The combined effect of very low nicotine content cigarettes, used as an adjunct to usual Quitline care (nicotine replacement therapy and behavioural support), on smoking cessation: a randomized controlled trial

Addiction. 2012 Oct;107(10):1857-67. doi: 10.1111/j.1360-0443.2012.03906.x. Epub 2012 May 17.


Aim: To determine the combined effect of very low nicotine content (VLNC) cigarettes and usual Quitline care [nicotine replacement therapy (NRT) and behavioural support] on smoking abstinence, in smokers motivated to quit.

Design: Single-blind, parallel randomized trial.

Setting: New Zealand. PARTICIPANTS Smokers who called the Quitline for quitting support were randomized to either VLNC cigarettes to use whenever they had an urge to smoke for up to 6 weeks after their quit date, in combination with usual Quitline care (8 weeks of NRT patches and/or gum or lozenges, plus behavioural support) or to usual Quitline care alone.

Measurements: The primary outcome was 7-day point-prevalence smoking abstinence 6 months after quit day. Secondary outcomes included continuous abstinence, cigarette consumption, withdrawal, self-efficacy, alcohol use, serious adverse events and views on the use of the VLNC cigarettes at 3 and 6 weeks and 3 and 6 months.

Findings: A total of 1410 participants were randomized (705 in each arm), with a 24% loss to follow-up at 6 months. Participants in the intervention group were more likely to have quit smoking at 6 months compared to the usual care group [7-day point-prevalence abstinence 33 versus 28%, relative risk (RR) = 1.18, 95% confidence interval (CI): 1.01, 1.39, P = 0.037; continuous abstinence 23 versus 15%, RR = 1.50, 95% CI: 1.20, 1.87, P = 0.0003]. The median time to relapse in the intervention group was 2 months compared to 2 weeks in the usual care group (P < 0.0001).

Conclusions: Addition of very low nicotine content cigarettes to standard Quitline smoking cessation support may help some smokers to become abstinent.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Behavior Therapy / methods*
  • Combined Modality Therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Nicotine / administration & dosage*
  • Nicotine / analysis
  • Nicotinic Agonists / administration & dosage*
  • Nicotinic Agonists / analysis
  • Recurrence
  • Single-Blind Method
  • Smoking Cessation / methods*
  • Smoking Cessation / statistics & numerical data
  • Tobacco Products / analysis*
  • Tobacco Use Cessation Devices*
  • Treatment Outcome
  • Young Adult


  • Nicotinic Agonists
  • Nicotine