Very Low Nicotine Content Cigarettes

At a glance

Most people who smoke want to quit. The nicotine in cigarettes is what makes cigarettes addictive. Cigarettes with very low nicotine levels may help people smoke less or quit. Quitting smoking completely is very important to protect health.

The bottom line

  • Nicotine is highly addictive and plays a dominant role in sustaining commercial tobacco use.
  • Using any commercial tobacco product is unsafe. Quitting smoking is very important to protect health.
  • Lowering the nicotine levels in all cigarettes so they are very low may help make them minimally addictive or not addictive and could help prevent people from becoming dependent on nicotine and smoking regularly. Lowering nicotine to minimally addictive or nonaddictive levels in all cigarettes could also help people quit smoking.
  • Preventing and stopping tobacco use would reduce tobacco-related disease and death.

Very low nicotine content cigarettes

Nicotine is a highly addictive chemical found in tobacco products.12 Nicotine can harm the developing adolescent brain.23 It can lead to lifelong nicotine addiction and plays a dominant role in sustaining commercial tobacco use.

Cigarette companies have purposely adjusted nicotine levels in cigarettes to promote addiction. These adjustments cause people to become addicted to cigarettes and keep smoking.4

Very low nicotine content cigarettes are cigarettes with nicotine levels so low they are minimally addictive or are not addictive.5

The public health impact of very low nicotine content cigarettes

Studies show that people who smoke cigarettes and switch to very low nicotine content cigarettes reduce the number of cigarettes they smoke each day.678 However, only reducing the number of cigarettes smoked each day, rather than quitting cigarettes completely, can still lead to serious health problems. Very low nicotine content cigarettes are still harmful. Quitting completely is the best way to protect health.92

Studies show that many people who smoke cigarettes and switch to very low nicotine content cigarettes try to quit smoking, and many are successful.10111213

Overall, adults support reducing nicotine in cigarettes to minimally addictive or nonaddictive levels, including adults who smoke and people who want to quit.141516

Research shows that very low nicotine content cigarettes could be more effective at helping people quit if all cigarettes on the market had very low levels of nicotine.

In 2022, FDA announced it would develop a proposed rule establishing a maximum nicotine content level in cigarettes and certain other combusted tobacco products.17

Reducing the nicotine in cigarettes to minimally addictive or nonaddictive levels could help prevent people who experiment with cigarettes from becoming dependent on nicotine and transitioning to regular use. Reducing the nicotine levels in cigarettes to minimally addictive or nonaddictive levels could help people quit smoking and protect them from tobacco-related death and disease if they quit smoking completely. Public education and proven treatments1819—behavioral counseling and FDA-approved medications—can also help people quit smoking.

Print
Content Source:
National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health
  1. Apelberg BJ, Feirman SP, Salazar E, et al. Potential Public Health Effects of Reducing Nicotine Levels in Cigarettes in the United States. N Engl J Med. 2018;378(18):1725–1733.
  2. U.S. Dept of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. U.S. Dept of Health and Human Services, Centers for Disease Control and Prevention; 2014. Accessed July 18, 2024. https://www.ncbi.nlm.nih.gov/books/NBK179276/
  3. U.S. Food and Drug Administration. Tobacco Product Standard for Nicotine Level of Combusted Cigarettes. 83 Fed. Reg. 11,818. March 16, 2018. Accessed July 18, 2024.https://www.federalregister.gov/documents/2018/03/16/2018-05345/tobacco-product-standard-for-nicotine-level-of-combusted-cigarettes
  4. United States v. Philip Morris USA, Inc. 449 F.Supp.2d 1 (D.D.C. 2006). Accessed July 18, 2024. https://casetext.com/case/us-v-philip-morris-usa-inc-ddc-2005
  5. Benowitz NL, Henningfield JE. Establishing a Nicotine Threshold for Addiction. The Implications for Tobacco Regulation. N Engl J Med. 1994 Jul 14;331(2):123–125.
  6. Puljevic C, Feulner L, Hobbs M, et al. Tobacco Endgame and Priority Populations: A Scoping Review. Tob Control. 2023:tc-2022-057715.
  7. Puljevic C, Morphett K, Hefler M, et al. Closing the Gaps in Tobacco Endgame Evidence: A Scoping Review. Tob Control. 2022;31:365–375.
  8. Shiffman S, Kurland BF, Scholl SM, Mao JM. Nondaily Smokers’ Changes in Cigarette Consumption with Very Low-Nicotine-Content Cigarettes: A Randomized Double-blind Clinical Trial. JAMA Psychiatry 2018;75(10):995–1002.
  9. Dept of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. U.S. Dept of Health and Human Services, Centers for Disease Control and Prevention; 2020. Accessed July 18, 2024. https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf
  10. Donny EC, Denlinger RL, Tidey JW, et al. Randomized Trial of Reduced-Nicotine Standards for Cigarettes. N Engl J Med. 2015;373(14):1340–1349.
  11. Foulds J, Veldheer S, Pachas G, et al. The Effects of Reduced Nicotine Content Cigarettes on Biomarkers of Nicotine and Toxicant Exposure, Smoking Behavior and Psychiatric Symptoms in Smokers with Mood or Anxiety Disorders: A Double-Blind Randomized Trial. PLoS One. 2022;17(11):e0275522.
  12. Hatsukami DK, Kotlyar M, Hertsgaard LA, et al. Reduced Nicotine Content Cigarettes: Effects on Toxicant Exposure, Dependence and Cessation. Addiction. 2010;105(2):343–355.
  13. Higgins ST, Tidey JW, Sigmon SC, et al. Changes in Cigarette Consumption With Reduced Nicotine Content Cigarettes Among Smokers With Psychiatric Conditions or Socioeconomic Disadvantage: 3 Randomized Clinical Trials. JAMA Netw Open. 2020;3(10):e2019311.
  14. Ali FRM, Al-Shawaf M, Wang TW, King BA. U.S. Adults' Attitudes Toward Lowering Nicotine Levels in Cigarettes. Am J Prev Med. 2019;57(3):403–407.
  15. Denlinger-Apte RL, Koopmeiners JS, Tidey JW, et al. Support for a Nicotine Reduction Policy Among Participants Enrolled in a 20-week Trial of Very Low Nicotine Content Cigarettes. Addict Behav. 2021;114:106727.
  16. Fairman RT, Cho YJ, Popova L, et al. Support for Nicotine Reduction in Cigarettes: Findings from the 2016 and 2020 ITC Four Country Smoking and Vaping Surveys. Tob Control. 2023:tc-2023-058128.
  17. FDA Authorizes Marketing of Tobacco Products that Help Reduce Exposure to and Consumption of Nicotine for Smokers Who Use Them. News release. U.S. Food and Drug Administration; December 23, 2021. Accessed January 20, 2022. http://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-tobacco-products-help-reduce-exposure-and-consumption-nicotine-smokers-who
  18. Benowitz NL, Nardone N, Dains KM, et al. Effect of Reducing the Nicotine Content of Cigarettes on Cigarette Smoking Behavior and Tobacco Smoke Toxicant Exposure: 2-year Follow Up. Addiction. 2015;110(10):1667–1675.
  19. Hatsukami DK, Donny EC, Koopmeiners JS, Benowitz NL. Compensatory Smoking from Gradual and Immediate Reduction in Cigarette Nicotine Content. Cancer Epidemiol Biomarkers Prev. 2015;24(2):472–476.