New plans by US regulatory body aim to tackle ‘devastating addiction crisis’ and reduce deaths from tobacco and tobacco-related disease

Nicotine levels in cigarettes could be reduced to non-addictive levels, according to new plans set out by the US regulatory body.

The Food and Drug Administration on Friday announced a roadmap to reduce deaths from tobacco, and tobacco-related disease. According to the body, more than 480,000 deaths in the US are caused by tobacco every year.

“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,” said Scott Gottlieb, the FDA commissioner.



Does a tobacco-free world need to be nicotine free? Read more

“Our approach to nicotine must be accompanied by a firm foundation of rules and standards for newly-regulated products,” he added. “To be successful all of these steps must be done in concert and not in isolation.”

The plans also push back deadlines by which e-cigarette manufacturers have to provide information on current and future products to gain FDA approval, shifting it from 2018 to 2022.

The announcements were met with mixed responses from experts, who noted that bans on advertising and the introduction of standardised packaging are not possible in the US, due to issues relating to the first amendment and freedom of speech.

“The idea of gradually reducing the addictive ingredient of cigarettes, nicotine, looks attractive on the surface,” said Robert West, professor of health psychology at University College London. “But unless nicotine is pretty much eliminated quickly and comprehensively in all available tobacco products – which seems unlikely – it runs a serious risk of making things worse as smokers smoke cigarettes harder in order to get the nicotine they need, leading to more exposure to the harmful tar.”

Linda Bauld, deputy director of the UK Centre for Tobacco and Alcohol Studies and professor of health policy at the University of Stirling agreed that the move could end up exposing smokers to higher levels of toxins.



“[The FDA] want to shift people to alternative products like vaping, which is good, but there are a number of risks,” she said, pointing out that reducing nicotine levels could also have other unintended consequences including people smokers smoking more cigarettes, or even an increase in black market activity.

Ten years after the smoking ban, vaping is a £1bn business Read more

But John Britton, professor of epidemiology at the University of Nottingham and Director of the UK Centre for Tobacco & Alcohol Studies, sounded slightly more hopeful. “I would always argue that if a policy is good idea, you should do it anyway,” he said. “So I am glad they are trying it, but I don’t personally think it will be effective.”

However both Bauld and Britton welcomed the FDA’s plans to push back the dates for e-cigarette manufacturers to submit information. “That is really good,” said Bauld, pointing out that small manufacturers would have struggled to provide the information in a short time frame. “It meant a lot of e-cigarettes in the market were going to disappear,” she said.

The shift in dates, she added, could prove beneficial. “I think that is good news for trying to shift smokers to vaping products – which all evidence suggests are safer,” she said.

Indeed, research published this week in the BMJ adds further weight to the argument that e-cigarettes can help smokers to quit.

While Matthew L Myers, president of the Campaign for Tobacco-Free Kids, welcomed the move to tackle the addictiveness of cigarettes and the drive for approaches to help smokers quit, he pushed back against the shift in dates for e-cigarette manufactures to gain product approval from the FDA.

“This long delay will allow egregious, kid-friendly e-cigarettes and cigars, in flavours like gummy bear, cherry crush and banana smash, to stay on the market with little oversight,” he said.

Gregory Connolly, professor of research at Northeastern University, also had concerns about the delay of the approval deadline, saying it could open the floodgates for heated tobacco products such as the iQos to enter the market, which could then be difficult to remove. Such products, said Connolly, incorporate sophisticated technology and are likely addictive.

Deborah Arnott, chief executive of the public health charity Ash, welcomed the move. “We have long recognised in this country that it’s not the nicotine but the smoke in cigarettes which makes them so deadly,” she said. “Until recently, however, the UK government was a voice in the wilderness in supporting smokers who are unable to quit to switch to less harmful nicotine products.”