FDA announces plan to reduce nicotine in cigarettes

Experts say it would prevent 8 million deaths

Created date

June 13th, 2018

Each year, cigarette smoking causes more deaths than AIDS, alcohol, illegal drug use, homicide, suicide, and motor vehicle crashes combined for adults over the age of 35. It is the primary cause of 163,700 deaths from cancer, 160,600 deaths from cardiovascular and metabolic diseases, and 113,100 deaths from pulmonary diseases.

Despite the widely known health dangers associated with cigarette smoking, an estimated 37.8 million American adults continue to light up.

According to the Centers for Disease Control and Prevention, the majority of smokers want to quit and about half have attempted to quit in the past year. Sadly, only 4% to 7% were successful.

As addictive as cocaine

Kicking the habit is difficult because cigarettes are highly addictive. Research shows that smoking is as addictive as opioids, alcohol, or cocaine, so it’s no wonder that only a tiny fraction of smokers who try to quit succeed.

Nicotine, a naturally occurring chemical found in the tobacco plant, is what makes cigarettes so addictive. As W.L. Dunn, principal scientist at tobacco giant Phillip Morris said in 1972, “No one has ever become a cigarette smoker by smoking cigarettes without nicotine.”

Tobacco companies have long known that nicotine is the ingredient in cigarettes that make people want to smoke. They also discovered that the more nicotine in a cigarette, the better the high; the better the high, the more people wanted to smoke.

To make cigarettes even more addictive, big tobacco companies genetically engineered tobacco plants that had twice the amount of nicotine as normal plants.

Plan to lower nicotine levels

Last year, the Food and Drug Administration (FDA) announced a plan to restrict the amount of nicotine in cigarettes. Presently, the average U.S.-made cigarette contains between 1.1 and 1.7 milligrams of nicotine. If the FDA plan is carried out, that number is expected to drop to between .03 and .05 milligrams.

Experts say that such a move could prevent over eight million tobacco-related deaths by the end of the century.

“Almost 90% of adult smokers started smoking by the age of 18, and we’ve known for decades cigarettes are highly engineered and designed to get—and keep—users addicted,” says Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “By moving to consider a nicotine product standard, we are imagining a future in which young people are significantly less likely to get hooked into a lifetime of addiction.”

When announcing the plan earlier this year, FDA Commissioner Scott Gottlieb said, “Despite years of aggressive efforts to tackle the leading cause of preventable disease and death in the United States, tobacco use—largely cigarette smoking—still kills more than 480,000 Americans every single year. Tobacco use also costs nearly $300 billion a year in direct health care and lost productivity. In fact, cigarettes are the only legal consumer product that, when used as intended, will kill half of all long-term users.

“Because nicotine lives at the core of both the problem and the solution to the question of addiction, addressing the addictive levels of nicotine in combustible cigarettes must be part of the FDA’s strategy for addressing the devastating, addiction crisis that is threatening American families.”

Projected results

According to the FDA, reducing the amount of nicotine in cigarettes would prompt approximately five million adult smokers to quit within the first year of implementation.

By 2100, the FDA estimates that such a move would discourage over 33 million people from becoming smokers in the first place. This would especially impact young people and overall smoking rates could drop from today’s 15% to as low as 1.4%.

Not surprisingly, anti-cigarette advocacy groups fully support reducing nicotine levels in cigarettes. Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, says, “Given these enormous public health benefits and the millions of lives that would be saved, it is critical that the FDA move as quickly as possible to turn this plan into reality. There is no other single action our country can take that would prevent more young people from smoking or save more lives.”

Opponents to the regulations say that such a move by the FDA will result in a thriving black market of high-nicotine cigarettes. Others say that reducing nicotine levels will simply encourage smokers to consume more cigarettes, a position the FDA pushes back on. While the FDA can’t exactly test such outcomes through trials, their analysis suggests that either outcome is unlikely.

Another possible outcome is that smokers will seek out other means of ingesting nicotine by switching to products like e-cigarettes, nicotine gum, and nicotine patches. E-cigarettes are of particular concern for antismoking advocates given the fact that they come in fruity flavors like grape and banana, which specifically appeal to children.

After taking public comments, the FDA will announce future steps sometime in the fall.