Low-nicotine cigarettes may help determined smokers cut back

Mallika Marshall, MD

Contributing Editor

It is abundantly clear that smoking damages the heart, the lungs, and virtually every other body system. According to the Centers for Disease Control and Prevention, smoking remains the leading cause of preventable death in the United States.

So why do people do it?

It’s the nicotine. This stimulant, found in all tobacco products, makes smokers feel calm and relaxed — and it can quickly lead to addiction. The more you smoke, the more you need to smoke to feel good. It’s the pull of nicotine that makes quitting so difficult.

But what if you could reduce the amount of nicotine available in cigarettes to begin with? Would it help people quit — or might it cause them to smoke more to compensate?

Recently, a team of researchers set out to answer this question by following more than 800 adults who smoked at least five cigarettes a day. These study volunteers had no desire to quit smoking. They were asked to either continue smoking their regular brand of cigarette or to smoke one of six types of investigational cigarettes that had varying amounts of nicotine, ranging from 15.8 milligrams (mg) of nicotine per gram of tobacco (the amount found in most commercial brands) all the way down to 0.4 mg per gram. The smokers were followed for six weeks. The results of the study were published in today’s New England Journal of Medicine.

These results were unexpected. The people given the lower-nicotine cigarettes smoked 23% to 30% fewer cigarettes per day than those who smoked the cigarettes with 15.8 mg of nicotine per gram. Perhaps even more surprising, the low-nicotine cigarette smokers also had reduced dependence on nicotine — and fewer cravings for cigarettes when they weren’t smoking.

This study lasted only six weeks, so we’ll need longer trials to help us really understand whether low-nicotine cigarettes are a “safer” option for people who are determined to smoke (as many as one in five Americans is a current smoker). However, these findings do suggest that if the nicotine content in commercial cigarettes could be lowered, users would smoke less and be less likely to get “hooked,” which could mitigate the health risks associated with smoking.

For those who do want to cut out nicotine, there are good options that can help them meet the challenge. They come in many forms, from nicotine patches and gums to lozenges and nasal sprays — not to mention e-cigarettes, which work by vaporizing nicotine. E-cigarettes have become wildly popular, but to date, we don’t know for sure that they are safer than regular cigarettes, or that they can actually help people quit. Prescription drugs like bupropion (Zyban) and varenicline (Chantix) can also help smokers quit. All of these methods work especially well when combined with behavioral supports, such as talk therapy. Of course, it often takes multiple attempts to quit before succeeding — but it can be done.

Anything that reduces the dangers of smoking is a step in the right direction. But as we’ve known for years, the truly best step is to quit altogether.

Related Information: How to Quit Smoking


  1. Ardeshir S. Khou, DDS

    As a dentist, I always warn my patients of the dangers of smoking. Although the addiction factor is valid and extremely important, there are also psychological factors that play a role. Looking cool, smoking to just smoke, smoking because others smoke around you, “cravings” etc.
    With that said, I don’t believe lowering the amount of nicotine will have any positive effect on this population of smokers.
    Thank you for this article. It is well written.

    Ardeshir S. Khou, DDS
    Los Angeles, CA

  2. jp

    Not surprised with the results, as less nicotine in the body would logically compel a smoker to crave less cigarettes. These cigarettes should be readily available to all smokers who wish to reduce or break their addiction, or even just smoke without the addictive component. Low nicotine cigarettes should be viewed (by smokers and the FDA) as a better option than those currently offered to consumers. But would “Big Tobacco” try to resist a move to mandatory lower nicotine to keep their customers hooked? I’m guessing, for as long as the FDA allows them to.

  3. Tothepoint

    You can get a very low nicotine cigarette in Spain. And hopefully the UK and France soon… They are a 0.0% or 0.2% nicotine cigarette with the brand name “Magic”. 22nd Century Group (ticker xxii) is the Corp that makes them. They will be submitting a modified risk application to the FDA for their Very low nicotine product hopefully in the coming weeks/month. Once approved, which could take a longer than a year (which would be absolutely ridiculous), they can sell their Very Low Nicotine product in the United States. They can do a lot more than just what I have noted above too.

  4. B.DOYLE


  5. Jean Hurd

    Well written…..I did learn something… personally, I do not smoke. Parents did..part of the culture in the 1930s to1960s….I would cough when around smoke. JCH

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