title: Separate and combined effects of very low nicotine cigarettes and nicotine replacement in smokers with schizophrenia and controls.
abstract: BACKGROUND
  The prevalence of smoking among people with schizophrenia in the United States is about 3 times that of the general population. Novel approaches are needed to reduce rates of smoking-related morbidity and mortality among these smokers.
  
  
  METHODS
  This study used a within-subjects design to investigate the separate and combined effects of sensorimotor replacement for smoking (very low nicotine content [VLNC] cigarettes vs. no cigarettes) and transdermal nicotine replacement (42 mg nicotine [NIC] vs. placebo [PLA] patches) in smokers with schizophrenia (SS; n = 30) and control smokers without psychiatric illness (CS; n = 26). Each session contained a 5-hr controlled administration period in which participants underwent the following conditions, in counterbalanced order: VLNC + NIC, VLNC + PLA, no cigarettes + NIC, no cigarettes + PLA, usual-brand cigarettes + no patches. Next, participants completed measures of cigarette craving, nicotine withdrawal, smoking habit withdrawal, and cigarette subjective effects, followed by a 90-min period of ad libitum usual-brand smoking.
  
  
  RESULTS
  Smoking VLNC cigarettes during the controlled administration periods reduced cigarette craving, nicotine withdrawal symptoms, habit withdrawal symptoms, and usual-brand smoking in SS and CS relative to the no cigarette conditions. VLNC cigarettes were well accepted by both groups and did not affect psychiatric symptom levels in SS. Transdermal nicotine significantly reduced cigarette craving but did not affect usual-brand smoking.
  
  
  CONCLUSIONS
  These findings suggest that reducing the nicotine content of cigarettes to nonaddictive levels may be a promising approach for reducing nicotine dependence among people with schizophrenia.
authors.affiliation: Brown University Center for Alcohol and Addiction Studies, Providence, RI 02912, USA. jennifer_tidey@brown.edu
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Tidey
authors.forename: Damaris J
authors.initials: DJ
authors.lastname: Rohsenow
authors.forename: Gary B
authors.initials: GB
authors.lastname: Kaplan
authors.forename: Robert M
authors.initials: RM
authors.lastname: Swift
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Ahnallen
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012565:Schizophrenic Psychology; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D013375:Substance Withdrawal Syndrome / Q000523:psychology; D062789:Tobacco Products; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome