title: The reinforcement threshold for nicotine as a target for tobacco control.
abstract: BACKGROUND
  Cigarette smoking represents an enormous public health problem worldwide that leads to over 5 million deaths per year. The gradual reduction of the nicotine content of cigarettes below the threshold that is required to develop addiction is one strategy that might substantially reduce the number of addicted smokers and prevent adolescents from becoming addicted to nicotine (Benowitz and Henningfield, 1994). While the potential public health benefits of this approach are enormous, the guiding concepts and relevant empirical evidence needed to support the implementation of a nicotine reduction policy require a critical examination.
  
  
  METHODS
  The purpose of this paper is to briefly review the current concepts and research regarding nicotine reduction while also discussing the utility of the addictive threshold for nicotine in this approach. The accurate determination of the nicotine addiction threshold presents some conceptual challenges as there is a lack of consensus on how to best measure nicotine addiction. This difficulty can impede the progress for developing a science-based tobacco control policy. As an alternative, the nicotine reinforcement threshold is a relatively clear concept, and well-accepted methods and criteria are available to measure nicotine reinforcement.
  
  
  RESULTS
  However, there are many gaps in our current knowledge concerning the nicotine reinforcement threshold in humans. The threshold for nicotine reinforcement remains to be determined in controlled settings using different populations of current or potential tobacco users. In addition, the value of the nicotine reinforcement threshold in predicting tobacco use in real-world settings needs to be examined. The results of such studies will determine the potential utility of the estimated threshold for nicotine reinforcement in developing science-based tobacco control policies.
authors.affiliation: Yale University, School of Medicine, Department of Psychiatry and VA Connecticut Healthcare System, West Haven, CT 06516, United States. mehmet.sofuoglu@yale.edu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sofuoglu
authors.forename: Mark G
authors.initials: MG
authors.lastname: LeSage
mesh_terms: D000293:Adolescent; D000818:Animals; D006801:Humans; D009538:Nicotine / Q000494:pharmacology* / Q000627:therapeutic use*; D018722:Nicotinic Agonists / Q000494:pharmacology* / Q000627:therapeutic use*; D012054:Reinforcement, Psychology; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology / Q000534:rehabilitation
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine