The new initiative was released as a part of what is called the administration’s “unified agenda.” Released twice a year, this is a set of planned federal regulatory actions.
The rule says that the effort to lower nicotine in tobacco products would reduce people’s addiction to smoking and give people a better shot at quitting. Reducing the amount of nicotine in these products would also likely prevent people from starting smoking.
“Nicotine is powerfully addictive,” FDA Commissioner Dr. Robert Califf said in the statement. “Lowering nicotine levels to minimally addictive or non-addictive levels would decrease the likelihood that future generations of young people become addicted to cigarettes and help more currently addicted smokers to quit.”
“If you don’t have high enough levels of nicotine, it seems that you don’t trigger as strong as an addiction,” Dr. Rose Marie Robertson, the chief science officer of the American Heart Association, said. “I’ve had patients in the past who had been addicted to both nicotine and heroin at different times in their lives and one of them said it was much tougher to quit nicotine.”
“If we could keep them from being addicted in the first place, that would be good and this has the potential to really produce a dramatic change in tobacco use,” Robertson said.
The number of smokers has declined significantly in the past 15 years, but as of 2020, still about 12.5% of US adults, or 30.8 million people smoked cigarettes. More than 16 million live with a smoking-related disease according to the CDC.
“This is an important step forward for public health,” said Erika Sward, the assistant vice president of national advocacy for the American Lung Association.
Even with low nicotine products, not all smoking-related disease would disappear. The low nicotine cigarettes still contain the harmful products that can cause disease.
“Much of the harm comes from inhaling the combusted smoke. Combusted smoke is still there in low nicotine cigarettes,” Robertson said. “Because they are low on nicotine, does not mean they are low in anything else.”
So, there would still need to be a public health effort to get people to quit, Robertson said. Lowering the nicotine content could certainly help with that.
The regulations won’t happen overnight, experts say, and there’s no guaranteed that it would be enacted.
Next, the FDA will have to issue a notice of proposed rulemaking by May 2023 and there would be time for public comment. That process could take at least a year. Then, it is “very likely,” experts say, that the tobacco companies would then sue to keep the rule from going into place.
Myers and other tobacco experts said they hope the FDA and the Biden administration will move quickly on this initiative.
“We have seen how slow things move in many areas with tobacco and many impediments to action can arise,” said Myers. “We just have to make a commitment to make sure it gets done.”