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  1. Article ; Online: A review of the evidence on cigarettes with reduced addictiveness potential.

    Donny, Eric C / White, Cassidy M

    The International journal on drug policy

    2021  Volume 99, Page(s) 103436

    Abstract: Background: In May 2018, the Secretariat for the World Health Organization Framework Convention on Tobacco Control convened a meeting to discuss the potential for reducing the addictiveness of tobacco products. A central focus was to review research ... ...

    Abstract Background: In May 2018, the Secretariat for the World Health Organization Framework Convention on Tobacco Control convened a meeting to discuss the potential for reducing the addictiveness of tobacco products. A central focus was to review research findings on the behavioral effects of reducing the addictiveness of cigarettes.
    Methods: This manuscript reports the results of a review of the behavioral science literature, updated through April 2021, with special attention to both the potential benefits and unintended consequences of reducing nicotine in cigarettes.
    Results: Available evidence suggests that reducing nicotine content in cigarettes to very low levels could benefit public health in three primary ways, by 1) decreasing uptake of regular smoking, 2) decreasing the amount people smoke, and 3) increasing the likelihood of smoking cessation. Current evidence also suggests that reducing nicotine in cigarettes may produce similar benefits across many important subpopulations of people who smoke, including those with psychiatric comorbidities, those who use other substances, those with low socioeconomic status, young people, people who smoke infrequently and people who prefer menthol cigarettes. Cigarette nicotine reduction could also lead to some undesirable outcomes, such as experiencing withdrawal, product manipulation, an illicit market, and harm misperceptions; strategies that may mitigate each are discussed.
    Conclusion: Overall, behavioral research suggests product standards that limit the nicotine content of combusted tobacco products could render cigarettes and similar products less addictive. The availability of legal, non-combusted products that effectively substitute for cigarettes and the dissemination of public health campaigns that clarify misperceptions about the relationship between nicotine, tobacco and disease may facilitate the extent to which a nicotine reduction policy reduces smoking.
    MeSH term(s) Adolescent ; Electronic Nicotine Delivery Systems ; Humans ; Nicotine ; Smoking ; Smoking Cessation ; Tobacco Products
    Chemical Substances Nicotine (6M3C89ZY6R)
    Language English
    Publishing date 2021-09-15
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2010000-0
    ISSN 1873-4758 ; 0955-3959
    ISSN (online) 1873-4758
    ISSN 0955-3959
    DOI 10.1016/j.drugpo.2021.103436
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  2. Article ; Online: Reducing the relative value of cigarettes: Considerations for nicotine and non-nicotine factors.

    White, Cassidy M / Hatsukami, Dorothy K / Donny, Eric C

    Neuropharmacology

    2020  Volume 175, Page(s) 108200

    Abstract: Despite notable progress in recent decades, cigarette smoke persists as a leading cause of premature death and preventable disease. To weaken the link between nicotine reinforcement and the toxicity associated with combusted tobacco, the United States ... ...

    Abstract Despite notable progress in recent decades, cigarette smoke persists as a leading cause of premature death and preventable disease. To weaken the link between nicotine reinforcement and the toxicity associated with combusted tobacco, the United States Food and Drug Administration is considering a product standard targeting cigarette nicotine content. In this review, we summarize research assessing the potential impacts of reducing nicotine in cigarettes. Evidence to date suggests cigarette smoking, toxicant exposure and dependence would decline following substantial reductions in nicotine content. However, reduced nicotine content may not eliminate smoking entirely. Regulatory efforts that shape the nicotine and tobacco marketplace should consider that non-nicotine reinforcing factors and decision-making biases can contribute to the value of smoking. The impact of reducing nicotine in cigarettes will likely depend on the alternative nicotine products available to current smokers. This article is part of the special issue on 'Contemporary Advances in Nicotine Neuropharmacology'.
    MeSH term(s) Decision Making ; Humans ; Nicotine/adverse effects ; Reinforcement, Psychology ; Tobacco Products/adverse effects ; Tobacco Use Disorder/prevention & control ; Tobacco Use Disorder/psychology ; United States
    Chemical Substances Nicotine (6M3C89ZY6R)
    Language English
    Publishing date 2020-06-12
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Review
    ZDB-ID 218272-5
    ISSN 1873-7064 ; 0028-3908
    ISSN (online) 1873-7064
    ISSN 0028-3908
    DOI 10.1016/j.neuropharm.2020.108200
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  3. Article ; Online: General and own-species attentional face biases.

