{"doi":"10.32920/21430488","title":"An Evaluation of Potential Unintended Consequences of a Nicotine Product Standard: A Focus on Drinking History and Outcomes","abstract":"<p>Introduction: A nicotine product standard reducing the nicotine content in cigarettes could improve public health by reducing smoking. This study evaluated the potential unintended consequences of a reduced nicotine product standard by examining its effects on (1) smoking behaviors based on drinking history; (2) drinking behavior; and (3) daily associations between smoking and drinking.</p> <p>Methods: Adults who smoke daily (n = 752) in the United States were randomly assigned to smoke very low nicotine content (VLNC) cigarettes versus normal nicotine content (NNC; control) cigarettes for 20 weeks. Linear mixed models determined if baseline drinking moderated the effects of VLNC versus NNC cigarettes on Week 20 smoking outcomes. Time-varying effect models estimated the daily association between smoking VLNC cigarettes and drinking outcomes.</p> <p>Results: Higher baseline alcohol use (vs no use or lower use) was associated with a smaller effect of VLNC on Week 20 urinary total nicotine equivalents (ps < .05). No additional moderation was supported (ps > .05). In the subsample who drank (n = 415), in the VLNC versus NNC condition, daily alcohol use was significantly reduced from Weeks 17 to 20 and odds of binge drinking were significantly reduced from Weeks 9 to 17. By Week 7, in the VLNC cigarette condition (n = 272),</p> <p>smoking no longer predicted alcohol use but remained associated with binge drinking.</p> <p>Conclusions: We did not support negative unintended consequences of a nicotine product standard. Nicotine reduction in cigarettes generally affected smoking behavior for individuals who do not drink or drink light-to-moderate amounts in similar ways. Extended VLNC cigarette use may improve public health by reducing drinking behavior.</p> <p>Implications: There was no evidence that a VLNC product standard would result in unintended consequences based on drinking history or when considering alcohol outcomes. Specifically, we found that a very low nicotine standard in cigarettes generally reduces smoking outcomes for those who do not drink and those who drink light-to-moderate amounts. Furthermore, an added public health benefit of a very low nicotine standard for cigarettes could be a reduction in alcohol use and binge drinking over time. Finally, smoking VLNC cigarettes may result in a decoupling of the daily associations between smoking and drinking.</p>","journal":null,"year":2022,"id":312629,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9533,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":392775,"name":"Katelyn Tessier","orcid":"0000-0002-5513-583X","position":1,"is_corresponding":false},{"id":453817,"name":"Ellen Meier","orcid":null,"position":2,"is_corresponding":false},{"id":393050,"name":"Mustafa Al’Absi","orcid":"0000-0003-4531-038X","position":3,"is_corresponding":false},{"id":1010500,"name":"Rachel L. Denliger-Apte","orcid":null,"position":4,"is_corresponding":false},{"id":453818,"name":"David J. Drobes","orcid":null,"position":5,"is_corresponding":false},{"id":370076,"name":"Joni Jensen","orcid":null,"position":6,"is_corresponding":false},{"id":444066,"name":"Joseph S. Koopmeiners","orcid":"0000-0001-6147-3168","position":7,"is_corresponding":false},{"id":403935,"name":"Lauren R. Pacek","orcid":"0000-0002-1412-1765","position":8,"is_corresponding":false},{"id":307143,"name":"Jennifer W. Tidey","orcid":"0000-0002-8651-4947","position":9,"is_corresponding":false},{"id":452729,"name":"Ryan G. Vandrey","orcid":"0000-0001-6657-884X","position":10,"is_corresponding":false},{"id":414599,"name":"Eric C. Donny","orcid":"0000-0003-3288-9652","position":11,"is_corresponding":false},{"id":252495,"name":"Dorothy K. Hatsukami","orcid":"0000-0002-1108-2609","position":12,"is_corresponding":false},{"id":403932,"name":"Sarah S. Dermody","orcid":"0000-0003-4998-6803","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T00:33:40.460845Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}