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Acute effects of AdvanceTM: a potential reduced exposure product for smokers
  1. A B Breland,
  2. S E Evans,
  3. A R Buchhalter,
  4. T Eissenberg
  1. Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
  1. Correspondence to:
 Thomas Eissenberg, PhD, Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Box 980205, Richmond, VA 23298-0205, USA;


Objective: To examine the acute effects of AdvanceTM, a potential reduced exposure product (PREP) for smokers marketed as a means to reduce exposure to toxic gases and tobacco specific nitrosamines.

Design, setting, participants: Latin square ordered, three condition, laboratory based, crossover design with 20 smokers of light or ultra-light cigarettes (15 or more cigarettes/day). In each 2.5 hour condition, participants completed an 8-puff smoking bout from their own brand, AdvanceTM, or an unlit cigarette (that is, sham smoking) every 30 minutes for a total of four bouts.

Main outcome measures: Subject rated measures of tobacco/nicotine withdrawal; carbon monoxide (CO), and heart rate; plasma nicotine concentrations.

Results: Relative to own brand, AdvanceTM produced similar withdrawal suppression and heart rate increase, lower CO boost, and higher plasma nicotine concentrations.

Conclusions: PREPs for smokers need to be evaluated using a comprehensive strategy that includes empirical examination of acute and long term effects. Adequate withdrawal suppression and potentially lower concentrations of CO associated with AdvanceTM use are positive factors, although higher nicotine concentrations do not constitute “reduced exposure”. Overall, longer exposure periods are necessary to determine carcinogen delivery. PREP evaluation is complex and should be completed objectively.

  • AdvanceTM
  • potential reduced exposure product
  • CO, carbon monoxide
  • HR, heart rate
  • HSD, honestly significant difference
  • IPI, interpuff interval
  • NS, non-significant
  • PREP, potential reduced exposure product
  • QSU, questionnaire of smoking urges
  • TSNs, tobacco specific nitrosamines
  • VAS, visual analogue scale

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