Titled, “Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta‐analyses,” the study concluded that the most effective smoking cessation tools were nicotine vapes, varenicline and cytisine in that order. “We found high‐certainty evidence that nicotine e‐cigarettes (OR 2.37, 95% CrI 1.73 to 3.24; 16 RCTs, 3828 participants), varenicline (OR 2.33, 95% CrI 2.02 to 2.68; 67 RCTs, 16,430 participants) and cytisine (OR 2.21, 95% CrI 1.66 to 2.97; 7 RCTs, 3848 participants) were associated with higher quit rates than control.”

The researchers added that a combination of NRTs, namely nicotine patches, fast‐acting NRTs and bupropion, were the next most effective aids. While the least effective appeared to be nortriptyline, non‐nicotine vapes and the method of gradually lowering the nicotine dosage of an NRT.

Why lowering nicotine does not work

Many experts are questioning how VLN cigarettes managed to meet the FDA’s tough MRTP standard, which requires products to “significantly reduce harm and the risk of tobacco-related disease.” since reducing nicotine does not reduce risk at all.
The latter finding is in line with what many tobacco harm reduction (THR) experts have been highlighting, in relation to the ineffectivity of low nicotine products for smoking cessation. In fact, when in 2022 New Zealand’s Vaping Regulatory Authority (VRA) wanted to reduce the maximum ‘nicotine salt’ limit in vapes, Aotearoa Vapers Community Advocacy (AVCA) co-founder Nancy Loucas had highlighted that this would jeopardise the smoking cessation efforts of many.

Similarly, on discussing reducing the nicotine limit on regular cigarettes, ACT Social Development and Children spokesperson Karen Chhou, said that having only low nicotine cigarettes available on the market, only pushes smokers to consume more. She added that this would also increase their financial burden, as those smokers who are reluctant to quit, will do anything possible to consume the same amount of nicotine, hence they would just purchase more cigarettes. She had added that that low income nationals would be hit the hardest, and that the measure could lead to more poverty.

Meanwhile a research team at the University of Waterloo, found that the public remains largely misinformed about low nicotine products. In fact, 64% of the 3,500 smokers who participated in this study supported the reduction of nicotine in cigarettes/tobacco products in order to make them less addictive.

The FDA labelled low nicotine products “low risk.” How does this make sense?

Adding fuel to the fire, last year the US Food and Drug Administration (FDA) authorized the marketing of low nicotine cigarettes as reduced risk products. To this effect, 22nd Century Group Inc. had initiated a pilot for its very-low-nicotine traditional cigarettes. The tobacco company had commenced retail production of the first cartons of the very-low- nicotine branded VLN King and VLN Menthol King cigarettes, and started marketing and distributing the cigarettes in March.

Discussing the FDA’s move, THR expert Clive Bates had said that this was the agency’s “most ill-judged moves to date.” He explained that these products still produce all of the smoke and thousands of toxins of traditional cigarettes but practically none of the nicotine.

Similarly, professor of medicine and renowned THR researcher at the University of Louisville, Dr. Brad Rodu, highlighted that many experts are questioning how VLN cigarettes managed to meet the FDA’s tough MRTP standard, which requires products to “significantly reduce harm and the risk of tobacco-related disease to individual tobacco users and benefit the health of the population as a whole, taking into account both users of tobacco products and persons who do not currently use tobacco products.”

He reiterated that reducing nicotine does not reduce risk at all, as nicotine does not cause cancer or any of the other diseases associated with smoking. On the other hand, the chemicals which do, have not been reduced at all.

Kiwi Expert: Low Nicotine Cigs Will Just Make Smokers Consume More

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