Abstract

Background: Non-combustible potential reduced exposure products (PREPs; e.g., Star Scientific’s Ariva; a variety of other smokeless tobacco products) are marketed to reduce the harm associated with smoking. This marketing occurs despite an absence of objective data concerning the toxicant exposure and effects of these PREPs. This study adapted methods used to examine combustible PREPs to assess the acute effects of non-combustible PREPs for smokers.

Methods: Twenty-eight overnight abstinent cigarette smokers (17 men; 14 non-white) each completed seven, Latin-squared ordered, approximately 2.5-hour laboratory sessions that differed by product administered: Ariva, Marlboro snus (Philip Morris USA), Camel snus (RJ Reynolds), Commit nicotine lozenge (GlaxoSmithKline; 2 mg), own brand cigarettes, Quest cigarettes (Vector Tobacco; delivers very low levels of nicotine), and sham smoking (i.e., puffing on an unlit cigarette). In each session the product was administered twice (separated by 60 minutes), and plasma nicotine levels, expired air CO, and subjective effects were assessed regularly.

Results: Results indicated that the non-combustible products delivered less nicotine than own brand cigarettes, did not expose smokers to CO, and failed to suppress tobacco abstinence symptoms as effectively as combustible products.

Conclusions: While decreased toxicant exposure is a potential indicator of harm reduction potential, a failure to suppress abstinence symptoms suggests that currently marketed non-combustible PREPs may not be a viable harm reduction strategy for U.S. smokers. This study demonstrates how clinical laboratory methods can be used to evaluate the short-term effects of non-combustible PREPs for smokers.