Very low nicotine content (VLNC) tobacco use trial

Approved 12/03/2025, University of Auckland Human Participants Ethics Committee (UAHPEC) (Level 3, 49 Symonds Street, Auckland, 1010, New Zealand; +64 (09) 373 7599 Ext 83711; humanethics@auckland.ac.nz), ref: UAHPEC28879

The main focus of the trial is to determine whether a larger trial would be feasible to conduct based on the following criteria.
1. Can people be recruited, and how quickly can they be recruited?
This will be measured by
- the number of participants recruited in a month
- the number of participants in each ethnic group (NZ Europeans, Māori, Pacific people, Asian, Middle Eastern/Latin American/African and other ethnicity) as defined by Stat NZ (level 1 classification)
- the number and proportion of participants in priority and non-priority populations. Priority populations are defined as people with self-reported anxiety and/or depression, young people (aged 18-30 years) of low educational attainment or individuals who report heavy alcohol and/or cannabis use (following the same definitions as the CENIC-NZ study.
2. Do people attend the study site on their scheduled day and stay for their required time?
This will be measured by using on-site attendance records.
3. Are the study tasks and questionnaires understandable to participants? Specific questions will be asked in the questionnaire.
4. Are all questions answered? This will be determined by counting the number of unanswered questions in the questionnaire.
5. Did participants highlight any difficulties with the trial?
This will be measured by using the onsite records and feedback from the study participants.
6. Did participants face any adverse events or symptoms after smoking a VLNC cigarette?
This will be measured by using the onsite records and feedback from the participants.

The secondary focus of the trial is to gather data on the likely impact of the tested interventions on potential participant behaviours. The secondary outcome measures will be measured immediately after smoking and reading the health messages on VLNC cigarettes under the hypothetical scenario of all smoked tobacco legally available for purchase in New Zealand having 95% less nicotine than the tobacco they normally smoke. Specifically:
1. Their likelihood of using specific harmful products, measured using a 7-point Likert scale ranging from 0 to 6, where 0 is ‘very unlikely’ and 6 ‘very likely’. These products include:
1.1. VLNC cigarettes.
1.2. Illicit tobacco (i.e., tobacco with regular nicotine levels).
1.3. Homegrown tobacco (i.e., strictly self-grown tobacco. In New Zealand, individuals are allowed to manufacture up to 5kg of home-grown tobacco per adult per year for personal use. This amount translates to approximately 50 to 100 cigarettes per person daily, depending on the tobacco content per each cigarette. However, this tobacco is strictly for personal consumption and cannot be sold or shared).
1.4. Nicotine e-cigarette (vapes).
1.5. Heated tobacco products.
1.6. Nicotine Replacement Therapy (i.e., nicotine gum, patches, or nicotine lozenges or nicotine mouth spray).
1.7. Alcohol.
1.8. Cannabis/Marijuana/ Tetrahydrocannabinol products.
1.9. Other illicit drugs.
1.10. Their desire to quit smoking.
2. Their likelihood to add nicotine to low-nicotine cigarettes or other smoked tobacco was measured using a 5-point scale running from 0 to 4, where 0 is ‘never’ and 4 is ‘daily’.
3. The maximum amount they are willing to pay per VLNC cigarette is measured in New Zealand dollars.
4. If the participants select 1 and above on the 7-point Likert scale for illicit tobacco, the following questions will be triggered:
4.1. The maximum amount you are willing to pay per illicit cigarette, measured in New Zealand dollars.
4.2. The maximum time you would be prepared to travel to get illicit cigarettes, measured in minutes.
4.3. Their reasons for seeking illicit cigarettes to be collected in open field response.
5. The following perception questions will be asked of all the participants:
5.1. Perceptions on general harms of tobacco and vaping: The perceived harm of cigarettes, VLNC cigarettes, and e-cigarettes containing nicotine, and NRT will be measured on a five-point Likert scale (scores will range from 0 to 4, where 0 is “Not at all harmful” and 4 is “extremely harmful”).
5.2. Perceptions of Harm: Regular vs. Reduced-Nicotine Cigarettes: Participants' perceptions of harm will be recorded by asking whether they believe cigarettes with 95% less nicotine are more harmful or equally harmful or less harmful or if they don’t know, compared to regular cigarettes.