    Jakobsen, Krisztina V / White, Cassidy / Simpson, Elizabeth A

    Attention, perception & psychophysics

    2020  Volume 83, Issue 1, Page(s) 187–198

    Abstract: Humans demonstrate enhanced processing of human faces compared with animal faces, known as own-species bias. This bias is important for identifying people who may cause harm, as well as for recognizing friends and kin. However, growing evidence also ... ...

    Abstract Humans demonstrate enhanced processing of human faces compared with animal faces, known as own-species bias. This bias is important for identifying people who may cause harm, as well as for recognizing friends and kin. However, growing evidence also indicates a more general face bias. Faces have high evolutionary importance beyond conspecific interactions, as they aid in detecting predators and prey. Few studies have explored the interaction of these biases together. In three experiments, we explored processing of human and animal faces, compared with each other and to nonface objects, which allowed us to examine both own-species and broader face biases. We used a dot-probe paradigm to examine human adults' covert attentional biases for task-irrelevant human faces, animal faces, and objects. We replicated the own-species attentional bias for human faces relative to animal faces. We also found an attentional bias for animal faces relative to objects, consistent with the proposal that faces broadly receive privileged processing. Our findings suggest that humans may be attracted to a broad class of faces. Further, we found that while participants rapidly attended to human faces across all cue display durations, they attended to animal faces only when they had sufficient time to process them. Our findings reveal that the dot-probe paradigm is sensitive for capturing both own-species and more general face biases, and that each has a different attentional signature, possibly reflecting their unique but overlapping evolutionary importance.
    MeSH term(s) Adult ; Animals ; Attention ; Attentional Bias ; Bias ; Facial Expression ; Humans
    Language English
    Publishing date 2020-10-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2464550-3
    ISSN 1943-393X ; 1943-3921
    ISSN (online) 1943-393X
    ISSN 1943-3921
    DOI 10.3758/s13414-020-02132-w
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  4. Article ; Online: Educating the Public on the Health Risks of Very Low Nicotine Content Cigarettes: Results From a US-Based Convenience Sample.

    Differding, MacKenzie / Katz, Sherri Jean / Strayer, Lori G / White, Cassidy / Strasser, Andrew A / Donny, Eric C / Hatsukami, Dorothy K / Carroll, Dana Mowls

    Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

    2022  Volume 24, Issue 6, Page(s) 871–880

    Abstract: Introduction: US FDA issued an advance notice of proposed rulemaking to reduce nicotine in cigarettes. To maximize the benefits of this potential standard, very low nicotine content (VLNC) cigarettes must be communicated in a way that does not result in ...

