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What to expect: the FDA’s plan to limit nicotine in cigarettes

When the U.S. Food and Drug Administration announced on July 28 a new push to substantially reduce and limit the amount of nicotine in cigarettes, the policy was informed by an evidence base developed with critical contributions from Brown University’s Center for Alcohol and Addiction Studies (CAAS) in the School of Public Health.

For years, a group of faculty members, postdoctoral researchers and students has been studying many dimensions of nicotine reduction, including the impact such a policy might have on smoking behavior in general and on specific populations of smokers, some of whom might face unintended consequences. Among those researchers is Jennifer Tidey, a professor of psychiatry and human behavior and of behavioral and social sciences, who co-authored a particularly influential paper in the New England Journal of Medicine in 2015. READ MORE

Naltrexone Does Not Improve Smoking Cessation Outcomes for Heavy Drinking Smokers

Alcohol use is positively associated with smoking initiation and escalation to regular cigarette use, and is among the most common smoking relapse precipitants. In the past, smoking cessation interventions that have incorporated counseling to reduce drinking have shown some success. An intriguing possibility for enhancing the effectiveness of such interventions is adding pharmacotherapies that impact alcohol use, such as naltrexone. The results of this study, led by Christopher Kahler, professor of behavioral and social sciences, and published in Alcohol: Clinical and Experimental Research, indicate that a smoking cessation intervention that includes counseling on alcohol use can have positive effects for heavy drinking smokers. However, this study provided no evidence that naltrexone is effective for enhancing reductions in drinking or improving smoking cessation in this population. READ MORE

Health Risk Perceptions in Those Using Very Low Nicotine Content Cigarettes

One possible strategy for reducing the harm caused by cigarettes is to implement a product standard requiring the reduction of nicotine content to make cigarettes less addictive. This could decrease youth uptake if fewer progress from experimentation to addiction, increase smoking cessation, and reduce smoke exposure in those unable to quit. However, this shift may carry with it unintended consequences, like a change in smokers’ beliefs about the health risks associated with smoking. Prior research has shown that some smokers incorrectly believe ‘light’ cigarettes are less harmful than regular cigarettes. Similar misunderstandings of health risk could also apply to reduced nicotine cigarettes. Little is known about how smokers experience reduced nicotine content cigarettes when they are aware of the reduced content, and how use may be impacted. The purpose of this study, published in Nicotine and Tobacco Research and led by Rachel Denlinger-Apte, doctoral student in the department of behavioral and social health sciences, was to investigate the effect of a very low nicotine content expectancy on health risk perceptions and subjective effects of smoking cigarettes with actual low nicotine content. READ MORE

Longitudinal Study of Persistent Smoking among HIV-Positive Gay and Bisexual Men

Tobacco use continues to be one of the leading causes of preventable morbidity and premature mortality and is a well-recognized risk factor for chronic diseases including cardiovascular disease, pulmonary disease, and cancer. In HIV-positive gay, bisexual, and other men who have sex with men, smoking is a highly prevalent behavior that, in addition to more general adverse outcomes, has been linked to an increased likelihood of HIV-related medical complications and has been shown to negatively impact immune and virologic response. However, smoking cessation rates among this population remain low. Within couples affected by HIV, primary partners play a positive role in HIV-related outcomes. The purpose of this study, published in Addictive Behaviors and led by Kristi Gamarel, Assistant Professor of Behavioral and Social Sciences, was to longitudinally assess smoking status in a population of HIV-positive men in same-sex relationships, and the impact of partner smoking status. READ MORE

Tailored Video Intervention to Reduce Smoking and Environmental Tobacco Exposure during and After Pregnancy

The purpose of this paper, published in Contemporary Clinical Trials and led by Patricia Risica, Assistant Professor of Behavioral and Social Sciences, Assistant Professor of Epidemiology, and faculty member in the Center for Health Equity Research, was to describe the Baby’s Breath study; a randomized, controlled trial of a tailored video intervention. The study aimed to test the efficacy of tailored video verses usual care approaches to reduce the ETS exposure of fetuses of low-income women during and after pregnancy; and to assess this intervention separately among non-smoking and smoking women. READ MORE

The Characteristics of Intermittent and Daily Smokers in a Sample of Heavy-drinking, HIV-infected MSM

The prevalence of cigarette smoking remains high among persons living with HIV, in particular among gay, bisexual, and other men who have sex with men. Smoking among persons living with HIV has been linked to increased rates of cardiovascular disease, cancer, and other pulmonary diseases. The purpose of this study, published in AIDS Care and led by Patricia Cioe, assistant professor of behavioral and social sciences, was to compare the quit intentions of daily smokers and intermittent smokers, in a population of heavy-drinking, HIV-infected men who have sex with men. read more