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The Impact of Smoking Very Low Nicotine Content Cigarettes on Alcohol Use

Dermody, Sarah Siodmok (2015) The Impact of Smoking Very Low Nicotine Content Cigarettes on Alcohol Use. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Product standards reducing the nicotine content in cigarettes could improve public health by reducing smoking behavior and toxicant exposure. However, relatively little is known about how the regulatory strategy could impact alcohol use. The primary objective of this project was to examine the effect of smoking cigarettes with varying nicotine levels on alcohol outcomes. Furthermore, the processes underlying the effect of smoking very low nicotine content (VLNC) cigarettes on alcohol outcomes were examined, including the role of nicotine exposure per se, as well as the indirect effects of cigarettes and withdrawal.
In a double-blind, randomized clinical trial, non-treatment seeking daily smokers (N = 840) were randomly assigned to smoke cigarettes for 6 weeks of varying nicotine content. This investigation focused on current drinkers (n = 476). The nicotine contents examined corresponded with a normal nicotine content (NNC) control condition (15.8 mg/g), a moderate nicotine content condition (5.2 mg/g), and several VLNC cigarette conditions (0.4 mg/g to 2.4 mg/g). Using latent growth curve models, each reduced nicotine content condition was compared to the NNC control condition with respect to the trajectories of average daily alcohol use and occurrence of binge drinking. Several moderating variables of these effects were also explored (i.e., gender, drinking to cope motives, baseline drinking level, history of problem drinking, nicotine dependence level). Furthermore, using mediation analyses, processes that may explain the effect of VLNC cigarettes on alcohol outcomes were investigated, including changes in nicotine exposure, smoking behavior, and withdrawal.
Reducing the nicotine content of cigarettes appeared to reduce alcohol use and binge drinking, particularly among less nicotine dependent smokers. The reduction in alcohol use appeared to be driven by a combination of interrelated processes, notably nicotine exposure and smoking rate. An important subgroup, however, that warrants further study is highly nicotine dependent individuals, who tended to increase their drinking in response to nicotine reduction.
Regulatory strategies reducing the nicotine content in cigarettes may also impact health behaviors that are closely related to smoking, like alcohol use and binge drinking. It is necessary to broadly define the public health impact to include unintended health consequences on non-smoking behaviors.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Dermody, Sarah Siodmoksls124@pitt.eduSLS124
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee MemberSayette, Michael Asayette@pitt.eduSAYETTE
Committee MemberMolina, Brookemolinab@upmc.eduBROOKEM
Committee MemberKamarck, Thomastkam@pitt.eduTKAM
Committee MemberShiffman, Saulshiffman@pitt.eduSHIFFMAN
Committee ChairDonny, Eric Cedonny@pitt.eduEDONNY
Date: 14 September 2015
Date Type: Publication
Defense Date: 24 April 2015
Approval Date: 14 September 2015
Submission Date: 8 July 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 133
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Psychology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: nicotine reduction, smoking, alcohol use, tobacco control, very low nicotine content cigarettes, binge drinking
Date Deposited: 14 Sep 2015 14:41
Last Modified: 19 Dec 2016 14:42


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