    Abstract Introduction: US FDA issued an advance notice of proposed rulemaking to reduce nicotine in cigarettes. To maximize the benefits of this potential standard, very low nicotine content (VLNC) cigarettes must be communicated in a way that does not result in misperceptions.
    Aims and methods: Adults (n = 567 who smoke; n = 610 non-smokers) from an online platform were randomized to a control message previously associated with accurate addictiveness perceptions of VLNC cigarettes but health misperceptions or to one of five messages that also included messaging on nicotine morbidity effects or VLNC cigarettes morbidity or mortality effects. p value <.01 was significant.
    Results: In participants who smoke, perceived lung cancer risk (responses: 1, very little risk to 10, very high risk) if smoked VLNC cigarettes regularly was higher in conditions that communicated mortality effects of VLNC cigarettes compared to the control (7.12-7.18 vs. 5.97, p values < .01). In non-smokers, perceived lung cancer risk was higher in all five message conditions when compared with the control (7.58-8.22 vs. 6.35, p values < .01). Proportion who responded accurately (ie, False) to the statement Cigarettes with 95% less nicotine are safer than cigarettes with normal nicotine levels was higher in conditions describing VLNC morbidity or mortality effects when compared with the control in both participants who smoke (52.04-67.37% vs. 30.85%, p values < .01) and do not smoke (62.50-72.38% vs. 32.00%, p values < .01).
    Conclusions: Messaging on mortality effects of VLNC cigarettes (ie, cigarettes with 95% less nicotine are as deadly as current cigarettes) was associated with more accurate perceptions of the health risks of VLNC cigarettes than the control; however, misperceptions remained in one-third of participants.
    Implications: One approach to communicating a VLNC cigarette standard to the public is to include messaging on the mortality effects of VLNC cigarettes. However, further study and possible refinement of this message condition are recommended since approximately one-third of participants exposed to this message still perceived VLNC cigarettes to be safer than normal nicotine content cigarettes.
    MeSH term(s) Adult ; Behavior, Addictive ; Humans ; Lung Neoplasms ; Nicotine/adverse effects ; Smoking Cessation/methods ; Tobacco Products/adverse effects
    Chemical Substances Nicotine (6M3C89ZY6R)
    Language English
    Publishing date 2022-01-13
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1452315-2
    ISSN 1469-994X ; 1462-2203
    ISSN (online) 1469-994X
    ISSN 1462-2203
    DOI 10.1093/ntr/ntac010
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  5. Article ; Online: Using Product Standards to Render the Most Harmful Tobacco Products Minimally Addictive: Maximum Nicotine Level, Non-Nicotine Constituents, and Scope.

    White, Cassidy M / Pickworth, Wallace B / Sved, Alan F / Donny, Eric C

    Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

    2019  Volume 21, Issue Suppl 1, Page(s) S13–S15

    Language English
    Publishing date 2019-12-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 1452315-2
    ISSN 1469-994X ; 1462-2203
    ISSN (online) 1469-994X
    ISSN 1462-2203
    DOI 10.1093/ntr/ntz121
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  6. Article ; Online: Sustained stoichiometric imbalance and its ecological consequences in a large oligotrophic lake.

    Elser, James J / Devlin, Shawn P / Yu, Jinlei / Baumann, Adam / Church, Matthew J / Dore, John E / Hall, Robert O / Hollar, Melody / Johnson, Tyler / Vick-Majors, Trista / White, Cassidy

    Proceedings of the National Academy of Sciences of the United States of America

    2022  Volume 119, Issue 30, Page(s) e2202268119

    Abstract: Considerable attention is given to absolute nutrient levels in lakes, rivers, and oceans, but less is paid to their relative concentrations, their nitrogen:phosphorus (N:P) stoichiometry, and the consequences of imbalanced stoichiometry. Here, we report ... ...

