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, Grace L Reed, MPH Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI Corresponding author: Grace L. Reed, Brown University School of Public Health, Box G-S121-3, Providence, RI 02912, 401-595-2666, grace_reed@alumni.brown.edu Search for other works by this author on: Oxford Academic Suzanne M Colby, PhD Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI Search for other works by this author on: Oxford Academic Jasminette DiLorenzo, BA Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI Search for other works by this author on: Oxford Academic Julia Totten Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI Search for other works by this author on: Oxford Academic Jennifer W Tidey, PhD Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI Search for other works by this author on: Oxford Academic Rachel N Cassidy, PhD Center for Alcohol and Addiction Studies, Brown University School of Public Health , Providence, RI Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0002-0806-2842 Nicotine & Tobacco Research, ntae153, https://doi.org/10.1093/ntr/ntae153
Published:
22 June 2024
Article history
Received:
20 September 2023
Published:
22 June 2024
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Grace L Reed, Suzanne M Colby, Jasminette DiLorenzo, Julia Totten, Jennifer W Tidey, Rachel N Cassidy, Reactions to a Nicotine Reduction Policy Among Adolescents Who Smoke: A Qualitative Study, Nicotine & Tobacco Research, 2024;, ntae153, https://doi.org/10.1093/ntr/ntae153
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Abstract
Introduction
The Biden administration is pursuing a nicotine reduction policy in the U.S. to render cigarettes less addictive. In this study, we qualitatively investigated adolescents’ subjective responses to very low nicotine content (VLNC) cigarettes, reasons for incomplete adherence to using them, and their expected responses to a nicotine reduction policy.
Methods
Adolescents who smoke cigarettes daily (ages 15-19; N=60) were enrolled in a three-week double-blind randomized clinical trial and assigned to smoke either normal nicotine content (NNC) or VLNC research cigarettes. Following the trial, 52 participants completed qualitative interviews about their reactions to the cigarettes and to the idea of a nicotine reduction policy. We utilized a template style approach to thematic analysis involving immersion in the data, codebook development with both inductive and deductive codes, and iterative refinement of themes.
Results
Reasons for incomplete adherence to smoking only research cigarettes focused on dislike for cigarette taste and lower satisfaction compared to usual brand cigarettes. Negative evaluations of research cigarettes were common across both groups. Many participants in both groups reported that they would decrease their smoking or quit entirely if the research cigarettes were the only ones legally available for purchase in the U.S.
Conclusions
Adolescents may respond to a cigarette nicotine reduction policy by decreasing their cigarette smoking and eventually quitting. These findings suggest a need for public health strategies to reduce smoking initiation and progression in young people and to encourage cessation in the context of a nicotine reduction policy.
Implications
Participants’ negative subjective responses and challenges with research cigarette adherence offer insight into factors that might influence young people’s reactions to a real-world nicotine reduction policy. Adolescents who smoke may increase their use of alternative tobacco products, especially e-cigarettes, if this policy were implemented. Specifically, themes identified across participant responses highlight important considerations for how such a policy might be implemented with specific attention to the unique smoking behaviors and needs of this vulnerable population.
Accepted manuscripts
Accepted manuscripts are PDF versions of the author’s final manuscript, as accepted for publication by the journal but prior to copyediting or typesetting. They can be cited using the author(s), article title, journal title, year of online publication, and DOI. They will be replaced by the final typeset articles, which may therefore contain changes. The DOI will remain the same throughout.
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© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
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