Call 413.540.1234 to
schedule an appointment
CONCERN/EAP: 413.534.2625
Billing questions? Call: 413.540.1212
CRISIS: 413.733.6661

Health Policy & Advocacy
Resources
Basic InformationMore InformationLatest News
Many Supplements Still Contain Dangerous Stimulants: StudyTapping Into TelehealthMenthol Cig Ban Didn't Spur Black Market Sales: StudyHip-Hop Loaded With Pot, Cigarette ReferencesWhite House Wants Prices in Drug Ads, But Big Pharma Fights BackMany Supplements Contain Unapproved, Dangerous Ingredients: StudyE-Cigs Continue to Spark Debate Over Health Risks/BenefitsClinical Trials Need More VolunteersGetting Your Medical Records Might Not Be EasyMost People Don't Know if They Have Genetic Risk for CancerConsumer Reports Says Warnings About Tainted Beef Don't Go Far EnoughThe Physician Assistant Will See You NowCoffee Shop Workers on Front Lines of Opioid CrisisDozens of Medical Groups Join Forces to Improve DiagnosesDoes Big Pharma Hike Prices When Meds Are in Short Supply?FDA Gets Tough on Juul, Other E-Cigarette Makers'No Documented Reason' for 1 in 3 Outpatient Opioid Rxs: StudyUrgent Care Centers Ease ER Burden in U.S.Poor Health Care Linked to 5 Million Deaths Worldwide a Year'Million Hearts' Project Aims to Prevent 1 Million Cardiac CrisesDoctor Burnout Likely to Impair CareHomelessness Takes Toll on Kids' Health Even Before They're BornFDA Warns of Dangers of Liquid Nitrogen in Food, DrinksStates Struggle With Onslaught of Opioid OD DeathsAHA: Why More Americans Are Kicking the Smoking HabitMonitoring System for Underage Tobacco Sales Falls Short: StudyHundreds of Human, Pet Homeopathy Products RecalledAHA: CPR Training at School Now Required in 38 StatesGovernment Rules Aimed at Curbing Opioid Prescriptions May Have BackfiredGut Enzyme Could Help Solve U.S. Blood ShortagesHealth Tip: Making an Emergency CallFrom Pigs to Peacocks, What's Up With Those 'Emotional-Support Animals'?Global Aid Programs Shortchange Teen Health Needs: StudyDoctors Write Fewer Opioid Scripts After Learning of Overdose DeathHow to Become an Educated PatientU.S. Murder, Suicide Rates Climbing AgainTo Boost Colon Cancer Screening, Use the MailMajority in U.S. Support Medical Pot, Think It Could Fight Opioid CrisisWhey Powder Blamed for Salmonella Tied to Ritz Crackers, Goldfish: FDAToo Few Americans Getting Screened for Cancer: CDCYou Have 11 Seconds to Tell Your Doc What's WrongFDA Warns of Deaths Tied to Tainted Synthetic PotWhere Are Opioid Painkillers Prescribed the Most?In the ICU, Patients' Relatives Often Mum About Care ConcernsResetting E-Prescriptions for Opioids Helps Curb Use: StudyHealth Tip: If You're 45 or Older, Get Screened for Colorectal CancerRed Cross Issues Nationwide Call for Blood DonationsDoctor Burnout Widespread, Helps Drive Many Medical ErrorsWarming Climate, More AC -- and More Unhealthy Smog AheadEven at 'Safe' Levels, Air Pollution May Boost Diabetes Risk
Questions and AnswersLinksBook Reviews
Related Topics

FDA Considers Lowering Nicotine Levels in Cigarettes

HealthDay News
by -- Robert Preidt
Updated: Mar 15th 2018

new article illustration

THURSDAY, March 15, 2018 (HealthDay News) -- In an unprecedented move, the U.S. Food and Drug Administration on Thursday said it plans to cut the amount of addictive nicotine in the nation's cigarettes.

The goal is to lower the amount of nicotine to minimally or non-addictive levels, the agency said.

