FDA proposes to lower nicotine levels in cigarettes

By Humra Laeeq

Under the 2009 Tobacco Control Act, the U.S. Food and Drug Administration (FDA) was given the power to regulate the tobacco industry. It was permitted to consider reducing nicotine in cigarettes but not ban it. On 28th July 2017, FDA announced a plan which seeks to lower nicotine in cigarettes to non-addictive levels in a move to tackle tobacco-related addiction and disease among Americans. Secondly, it pushed back deadlines from 2018 to 2022 for e-cigarette companies to provide information on new products to gain approval. FDA Commissioner Scott Gottlieb cited the reason as the time needed to set the proper foundation for supervising such products. How much of an advantage are we expecting?

Tobacco-biggest health threat for Americans

The key aim of the FDA’s approach is spreading awareness that nicotine—a highly addictive substance—is delivered through products that pose serious health risks through smoke particles in combustible cigarettes. In the United States, nicotine remains the leading cause of death, causing more than 480,000 deaths annually. Tobacco intake has been directly linked to loss in productivity costs and financial drainage to society totalling nearly $300 billion a year. Gottlieb stated, “Unless we change course, 5.6 million young people alive today will die prematurely later in life from cigarettes.”
Nicotine lives at the core of both the problem and the solution to the question of addiction. Since addiction perpetrates the cycle of chain-smoking, curbing it at the root became part of the strategy for the FDA. While satisfying the urge to smoke, amount of nicotine delivered will be non-addictive. This is especially relevant for teenagers and young adults who start smoking under peer pressure or societal influence.  Almost 90% of adult smokers started smoking before the age of 18 and nearly 2,500 youth smoke their first cigarette every day in the U.S. Lowering nicotine levels could decrease addiction among young and allow more currently addicted smokers to quit.

The critical side to the story

Some critics like Robert West, Professor of Health Psychology at University College, London have said that it could cause smokers to smoke in greater amounts to compensate. This, however, remains one of the most important decisions for FDA-whether it lowers nicotine gradually or reduces it sharply to a much less addictive level. In defense, Eric Donny, America’s foremost researchers at the University of Pittsburgh has studied how gradual changes lead to addiction but a sharp drop in levels could indeed prompt smokers to quit. Donny has run experiments for 6 years funded by the National Institutes of Health and the FDA on low-nicotine cigarettes and paves a way for the FDA to implement accordingly.

Others have expressed concerns that the withdrawal symptoms which the lack of nicotine creates could imbalance smokers with mental illnesses. In a comparative measure, medical rehabilitation post smoking seems to be a better alternative than risking them to fatal disease and loss of resource or controlling the population of smoking youth. Additionally, FDA has set in a comprehensive inquiry to prevent the emergence of a black market for higher nicotine cigarettes.

A ‘safer’ channel for hardliners

Critics have yet ignored the flip side of the FDA’s move. For those who might possibly suffer mental imbalance or hardship, a new ‘safer’ channel would be sanctioned. The majority of toxic chemicals found in tobacco smoke are absent in e-cigarette vapor. FDA has shifted product approval dates to provide more time for e-cigarette companies to develop their products efficiently. Earlier, manufacturers were given about two years, till 2018, to get the FDA approval for their products or risk having them pulled off the market. Greg Conley, President of the American Vaping Association, said that he was relieved by Gottlieb’s announcement, further adding that with the 2018 deadline, 99 percent of vaping products would have been banned.

FDA’s double-tier ruling could prove to be a major milestone in achieving public healthcare in the US. By tying the two issues—reducing nicotine in conventional cigarettes and regulating e-cigarettes—FDA will create a bridge between eliminating cigarettes and creating a novel way to deal with substance craving.

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