reduced level of nicotine
intake for the 6 months that they continue smoking the lowest level RNC cigarette. When they
are again free to choose any smoking behavior (follow-up phase), as a result of the period
of lowered dependence they will smoke fewer cigarettes and/or have a greater interest in
quitting compared to the control group, whose level of nicotine dependence is hypothesized
to be sustained throughout.
Primary Hypotheses:
1. Nicotine intake will be lower for the RNC group than for the control group.
2. Exposure to tobacco smoke gas phase constituents will be similar for the RNC and
control group.
3. Exposure to tobacco smoke tar constituents will be similar for the RNC and control
group.
4. Cardiovascular biomarkers of inflammation, platelet activation, endothelial
dysfunction, and HDL cholesterol will be lower for the RNC group than for the control
group.
5. Cigarette consumption, as measured by cigarettes-per-day (CPD), will be lower for the
RNC group than for the control group.
Secondary hypotheses:
1. Over the course of tapering and maintenance and at follow-up, interest in quitting will
be higher in the RNC group compared to the control group.
2. At follow-up, measures of cigarette consumption, nicotine intake, and exposure to
tobacco smoke combustion constituents will be lower for the RNC group compared to the
control group.
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Observational Model: Case Control, Time Perspective: Prospective
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