Secondary analysis of a randomized clinical trial of very low nicotine cigarettes: Outcomes across social and demographic groups.

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine Pub Date : 2025-07-21 DOI:10.1016/j.ypmed.2025.108362

Ridwan J Said, Dana Mowls Carroll, Xianghua Luo, Jiayi Hu, Qing Cao, Katelyn M Tessier, Lorna Bittencourt, Dorothy K Hatsukami

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引用次数: 0

Abstract

Objective: To examine whether the impact of a nicotine reduction standard (NRS) varies by socio-demographics.

Methods: Secondary analysis of a 12-week trial (2018-2022) with 438 people who smoke (PWS) comparing very low nicotine content (VLNC) vs. normal nicotine content (NNC) cigarettes. Moderation by education, race, and age on cigarettes per day (CPD), smoke-free days, and biomarkers (CEMA, NNAL) was assessed using interaction models.

Results: For race and education, interaction tests for moderation were not significant (ps > 0.05). In subgroup analyses, VLNC condition reduced CPD and biomarkers and increased smoke-free days with the following exception: no difference in CEMA was observed by condition among those of lower education (Geometric mean ratio [GMR] = 0.72, 95 % confidence interval [CI] = 0.39, 1.33). For age, multiple interaction tests were significant. In subgroup analyses, older but not younger adults, had no VLNC vs. NNC differences for CEMA (GMR: 0.85 [CI = 0.51, 1.41] vs 0.47 [CI = 0.35, 0.62]) or smoke-free days (rate ratio: 1.85 [CI = 0.63, 5.55] vs 5.85 [CI = 3.12, 10.89]).

Conclusion: Age and potentially education moderate NRS effects among PWS.

Policy implications: Targeted support for older adults and those with lower education may maximize NRS benefits.

Trial registration: NCT03272685.

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低尼古丁香烟随机临床试验的二次分析：跨社会和人口群体的结果。

目的：探讨尼古丁减少标准（NRS）的影响是否因社会人口统计学而异。方法：对一项为期12周的试验（2018-2022）进行二次分析，该试验有438名吸烟者（PWS），比较了极低尼古丁含量（VLNC）和正常尼古丁含量（NNC）香烟。通过相互作用模型评估教育、种族和年龄对每日吸烟（CPD）、无烟天数和生物标志物（CEMA、NNAL）的调节作用。结果：在种族和教育程度上，适度性交互检验不显著（ps > 0.05）。在亚组分析中，VLNC条件降低了CPD和生物标志物，增加了无烟天数，但以下例外：不同教育程度的人群中CEMA没有差异（几何平均比[GMR] = 0.72,95 %置信区间[CI] = 0.39,1.33）。对于年龄，多重交互测试是显著的。在亚组分析中，年龄较大但不年轻的成年人在CEMA （GMR: 0.85 [CI = 0.51,1.41]vs 0.47 [CI = 0.35,0.62]）或无烟日数（比率比：1.85 [CI = 0.63,5.55]vs 5.85 [CI = 3.12,10.89]）方面没有VLNC和NNC的差异。结论：年龄和潜在教育程度可调节PWS患者的NRS效应。政策含义：对老年人和受教育程度较低的人提供有针对性的支持，可以最大限度地提高NRS的效益。试验注册：NCT03272685。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Preventive medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.70

自引率

3.90%

发文量

审稿时长

42 days

期刊介绍： Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.