Smokers may opt for lower nicotine cigarettes if offered at lower prices

Reducing nicotine intake, a step towards helping smokers reduce — or break — the habit, can be influenced by the price and availability of reduced-nicotine cigarettes, according to Penn State researchers.

The researchers found that smokers were more likely to choose lower-cost, lower-nicotine cigarettes if given a choice when compared to higher-cost, standard nicotine cigarettes. 

The results of the study, led by Steven Branstetter, associate professor of biobehavioral health, were published recently in the journal Nicotine and Tobacco Research.

“These findings are among the first to suggest that if cigarettes were priced according to their nicotine content, smokers may begin to regularly select a less-addictive, and potentially easier to quit, reduced-nicotine cigarette,” Branstetter said. 

“Previously, when reduced-nicotine cigarettes were available in the marketplace, they were a commercial flop. In recent studies of reduced-nicotine cigarettes, smokers almost universally rate them as inferior and unsatisfying. Therefore, the findings that smokers may voluntarily select and use these products based on a differential pricing system are important and may have an influence on future research and policy making efforts,” he said. 

Subjects were 20 male and female smokers between the ages of 21 and 46 from central Pennsylvania who had smoked a minimum of five cigarettes per day over the previous 30 days. Subjects had smoked on average for about 11 years.

They attended five separate, three-hour laboratory sessions in which they were presented with cigarettes of varying prices and nicotine content. Participants were given a limited income to spend on “purchasing” puffs of cigarettes during a four-hour laboratory session. Each puff of a low nicotine cigarette cost significantly less than a puff of a cigarette with normal levels of nicotine. 

Overall, smokers rated low-nicotine cigarettes less satisfying than standard nicotine cigarettes. However, those selecting lower-nicotine cigarettes after abstinence were more likely to smoke more cigarettes per day and to be more highly addicted to nicotine than those selecting standard nicotine cigarettes. 

“This finding was of particular interest as it was expected that those most addicted to nicotine would select the cigarettes with the most nicotine content. Indeed, nicotine addiction is associated with the need for higher levels of nicotine intake at a greater frequency,” Branstetter said. 

"The fact that those more highly addicted to nicotine selected lower-nicotine cigarettes was surprising,” he added. 

“It was speculated that the more highly addicted smokers selected lower-nicotine cigarettes because they were certain to not run out of money to purchase puffs when buying the less expensive low-nicotine options,” Branstetter said. “This demonstrates that smokers are making decisions not just based on nicotine content, but also on economic value. That is, they seem to be applying a ‘quantity over quality’ principle to ensure they do not run out of nicotine over the four hours they are in the laboratory.”   

Branstetter said he hopes this study will spark further studies and larger clinical trials in this area, with the ultimate goal of encouraging those who smoke to choose lower-nicotine options, and eventually quit smoking. 

“The goal is to get smokers to voluntarily select low-nicotine cigarettes if they are priced lower than full-nicotine cigarettes,” Branstetter said. “If reduced-nicotine cigarettes are brought to the marketplace, we believe people will buy them and use them. No such product is available for consumers now.”

“We’re not asking smokers to give up nicotine,” Branstetter said. “Lower-nicotine products might be the foot in the door for reduction and cessation, and maybe even deterring new smokers. If we can get new smokers to start off buying lower-nicotine products then that’s better in the long run.”

The FDA has proposed a rule that would reduce nicotine content in commercially available cigarettes. However, it is not known how smokers may respond in an environment where products of differing nicotine content and of differing prices are available. This study demonstrates that price may be an important factor that could lead smokers to select reduced-nicotine products voluntarily, even if those products are rated as inferior or less satisfying. 

The study was funded by the National Institutes of Health.