PT - JOURNAL ARTICLE AU - A B Breland AU - S E Evans AU - A R Buchhalter AU - T Eissenberg TI - Acute effects of Advance<sup>TM</sup>: a potential reduced exposure product for smokers AID - 10.1136/tc.11.4.376 DP - 2002 Dec 01 TA - Tobacco Control PG - 376--378 VI - 11 IP - 4 4099 - http://tobaccocontrol.bmj.com/content/11/4/376.short 4100 - http://tobaccocontrol.bmj.com/content/11/4/376.full SO - Tob Control2002 Dec 01; 11 AB - 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.