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Trials
Published in: Trials 1/2017

Open Access 01-12-2017 | Study protocol

Reduced nicotine content cigarettes in smokers of low socioeconomic status: study protocol for a randomized control trial

Authors: Nicolle M. Krebs, Sophia I. Allen, Susan Veldheer, Diane J. Martinez, Kimberly Horn, Craig Livelsberger, Jennifer Modesto, Robin Kuprewicz, Ashley Wilhelm, Shari Hrabovsky, Abid Kazi, Alyse Fazzi, Jason Liao, Junjia Zhu, Emily Wasserman, Samantha M. Reilly, Lisa Reinhart, Neil Trushin, Robinn E. Moyer, Rebecca Bascom, Jonathan Foulds, John P. Richie Jr., Joshua E. Muscat

Published in: Trials | Issue 1/2017

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Abstract

Background

The Family Smoking Prevention and Tobacco Control Act gave the Food and Drug Administration jurisdiction over the regulation of all tobacco products, including their nicotine content. Under this act, a major strategy to reduce harm from cigarette tobacco is lowering the nicotine content without causing unintended adverse consequences. Initial research on reduced nicotine content (RNC) cigarettes has shown that smokers of these cigarettes gradually decrease their smoking frequency and biomarkers of exposure. The effectiveness of this strategy needs to be demonstrated in different populations whose response to RNC cigarettes might be substantially mediated by personal or environmental factors, such as low socioeconomic status (SES) populations. This study aims to evaluate the response to a reduced nicotine intervention in low SES smokers, as defined here as those with less than 16 years of education, by switching smokers from high nicotine commercial cigarettes to RNC cigarettes.

Methods/design

Adults (N = 280) who have smoked five cigarettes or more per day for the past year, have not made a quit attempt in the prior month, are not planning to quit, and have less than 16 years of education are recruited into a two-arm, double-blinded randomized controlled trial. First, participants smoke their usual brand of cigarettes for 1 week and SPECTRUM research cigarettes containing a usual amount of nicotine for 2 weeks. During the experimental phase, participants are randomized to continue smoking SPECTRUM research cigarettes that contain either (1) usual nicotine content (UNC) (11.6 mg/cigarette) or (2) RNC (11.6 to 0.2 mg/cigarette) over 18 weeks. During the final phase of the study, all participants are offered the choice to quit smoking with nicotine replacement therapy, continue smoking the research cigarettes, or return to their usual brand of cigarettes. The primary outcomes of the study include retention rates and compliance with using only research cigarettes and no use of other nicotine-containing products. Secondary outcomes are tobacco smoke biomarkers, nicotine dependence measures, smoking topography, stress levels, and adverse health consequences.

Discussion

Results from this study will provide information on whether low SES smokers can maintain a course of progressive nicotine reduction without increases in incidence of adverse effects.

Trial registration

ClinicalTrials.gov, NCT01928719. Registered on 21 August 2013.
Appendix
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Metadata
Title
Reduced nicotine content cigarettes in smokers of low socioeconomic status: study protocol for a randomized control trial
Authors
Nicolle M. Krebs
Sophia I. Allen
Susan Veldheer
Diane J. Martinez
Kimberly Horn
Craig Livelsberger
Jennifer Modesto
Robin Kuprewicz
Ashley Wilhelm
Shari Hrabovsky
Abid Kazi
Alyse Fazzi
Jason Liao
Junjia Zhu
Emily Wasserman
Samantha M. Reilly
Lisa Reinhart
Neil Trushin
Robinn E. Moyer
Rebecca Bascom
Jonathan Foulds
John P. Richie Jr.
Joshua E. Muscat
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Trials / Issue 1/2017
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-017-2038-9

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