Substitutes for tobacco smoking: a behavioral economic analysis of nicotine gum, denicotinized cigarettes, and nicotine-containing cigarettes

• Published in: Drug and alcohol dependence 2004-06, Vol.74 (3), p.253-264
• Main Authors: Johnson, Matthew W, Bickel, Warren K, Kirshenbaum, Ari P
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Analysis of Variance; Behavioral economics; Behavioural economics; Biological and medical sciences; Cessation; Chewing Gum - economics; Cigarettes; Denicotinized cigarettes; Humans; Medical sciences; Middle Aged; Nicotine; Nicotine - administration & dosage; Nicotine - analogs & derivatives; Nicotine - economics; Nicotine gum; Placebo; Polymethacrylic Acids - administration & dosage; Polymethacrylic Acids - economics; Polyvinyls - administration & dosage; Polyvinyls - economics; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Administration; Smoking; Smoking - economics; Smoking - psychology; Smoking Cessation - economics; Smoking Cessation - psychology; Substitution; Tobacco; Tobacco Use Cessation Products; Tobacco, tobacco smoking; Toxicology; USA
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2003.12.012

Both pharmacological and nonpharmacological stimuli may be responsible for the reinforcement and maintenance of tobacco smoking. The present study examined the self-administration of nicotine gum, denicotinized cigarettes, and nicotine-containing cigarettes utilizing a behavioral economic design in order to investigate the pharmacological and nonpharmacological aspects of cigarette smoking. Cigarette-deprived, dependent smokers worked for cigarette puffs and nicotine gum in daily operant sessions. In one phase, nicotine-containing cigarettes were available at increasing unit prices across sessions. Three phases replicated these sessions with nicotine gum, denicotinized cigarettes, or both, concurrently available at a constant unit price. As nicotine-containing cigarette unit price increased, consumption decreased. However, as nicotine-containing cigarette unit price increased, nicotine gum and denicotinized cigarette consumption increased. Consumption of nicotine gum, but not denicotinized cigarettes, diminished when all three reinforcers were concurrently available. Concurrently available denicotinized cigarettes, but not nicotine gum, caused a statistically significant reduction in nicotine-containing cigarette consumption. In another phase, denicotinized cigarettes were available at increasing unit prices across sessions while nicotine gum was concurrently available at a constant unit price. This phase demonstrated that nicotine content had no reliable effect on cigarette or nicotine gum consumption. These results suggest that denicotinized cigarettes are a more effective alternative reinforcer than nicotine gum, indicating that nonpharmacological stimuli of smoking merit attention in smoking cessation treatment. Furthermore, these findings indicate that alternative reinforcement would be most effective in smoking cessation treatment when combined with high prices for cigarettes.