"We see a historic opportunity here to use that product standard to potentially more rapidly migrate smokers off of combustible cigarettes, that we know cause a lot of death and disease related to tobacco use, and potentially onto products that can provide adults with access to nicotine without all the harms associated with combustion," FDA Commissioner Dr. Scott Gottlieb said during a media briefing.

But e-cigarettes "and other products that could offer a bridge to quitting need to be properly evaluated," he noted.

One lung health expert applauded the move.

"Exploring a product standard to lower nicotine content in cigarettes to minimally or non-addictive levels is an exciting concept," said Andrea Spatarella, from the Center for Tobacco Control at Northwell Health, in Great Neck, N.Y. "Any and all efforts to reduce or eliminate the health burdens and tobacco-related deaths to millions of Americans deserves consideration."

Tobacco use -- mainly cigarette smoking -- kills more than 480,000 Americans a year and costs nearly $300 billion a year in direct health care and lost productivity, the FDA noted.

Mitch Zeller, director of the FDA's Center for Tobacco Products, said at the briefing, "Given their combination of toxicity, addictiveness, prevalence and effect on non-users, cigarettes are the category of tobacco product that causes the greatest public health burden. In fact, cigarettes are the only legal consumer product that when if used as intended will kill half of all long-term users prematurely."

Reducing nicotine levels in cigarettes and other policy measures could help prevent millions of tobacco-related deaths in the United States, Gottlieb added.

The proposal on reducing nicotine levels includes a review of current science about how nicotine creates and sustains addiction to cigarettes, and asks for public input and review.

Gottlieb said answers will be sought on questions such as, "What potential maximum nicotine level would be appropriate for the protection of public health? Should a product standard be implemented all at once or gradually?"

Also, he added, there could be "unintended consequences" to making cigarettes less addictive, for example, the growth of a black market in high-nicotine cigarettes.

Still, Gottlieb said a new analysis, published online March 15 in the New England Journal of Medicine, has suggested that millions could benefit from the proposed move.

"If this scenario were implemented, this analysis suggests that approximately 5 million additional adult smokers could quit smoking within one year of implementation," Gottlieb said.

"And with this scenario, an even greater impact could be felt over time: by the year 2100, the analysis estimates that more than 33 million people -- mostly youth and young adults -- would have avoided becoming regular smokers. And smoking rates could drop from the current 15 percent to as low as 1.4 percent," he added.

"All told, this framework could result in more than 8 million fewer tobacco-caused deaths through the end of the century -- an undeniable public health benefit," Gottlieb said.

Young people would benefit hugely from the proposed move, one lung health expert said.

"The benefits the FDA cites for this proposal are extraordinary," said Matthew Myers, president of the Campaign for Tobacco-Free Kids.

"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," Myers said. "There is no other single action our country can take that would prevent more young people from smoking or save more lives."

Still, another expert said the move could backfire.

"Lowering the nicotine level in cigarettes may simply lead to more cigarettes smoked by current smokers," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City. He believes that to really put an end to the scourge of smoking, "tobacco and nicotine -- in other words, cigarettes -- must be eliminated as a threat to health."

Spatarella agreed the nicotine-lowering strategy could fail.

"It is feasible that the end user may react to the decrease in the addictive chemical nicotine by smoking more. What they perceive as a lack in quality, or the amount of nicotine needed to satisfy their nicotine craving, they may make up for in quantity, the number of products consumed," she suggested.

"The smoking behaviors may remain unchanged and the smoker may seek other tobacco products to fill that nicotine gap," Spatarella added. "They may seek to purchase traditional cigarettes with higher nicotine content from illegal sources."

In its proposal, the FDA said that it also plans to examine the role that flavors -- including menthol -- play in people starting, continuing and quitting smoking, to assess regulation of premium cigars, and to update how it deals with the development and regulation of nicotine-replacement products, such as nicotine gums, patches and lozenges that help smokers quit.

More information

The American Cancer Society offers a guide to quitting smoking.