The FDA aims for cuts in the nicotine levels in cigarettes to minimize addiction and plans to regulate electronic cigarettes to protect kids.
The Food and Drug Administration (FDA) has announced that it aims to bring the nicotine levels in cigarettes low enough that they would be “minimally or non-addictive.”
The agency will ask for public comments on the best way to accomplish this goal and protect children from electronic cigarette nicotine levels as well.
Cigarettes are “the only legal consumer product that, when used as intended, will kill half of all long-term users,” said FDA Commissioner Scott Gottlieb, MD.
“As a physician who cared for hospitalized cancer patients, and as a cancer survivor myself, I saw first-hand the impact of tobacco,” he said. In 2014, a Surgeon General’s report found that 480,000 Americans died each year from cigarette smoking.
Almost 90 percent of adult smokers started smoking before the age of 18, so the agency plans a hard look at what attracts young people. For instance, Gottlieb raised the possibility of banning menthol, a flavor that makes it easier to get used to tobacco, and other flavors in cigarillos.
Nicotine is one of the most difficult drugs to quit — half of adult smokers try to quit each year, Gottlieb noted. No one knows a magic number that would make cigarettes non-addictive. Some people inhale more; and people process nicotine at different rates.
The FDA press office said that the agency didn’t have information on specific levels. At least a 95 percent cut would be needed, said Neal Benowitz, MD, a professor of medicine at the University of California, San Francisco, who proposed cutting nicotine levels in cigarettes back in 1994. The nicotine could be extracted from tobacco (much like decaffeinating coffee beans), or the plant could be genetically engineered to contain less nicotine.
In 2015, researchers reported on a study of cigarettes with tobacco engineered to contain less nicotine, varying from 2 to 33 percent of the nicotine in standard commercial cigarettes. After six weeks on the least potent cigarettes, volunteers showed fewer signs of addiction than people smoking more nicotine-heavy cigarettes. One key discovery: people didn’t smoke more cigarettes to compensate. In fact, the volunteers smoking less potent cigarettes smoked about a quarter to 30 percent fewer cigarettes in the last week, compared to everyone else.
You can check the nicotine levels in cigarette brands on this chart: Winston, Kent, and Marlboro Lights were on the high end; and Pine somewhat lower.
It isn’t nicotine that causes cancer, but other substances in tobacco smoke. People have chosen electronic cigarettes to avoid inhaling smoke. But Gottlieb stressed that e-cigs shouldn’t be available to minors, either.
The FDA began regulating electronic cigarettes in 2016, making it illegal to market them to minors, and asking manufacturers for information about ingredients.
“Unless we change course, 5.6 million children alive today will die prematurely later in life from tobacco use. A renewed focus on nicotine can help us to achieve a world where cigarettes no longer addict future generations of our kids; and where adults who still need or want nicotine can get it from alternative and less harmful sources,” Gottlieb said.
As the FDA gathers comment, expect a fierce debate and be ready for the nicotine levels in cigarettes to fall.
August 30, 2017
Janet O’Dell, RN