Nearly half of the tobacco consumed in the United States is smoked by people with psychiatric illness. Reducing the nicotine content of cigarettes to a non-addictive level {i.e., <0.2 mg nicotine) is an innovative regulatory strategy that could significantly reduce tobacco-related morbidity and mortality. However, an expert panel that evaluated the potential impact of this policy identified the possibility of unintended consequences for smokers with comorbid psychiatric illness as a key area of concern, as these smokers could also respond to reductions in the nicotine content of cigarettes with increases in psychiatric symptoms and with compensatory smoking. One important comorbid population to consider is smokers with current major depressive disorder (MDD), who comprise 20-30% of people with current nicotine dependence. Little is known about the effects a nicotine reduction policy might have on smokers with MDD, as to our knowledge no studies have reported the effects of very low nicotine content cigarettes on smoking rate, toxicant exposure, cigarette tolerability or depression severity in these smokers. This substantial gap in the literature will be addressed in the proposed project. In Study 1, participants will assess acute effects of four cigarette conditions of varying nicotine yield (0.83, 0.28, 0.10, 0.03 mg) on craving, nicotine withdrawal, and the degree to which the reduced-nicotine cigarettes substitute for normal-nicotine cigarettes when availability of the latter is constrained. In Study 2, after a 1-week, 2-session baseline assessment period, smokers with current MDD will be randomized to one of these same four cigarette conditions for a 12-week extended exposure phase. Over the baseline and extended-exposure phases, patterns of tobacco use, biomarkers of toxicant exposure, psychiatric symptoms, cognitive performance and smoking topography will be assessed. By examining both the potential positive and negative consequences of very low nicotine cigarette use in smokers with MDD, this study will examine whether a regulatory approach of reducing the nicotine content of cigarettes to a non-addictive level is a viable method of reducing smoking in this population.

Public Health Relevance

There is an unusually high rate of cigarette smoking and correspondingly high rates of smoking-related morbidity and mortality in smokers with major depressive disorder. This project will investigate the acute and extended effects of very low nicotine content cigarettes on smoking, toxicants, psychiatric symptoms, cognitive functioning and other measures in smokers with major depressive disorder. This information will help to determine whether a public health policy of limiting the nicotine content of cigarettes to very low levels would be effective and safe for these smokers.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Specialized Center (P50)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Vermont & St Agric College
United States
Zip Code
Parker, Maria A; Streck, Joanna M; Bergeria, Cecilia L et al. (2018) Reduced Nicotine Content Cigarettes and Cannabis Use in Vulnerable Populations. Tob Regul Sci 4:84-91
Taghavi, Taraneh; Arger, Christopher A; Heil, Sarah H et al. (2018) Longitudinal Influence of Pregnancy on Nicotine Metabolic Pathways. J Pharmacol Exp Ther 364:238-245
Kurti, Allison N; Redner, Ryan; Bunn, Janice Y et al. (2018) Examining the relationship between pregnancy and quitting use of tobacco products in a U.S. national sample of women of reproductive age. Prev Med 117:52-60
Taghavi, Taraneh; Arger, Christopher A; Heil, Sarah H et al. (2018) Cigarette consumption and biomarkers of nicotine exposure during pregnancy and postpartum. Addiction 113:2087-2096
Abudayyeh, Haneen S; Glasser, Allison M; Johnson, Amanda L et al. (2018) Social and substance use correlates of adult hookah use, 2016. Addict Behav 79:39-44
Smith, Tracy T; Hatsukami, Dorothy K; Benowitz, Neal L et al. (2018) Whether to push or pull? Nicotine reduction and non-combusted alternatives - Two strategies for reducing smoking and improving public health. Prev Med 117:8-14
Parker, Maria A; Villanti, Andrea C; Quisenberry, Amanda J et al. (2018) Tobacco Product Harm Perceptions and New Use. Pediatrics 142:
Parker, Maria A; Streck, Joanna M; Sigmon, Stacey C (2018) Associations between opioid and nicotine dependence in nationally representative samples of United States adult daily smokers. Drug Alcohol Depend 186:167-170
Zvorsky, Ivori; Skelly, Joan M; Higgins, Stephen T (2018) Effects of Financial Incentives for Smoking Cessation on Mood and Anxiety Symptoms Among Pregnant and Newly Postpartum Women. Nicotine Tob Res 20:620-627
Cepeda-Benito, A; Doogan, N J; Redner, R et al. (2018) Trend differences in men and women in rural and urban U.S. settings. Prev Med 117:69-75

Showing the most recent 10 out of 74 publications