Vermont Center on Behavior and Health

Vermont Business Magazine Assistant Professor of Psychiatry and UVM Cancer Center member Elias Klemperer, Ph.D., was recently awarded his first R01 grant—a combined award from the National Institute on Drug Abuse (NIDA) and the Food and Drug Administration Center for Tobacco Products —to further study nicotine-limiting standards for cigarettes and e-cigarettes among adults in Rhode Island, Vermont, and Northern New York State.

It's been well-documented that cigarette smoking is the primary cause of preventable illness and death in the United States. In recent years, the prevalence of using multiple tobacco products, notably cigarettes and e-cigarettes, has been on the rise in the U.S. While e-cigarettes offer a potentially safer alternative, most users continue to smoke cigarettes in the long term, especially those who use e-cigarettes infrequently. 

To combat this issue, the FDA is planning to impose a nicotine-limiting standard on cigarettes; however, it's uncertain how this regulation will affect dual users of cigarettes and e-cigarettes.

Klemperer, in collaboration with Professor of Psychiatry and Vermont Center for Behavior and Health Director Stephen Higgins, Ph.D., alongside colleagues from the Larner College of Medicine and Brown University, will conduct a 12-week, double-blind randomized controlled trial. The primary objective is to investigate the impact of the proposed nicotine-limiting standard for cigarettes on smoking behavior among adult dual users. Additionally, the study aims to assess whether any observed changes are influenced by corresponding limitations on e-cigarette nicotine content. Participants will be provided with four different combinations of high- and low-nicotine e-cigarettes and cigarettes, allowing researchers to determine the most effective combination in reducing cigarette use.

This grant follows a series of successful trials led by Higgins between 2016 and 2019, which revealed promising results regarding the effectiveness of very low-nicotine-content (VLNC) cigarettes in reducing smoking rates and dependence severity among vulnerable populations. These findings underscore the potential of reducing nicotine content in cigarettes to facilitate smoking cessation efforts, particularly among high-risk individuals.

“Cigarette smoking remains the most preventable cause of death in the United States,” said Klemperer. “However, tobacco use is changing, and this study will help us understand how policies to limit nicotine could affect adults who use both cigarettes and e-cigarettes.”