The effect of a novel smoking system--Accord--on ongoing smoking and toxin exposure

Multiple potentially reduced exposure products (PREPs) are being introduced to the market, yet little is known about how they will be used and what their public health impact might be. To determine the impact of one such PREP--Accord--on ongoing smoking and toxin exposure, 11 smokers of light cigarettes were required to use increasing amounts of Accord (5, 10, and 15 per day) with the option of using their traditional cigarettes. Accord suppressed ongoing cigarettes per day and carbon monoxide (CO), but not cotinine, in a dose-dependent manner. Smoking 15 Accord per day decreased the number of traditional cigarettes smoked by 32% (-8.6 cigarettes per day) and CO levels by 27% (-5.9 ppm). However, Accord did not function as a perfect (i.e., one to one) substitute for cigarettes because the total number of nicotine products (Accord plus usual brand) per day increased by 24%. Participants believed that Accord was safer than traditional cigarettes but rated Accord as ineffective at suppressing cravings for cigarettes. These findings suggest that use of Accord results in significant decreases in cigarettes smoked and CO exposure. Whether these reductions will translate into health benefits or endure beyond 2 weeks is unknown. Because most PREPs will probably be used along with traditional cigarettes, their net health impact is a function of not only their toxicological profile but also their effect on ongoing smoking.