    Abstract Considerable attention is given to absolute nutrient levels in lakes, rivers, and oceans, but less is paid to their relative concentrations, their nitrogen:phosphorus (N:P) stoichiometry, and the consequences of imbalanced stoichiometry. Here, we report 38 y of nutrient dynamics in Flathead Lake, a large oligotrophic lake in Montana, and its inflows. While nutrient levels were low, the lake had sustained high total N: total P ratios (TN:TP: 60 to 90:1 molar) throughout the observation period. N and P loading to the lake as well as loading N:P ratios varied considerably among years but showed no systematic long-term trend. Surprisingly, TN:TP ratios in river inflows were consistently lower than in the lake, suggesting that forms of P in riverine loading are removed preferentially to N. In-lake processes, such as differential sedimentation of P relative to N or accumulation of fixed N in excess of denitrification, likely also operate to maintain the lake's high TN:TP ratios. Regardless of causes, the lake's stoichiometric imbalance is manifested in P limitation of phytoplankton growth during early and midsummer, resulting in high C:P and N:P ratios in suspended particulate matter that propagate P limitation to zooplankton. Finally, the lake's imbalanced N:P stoichiometry appears to raise the potential for aerobic methane production via metabolism of phosphonate compounds by P-limited microbes. These data highlight the importance of not only absolute N and P levels in aquatic ecosystems, but also their stoichiometric balance, and they call attention to potential management implications of high N:P ratios.
    MeSH term(s) Animals ; China ; Ecosystem ; Environmental Monitoring ; Eutrophication ; Lakes/chemistry ; Lakes/microbiology ; Methane/biosynthesis ; Nitrogen/analysis ; Nitrogen/metabolism ; Organophosphonates/metabolism ; Phosphorus/analysis ; Phosphorus/metabolism ; Phytoplankton/growth & development ; Phytoplankton/metabolism ; Zooplankton/growth & development ; Zooplankton/metabolism
    Chemical Substances Organophosphonates ; Phosphorus (27YLU75U4W) ; Nitrogen (N762921K75) ; Methane (OP0UW79H66)
    Language English
    Publishing date 2022-07-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 209104-5
    ISSN 1091-6490 ; 0027-8424
    ISSN (online) 1091-6490
    ISSN 0027-8424
    DOI 10.1073/pnas.2202268119
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  7. Article ; Online: Preliminary evidence on cigarette nicotine reduction with concurrent access to an e-cigarette: Manipulating cigarette nicotine content, e-liquid nicotine content, and e-liquid flavor availability.

    White, Cassidy M / Tessier, Katelyn M / Koopmeiners, Joseph S / Denlinger-Apte, Rachel L / Cobb, Caroline O / Lane, Tonya / Campos, Claudia L / Spangler, John G / Hatsukami, Dorothy K / Strasser, Andrew A / Donny, Eric C

    Preventive medicine

    2022  Volume 165, Issue Pt B, Page(s) 107213

    Abstract: The reinforcing characteristics of e-cigarettes could moderate the impact of reducing cigarette nicotine content. In this study, people who smoke daily were recruited from North Carolina and Pennsylvania (US) in 2018 and 2019. Within a randomized 2 × 2 ×  ...

    Abstract The reinforcing characteristics of e-cigarettes could moderate the impact of reducing cigarette nicotine content. In this study, people who smoke daily were recruited from North Carolina and Pennsylvania (US) in 2018 and 2019. Within a randomized 2 × 2 × 2 factorial design, participants received investigational cigarettes and an e-cigarette for 12 weeks. Cigarette nicotine content was very low (0.4 mg/g of tobacco; VLNC) or normal (15.8 mg/g; NNC). E-liquids were 0.3% ("low") or 1.8% ("moderate") freebase nicotine, and available in tobacco flavors or tobacco, fruit, dessert and mint flavors. Study recruitment concluded before reaching the planned sample size (N = 480). Fifty participants were randomized and 32 completed the study. We found that randomization to VLNC, relative to NNC cigarettes, reduced self-reported cigarettes per day (CPD; mean difference: -12.96; 95% CI: -21.51, -4.41; p = 0.005); whereas e-liquid nicotine content and flavor availability did not have significant effects. The effect of cigarette nicotine content was larger in the moderate vs. low nicotine e-liquid groups and in the all flavors versus tobacco flavors e-liquid groups; tests of the interaction between e-liquid characteristics and cigarette nicotine content were not significant. Biomarkers of smoke exposure at Week 12 did not differ across conditions, which may reflect variability in adherence to only using VLNC cigarettes. In conclusion this study offers preliminary evidence that the extent to which cigarette nicotine reduction decreases smoking may depend on the reinforcing characteristics of alternative products, including the available nicotine contents and flavors of e-cigarettes.
    MeSH term(s) Humans ; Electronic Nicotine Delivery Systems ; Nicotine ; Tobacco Products ; Tobacco Use ; Biomarkers
    Chemical Substances Nicotine (6M3C89ZY6R) ; Biomarkers
    Language English
    Publishing date 2022-08-19
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2022.107213
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    Zs.A 878: Show issues Location:
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  8. Article ; Online: Centering racial justice for Black/African American and Indigenous American people in commercial tobacco product regulation.

