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Reduced Nicotine Content Cigarette Knowledge, Attitudes, and Practices of Patients at a Perinatal Substance Abuse Treatment Center

Andersen, Allan MD*; Chisolm, Margaret S. MD*; Kleykamp, Bethea A. PhD; Yunus, Fahd N. BA; Smith, Cheri MLS§; Terplan, Mishka MD, MPH∥,¶

Addictive Disorders & Their Treatment: September 2013 - Volume 12 - Issue 3 - p 111–117
doi: 10.1097/ADT.0b013e31825afda6
Original Article

Objectives: Maternal cigarette smoking is the leading modifiable risk factor for adverse pregnancy outcomes, and yet approximately 14% of women in the United States smoke cigarettes during pregnancy. This study examines cigarette smoking and cessation and reduced nicotine content (RNC) cigarette knowledge, attitudes, and practices in patients at an outpatient perinatal substance abuse treatment center.

Methods: Consenting patients who were smokers (N=26) completed the 11-item survey instrument.

Results: Eighty-eight percent of participants reported current interest in quitting smoking. Four percent endorsed smoking RNC cigarettes before the survey, and 60% reported interest in trying them in the future. Sixty-nine percent reported interest in learning more about RNC cigarettes and 68% believed that they were at least as safe as regular cigarettes.

Conclusions: Under the 2009 Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration has the authority to mandate reduction in the nicotine content of cigarettes. Results show the potential for pregnant smokers to perceive RNCs as relatively safe and appealing alternatives to regular cigarettes. Further study of the efficacy and safety of RNC cigarettes in pregnancy is needed to minimize the risk of any unintended maternal and child public health consequences of a national policy to reduce the cigarette nicotine content.

*The Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine

§Johns Hopkins Bayview Medical Center

Departments of Obstetrics/Gynecology and Reproductive Sciences

Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD

Hayes Incorporated, Lansdale, PA

New York Medical College, Valhalla, NY.

The authors declare no conflict of interest.

Reprints: Margaret S. Chisolm, MD, 5300 Alpha Commons Drive, Suite 446B, Baltimore, MD 21224 (e-mail:

© 2013 by Lippincott Williams & Wilkins