title: Acute effects of Advance: a potential reduced exposure product for smokers.
abstract: OBJECTIVE
  To examine the acute effects of Advance, a potential reduced exposure product (PREP) for smokers marketed as a means to reduce exposure to toxic gases and tobacco specific nitrosamines.
  
  
  METHODS
  Latin square ordered, three condition, laboratory based, crossover design with 20 smokers of light or ultra-light cigarettes (15 or more cigarettes/day). In each 2.5 hour condition, participants completed an 8-puff smoking bout from their own brand, Advance, or an unlit cigarette (that is, sham smoking) every 30 minutes for a total of four bouts.
  
  
  METHODS
  Subject rated measures of tobacco/nicotine withdrawal; carbon monoxide (CO), and heart rate; plasma nicotine concentrations.
  
  
  RESULTS
  Relative to own brand, Advance produced similar withdrawal suppression and heart rate increase, lower CO boost, and higher plasma nicotine concentrations.
  
  
  CONCLUSIONS
  PREPs for smokers need to be evaluated using a comprehensive strategy that includes empirical examination of acute and long term effects. Adequate withdrawal suppression and potentially lower concentrations of CO associated with Advance use are positive factors, although higher nicotine concentrations do not constitute "reduced exposure". Overall, longer exposure periods are necessary to determine carcinogen delivery. PREP evaluation is complex and should be completed objectively.
authors.affiliation: Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia 23298-0205, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Breland
authors.forename: S E
authors.initials: SE
authors.lastname: Evans
authors.forename: A R
authors.initials: AR
authors.lastname: Buchhalter
authors.forename: T
authors.initials: T
authors.lastname: Eissenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000393:Air Pollutants; D002248:Carbon Monoxide / Q000097:blood; D018592:Cross-Over Studies; D004781:Environmental Exposure / Q000517:prevention & control*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000097:blood; D018722:Nicotinic Agonists / Q000097:blood; D012907:Smoking / Q000009:adverse effects* / Q000097:blood; D016540:Smoking Cessation / Q000379:methods; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D014029:Tobacco Use Disorder / Q000097:blood
chemical_list: D000393:Air Pollutants; D018722:Nicotinic Agonists; D009538:Nicotine; D002248:Carbon Monoxide