INTRODUCTION: Current smoking cessation treatments largely address 
pharmacological dependence on nicotine. New approaches are needed that address 
both nicotine dependence and psychological dependence on cigarettes as the 
source of nicotine. One such approach is the use of cigarettes with reduced 
nicotine content.
METHODS: We reviewed the available literature on the use of reduced-nicotine 
content cigarettes as a cessation aid.
RESULTS: One case series study and trial data indicate that reduction in the 
level of nicotine in cigarette tobacco can reduce the level of nicotine 
dependence in smokers and do so without adverse effects on cardiovascular 
biomarkers or significant compensatory smoking. We identified three clinical 
trials (total n = 489) that suggest that smokers can dissociate nicotine 
delivery from the act of smoking if they use reduced-nicotine content cigarettes 
in combination with nicotine replacement therapy.
DISCUSSION: The identified studies point to a benefit but involved only a small 
number of participants and provide only limited data on long-term abstinence. 
More definitive evidence from larger trials with longer follow-up is needed to 
clarify the role of reduced nicotine cigarettes as an aid to smoking cessation.