Biden administration moves to restrict nicotine levels in tobacco products

“This is the first time that there has been a serious discussion with the highest levels of government commitment to fighting tobacco in a transformative way,” said Matthew Myers, president of the Campaign for Tobacco-Free Children. “This will transform public health in the United States and literally do more to reduce cancer, cardiovascular disease and respiratory disease than any other set of actions the government can take.”

The new initiative was launched as part of the government’s so-called “unified agenda”. Released twice a year, it is a set of planned federal regulatory actions.

The rule says that the effort to decrease the nicotine in tobacco products would reduce people’s addiction to smoking and give people a better chance to quit. Reducing the amount of nicotine in these products would likely also prevent people from starting to smoke.

“Nicotine addiction in burnt products is the main driver of sustained use of these products. In fact, more than half of adult smokers make a serious attempt to quit each year (stop for at least a day), but most fail to do so. to the addictive nature of cigarettes. Such a product standard, if proposed and finalized after a thorough process, would make these products minimally or non-addictive,” the US Food and Drug Administration said in a statement Tuesday.

“Nicotine is powerfully addictive,” said FDA Commissioner Dr. Robert Califf, in the statement. “Reducing nicotine levels to minimally addictive or non-addictive levels would decrease the likelihood that future generations of young people will become addicted to cigarettes and help more addicted smokers to quit.”

Nicotine is the chemical in tobacco products that is highly addictive. The chemical could change the way the brain works, making people crave it more, according to the FDA.
Studies show that when the nicotine content of cigarettes is reduced, people seem not to smoke anymore to make up for the lack of nicotine. Cigarettes with lower nicotine levels also appear to be effective in relieving withdrawal, studies show.
“If you don’t have high enough levels of nicotine, it doesn’t seem like you trigger such a strong addiction,” said Rose Marie Robertson, deputy director of science for the American Heart Association. “I’ve had patients in the past who have been addicted to nicotine and heroin at different times in their lives and one of them said it was much harder to quit.”
Surveys show that two-thirds of young smokers say they want to quit. Reducing nicotine levels can make a big difference.

“If we could stop them from being addicted in the first place, that would be good and that has the potential to actually produce a dramatic change in tobacco use,” Robertson said.

About 480,000 people in the US die from smoking-related illnesses, according to the US Centers for Disease Control and Prevention. It is the leading cause of preventable death in the US.

The number of smokers has declined significantly over the past 15 years, but in 2020, still about 12.5% ​​of US adults, or 30.8 million people, smoked cigarettes. More than 16 million are living with a smoking-related disease, according to the CDC.

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“This is an important step for public health,” said Erika Sward, assistant vice president for national defense for the American Lung Association.

The FDA estimates that reducing nicotine levels could prevent more than 33 million becoming regular smokers and about 5 million additional smokers would quit within a year of reducing nicotine levels and 134 million years of life would be earnings.

Even with low-nicotine products, not all smoking-related illnesses would go away. Low nicotine cigarettes still contain the harmful products that can cause illness.

“Much of the damage comes from inhaling the burnt smoke. Burnt smoke still exists in low-nicotine cigarettes,” Robertson said. “Because they’re low in nicotine doesn’t mean they’re low in anything else.”

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So it would still take a public health effort to get people to give up, Robertson said. Reducing the nicotine content could certainly help with this.

Regulations will not happen overnight, experts say, and there is no guarantee that they will be enacted.

Then the FDA will have to issue a notice of proposed regulation by May 2023 and there will be time for public comment. This process can take at least a year. So it is “very likely”, experts say, that tobacco companies will sue to prevent the rule from taking effect.

Myers and other tobacco experts said they expected the FDA and the Biden administration to act quickly on this initiative.

“We’ve seen how things move slowly in many areas with tobacco and many impediments to action can arise,” Myers said. “We just have to make a compromise to make sure it gets done.”

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