    Breland, Alison B / Carroll, Dana / Denlinger-Apte, Rachel / Ross, Jennifer Cornacchione / Soto, Claradina / White, Cassidy / Donny, Eric C / Fagan, Pebbles / Gardiner, Phillip / Eissenberg, Thomas / Guy, Mignonne C

    Preventive medicine

    2022  Volume 165, Issue Pt B, Page(s) 107117

    Abstract: Although overall health in the United States (US) has improved dramatically during the past century, long-standing health inequities, particularly the unequal and unjust burden of tobacco-related disease and death among racialized populations, persist. A ...

    Abstract Although overall health in the United States (US) has improved dramatically during the past century, long-standing health inequities, particularly the unequal and unjust burden of tobacco-related disease and death among racialized populations, persist. A considerable gap exists in our understanding of how commercial tobacco product regulations and policies cause and/or exacerbate race-based health inequities among Black/African American (B/AA) and Indigenous American people. The purpose of this paper is to 1) describe how existing US commercial tobacco regulatory policies may contribute to structural racism and undermine the full benefits of tobacco prevention and control efforts among B/AA and Indigenous American groups; and 2) initiate a call to action for researchers and regulators of tobacco products to examine policies using an equity lens. These actions are imperative if empirically-informed regulation of commercial tobacco products is to address health equity.
    MeSH term(s) United States ; Humans ; Racism ; Social Justice ; Black or African American ; Nicotiana ; Tobacco Products
    Language English
    Publishing date 2022-06-15
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2022.107117
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  9. Article ; Online: "I actually finally feel like the cigarettes aren't controlling me." - Interviews with participants smoking very low nicotine content cigarettes during a residential study.

    Denlinger-Apte, Rachel L / White, Cassidy M / Donny, Eric C / Hatsukami, Dorothy K / Benowitz, Neal L / Carpenter, Matthew J / Smith, Tracy T

    Drug and alcohol dependence

    2020  Volume 219, Page(s) 108465

    Abstract: Background: The U.S. Food and Drug Administration (FDA) is considering a low-nicotine product standard for cigarettes. The purpose of this qualitative study was to explore participants' experiences after 72 hours of exclusively smoking very low nicotine ...

    Abstract Background: The U.S. Food and Drug Administration (FDA) is considering a low-nicotine product standard for cigarettes. The purpose of this qualitative study was to explore participants' experiences after 72 hours of exclusively smoking very low nicotine content (VLNC) cigarettes.
    Methods: We conducted a residential study during which participants who smoked cigarettes (N = 16) stayed in a smoking-friendly hotel for 5 days/4 nights. Participants only had access to VLNC cigarettes and were told the cigarettes had 97% less nicotine compared to conventional cigarettes. We conducted individual interviews with participants to assess their initial expectations about VLNC cigarettes, subjective experiences when smoking VLNC cigarettes, opinions regarding a low-nicotine product standard, and predicted use behavior if only VLNC cigarettes were available. Interviews were transcribed verbatim and analyzed using thematic analysis methods.
    Results: Several participants expected, prior to trying VLNC cigarettes, to compensate for the reduced nicotine levels by smoking more cigarettes but were surprised when they did not increase their smoking. A subset of participants reported experiencing minor withdrawal symptoms, such as irritability and fatigue. Several participants reported feeling less dependent after exclusively smoking VLNC cigarettes. Most participants said they would smoke VLNC cigarettes if they were the only cigarettes available to purchase. Some also said that smoking VLNC cigarettes could help people taper down or quit smoking.
    Conclusions: Health communication strategies are needed to inform people who smoke about what to expect from a low-nicotine product standard for cigarettes in order to maximize the public health impact of the policy and increase support.
    MeSH term(s) Adult ; Attitude ; Cigarette Smoking ; Emotions ; Fatigue ; Female ; Humans ; Male ; Nicotine ; Policy ; Public Health ; Qualitative Research ; Smoking ; Smoking Cessation/methods ; Tobacco Products ; Tobacco Smoking
    Chemical Substances Nicotine (6M3C89ZY6R)
    Language English
    Publishing date 2020-12-19
    Publishing country Ireland
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 519918-9
    ISSN 1879-0046 ; 0376-8716
    ISSN (online) 1879-0046
    ISSN 0376-8716
    DOI 10.1016/j.drugalcdep.2020.108465
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  10. Article ; Online: Early Changes in Puffing Intensity When Exclusively Using Open-Label Very Low Nicotine Content Cigarettes.

    White, Cassidy M / Watson, Clifford / Bravo Cardenas, Roberto / Ngac, Phuong / Valentin-Blasini, Liza / Blount, Benjamin C / Koopmeiners, Joseph S / Denlinger-Apte, Rachel L / Pacek, Lauren R / Benowitz, Neal L / Hatsukami, Dorothy K / Donny, Eric C / Carpenter, Matthew J / Smith, Tracy T

    Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

    2022  Volume 24, Issue 11, Page(s) 1798–1802

    Abstract: Introduction: In response to reducing cigarette nicotine content, people who smoke could attempt to compensate by using more cigarettes or by puffing on individual cigarettes with greater intensity. Such behaviors may be especially likely under ... ...

    Abstract Introduction: In response to reducing cigarette nicotine content, people who smoke could attempt to compensate by using more cigarettes or by puffing on individual cigarettes with greater intensity. Such behaviors may be especially likely under conditions where normal nicotine content (NNC) cigarettes are not readily accessible. The current within-subject, residential study investigated whether puffing intensity increased with very low nicotine content (VLNC) cigarette use, relative to NNC cigarette use, when no other nicotine products were available.
    Aims and methods: Sixteen adults who smoke daily completed two four-night hotel stays in Charleston, South Carolina (United States) in 2018 during which only NNC or only VLNC cigarettes were accessible. We collected the filters from all smoked cigarettes and measured the deposited solanesol to estimate mouth-level nicotine delivery per cigarette. These estimates were averaged within and across participants, per each 24-h period. We then compared the ratio of participant-smoked VLNC and NNC cigarette mouth-level nicotine with the ratio yielded by cigarette smoking machines (when puffing intensity is constant).
    Results: Average mouth-level nicotine estimates from cigarettes smoked during the hotel stays indicate participants puffed VLNC cigarettes with greater intensity than NNC cigarettes in each respective 24-h period. However, this effect diminished over time (p < .001). Specifically, VLNC puffing intensity was 40.0% (95% CI: 29.9, 53.0) greater than NNC puffing intensity in the first period, and 16.1% (95% CI: 6.9, 26.0) greater in the fourth period.
    Conclusion: Average puffing intensity per cigarette was elevated with exclusive VLNC cigarette use, but the extent of this effect declined across four days.
    Implications: In an environment where no other sources of nicotine are available, people who smoke daily may initially attempt to compensate for cigarette nicotine reduction by puffing on individual cigarettes with greater intensity. Ultimately, the compensatory behavior changes required to achieve usual nicotine intake from VLNC cigarettes are drastic and unrealistic. Accordingly, people are unlikely to sustain attempts to compensate for very low cigarette nicotine content.
    MeSH term(s) Adult ; Humans ; Nicotine ; Smoking Cessation ; Tobacco Products ; Cigarette Smoking ; Research
    Chemical Substances Nicotine (6M3C89ZY6R)
    Language English
    Publishing date 2022-05-07
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1452315-2
    ISSN 1469-994X ; 1462-2203
    ISSN (online) 1469-994X
    ISSN 1462-2203
    DOI 10.1093/ntr/ntac118
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    ab Jg. 2022: Lesesaal (EG)

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