Biden administration moves to restrict nicotine levels in tobacco products

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

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

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

“Addiction to nicotine in burnt products is the primary driver of sustained use of these products. In fact, more than half of adult cigarette smokers make a serious quit attempt each year (quitting for at least one day), but most fail to do so due to the addictive nature of cigarettes. Such a product standard, if proposed and then finalized after a thorough process, would render these products minimally or non-addictive,” the Commission said on Tuesday. U.S. Food and Drug Administration in a statement.

“Nicotine is highly addictive,” FDA Commissioner Dr. Robert Califf said in the statement. “Lowering nicotine levels to minimally addictive or non-addictive levels would reduce the likelihood of future generations of young people becoming addicted to cigarettes and would further help currently addicted smokers to quit.”

Nicotine is the highly addictive chemical in tobacco products. According to the FDA, the chemical can alter brain function, making people want more of it.
Studies show that when the nicotine content of cigarettes is reduced, people don’t seem to smoke more to make up for the missing nicotine. Low-nicotine cigarettes also appear to be effective in easing withdrawal, studies show.
“If you don’t have high enough levels of nicotine, it doesn’t seem like you’re kicking in as badly as an addiction,” said Dr. Rose Marie Robertson, deputy scientific director of the American Heart Association. “I’ve had patients in the past who had been addicted to both nicotine and heroin at different times in their lives and one said it was much harder to quit To smoke.”
Surveys show that two-thirds of young smokers say they want to quit. Lowering nicotine levels could make a big difference.

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

About 480,000 people in the United States 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 United States.

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

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

The FDA estimates that lowering nicotine levels could prevent more than 33 million people from becoming regular smokers and about 5 million more smokers would quit within a year of lower nicotine levels and 134 million life years. would be won.

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

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

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

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

Then the FDA would have to issue a Notice of Proposed Rulemaking by May 2023 and there would be time for public comment. This process could take at least a year. Then it’s “highly likely”, experts say, that tobacco companies would then take legal action to stop the rule from going into effect.

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

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

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