Can cutting the nicotine in cigarettes help people quit?
When the US Food and Drug Administration announced in July a new policy to substantially reduce and limit the amount of nicotine in cigarettes, Jennifer Tidey, PhD, a professor of psychiatry and human behavior and of behavioral and social sciences (research), was in the spotlight. She co-authored an influential 2015 paper in the New England Journal of Medicine that found that, after just six weeks, people who received very low nicotine cigarettes smoked fewer per day, were less dependent, and had minimal withdrawal discomfort compared to those who smoked normal-nicotine cigarettes. Tidey, an investigator in the Center for Alcohol and Addiction Studies in the School of Public Health, hopes this approach will help smokers with psychiatric disorders quit smoking.
People with psychiatric and substance use disorder smoke almost half of the cigarettes consumed in the US. There has long been a belief that a major reason for the high prevalence of smoking in people with psychiatric disorders is that nicotine helps with psychiatric symptoms, by improving negative mood and anxiety, for example. If so, these smokers might experience worsening of symptoms when nicotine is reduced. However, when we compared responses to very low-nicotine cigarettes in people with higher and lower depressive symptoms, we found that those with higher depression reduced their smoking rates just as much as those with lower depression, and their depressive symptoms also improved. Finding effective treatments for vulnerable populations is an important public health priority. We are continuing to study effects of this policy on people with psychiatric disorders and other vulnerable populations, and hope this policy will enable these individuals to achieve greater benefit from smoking treatments and other tobacco control policies.