title: Reduced nicotine product standards for combustible tobacco: building an empirical basis for effective regulation.
abstract: BACKGROUND
  Both the Tobacco Control Act in the U.S. and Article 9 of the Framework Convention on Tobacco Control enable governments to directly address the addictiveness of combustible tobacco by reducing nicotine through product standards. Although nicotine may have some harmful effects, the detrimental health effects of smoked tobacco are primarily due to non-nicotine constituents. Hence, the health effects of nicotine reduction would likely be determined by changes in behavior that result in changes in smoke exposure.
  
  
  METHODS
  Herein, we review the current evidence on nicotine reduction and discuss some of the challenges in establishing the empirical basis for regulatory decisions.
  
  
  RESULTS
  To date, research suggests that very low nicotine content cigarettes produce a desirable set of outcomes, including reduced exposure to nicotine, reduced smoking, and reduced dependence, without significant safety concerns. However, much is still unknown, including the effects of gradual versus abrupt changes in nicotine content, effects in vulnerable populations, and impact on youth.
  
  
  CONCLUSIONS
  A coordinated effort must be made to provide the best possible scientific basis for regulatory decisions. The outcome of this effort may provide the foundation for a novel approach to tobacco control that dramatically reduces the devastating health consequences of smoked tobacco.
authors: Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA. Electronic address: edonny@pitt.edu.
authors: Eric C
authors: EC
authors: Donny
authors: Department of Psychiatry, University of Minnesota, Minneapolis, MN 55414, USA.
authors: Dorothy K
authors: DK
authors: Hatsukami
authors: Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA; Department of Bioengineering & Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94143, USA.
authors: Neal L
authors: NL
authors: Benowitz
authors: Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA.
authors: Alan F
authors: AF
authors: Sved
authors: Center for Alcohol & Addiction Studies, Brown University, Providence, RI 02912, USA.
authors: Jennifer W
authors: JW
authors: Tidey
authors: Center for Alcohol & Addiction Studies, Brown University, Providence, RI 02912, USA.
authors: Rachel N
authors: RN
authors: Cassidy
mesh_terms: D033161:Government Regulation; D006801:Humans; D001523:Mental Disorders / Q000523:psychology; D009538:Nicotine / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry*; D016032:Randomized Controlled Trials as Topic; D012907:Smoking / Q000009:adverse effects / Q000331:legislation & jurisprudence / Q000523:psychology; D016540:Smoking Cessation; D019460:Tobacco Industry / Q000331:legislation & jurisprudence; D062789:Tobacco Products / Q000592:standards*; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D009538:Nicotine
keywords: Addiction; Cigarettes; Harm reduction; Nicotine; Regulatory science; Tobacco