The agency said 33 million young people could be prevented from becoming smokers if the plan is implemented

This article is more than 2 years old

This article is more than 2 years old

The US government is making a strong push to lower nicotine levels in cigarettes to “minimally or non-addictive levels”, the regulator Scott Gottlieb announced Thursday.

If the US Food and Drug Administration succeeds in mandating reduced nicotine, the agency said 33 million young people could be prevented from becoming regular smokers, and it would prompt 5 million people to quit within one year of implementation.

The latest push for changes will amend federal regulations, a process that does not involve Congress and has become a favorite tactic of the Trump administration to bring about change.

The rate of Americans who smoke has declined to 15% in the last decade. Nevertheless, tobacco-related illness still kills 480,000 Americans and costs the US $300bn per year, the FDA said.

Gottlieb, the commissioner of the FDA, said the announcement was “a significant step in our efforts to confront nicotine addiction in combustible cigarettes”. He added: “This milestone places us squarely on the road toward achieving one of the biggest public health victories in modern history and saving millions of lives in the process.”



The move is part of a comprehensive and ambitious government tobacco plan announced in July.

The plan emphasizes “harm reduction” – for example, encouraging people to switch to e-cigarettes as an alternative to traditional cigarettes.

The tobacco industry remains one of the most influential special interest groups in Washington DC, and a disproportionate backer of Republicans. Tobacco companies spent $21m lobbying Congress in 2017 alone, and also spent $5.1m on political campaigns in 2016.

Thursday’s FDA announcement begins a multi-year process and formally requests public input.

Altria Group, the company formerly known as Philip Morris and maker of Marlboro cigarettes, downplayed the significance of the announcement.

“Today’s advance notice is a request for information, not a proposed rule,” said Murray Garnick, general counsel for Altria Group. The announcement “is the first step in a multi-year process that will require the agency to examine and resolve many complex issues”.

In recent years, tobacco companies have lobbied against regulations on e-cigarettes and cigars. A recent FDA scientific review found e-cigarettes are less harmful than traditional smoked tobacco, but not wholly harmless.

Gottlieb has long been a proponent of e-cigarettes as a harm reduction tool. The commissioner held investments in an e-cigarette company when he was nominated for FDA chief.

Although the overall rate of Americans who smoke is declining, public health gains are not evenly spread. Smokers are disproportionately likely to be poor, less educated, and live in the south or midwest. For example, 40% of people who hold a high school diploma equivalent smoke.

Tobacco advertising restrictions have closed off companies’ ability to advertise at sports events or on television, but companies still spend $1m per hour advertising. Most advertising is for coupons to reduce the cost of cigarettes.

Matthew Myers, the president of the Campaign for Tobacco Free Kids, said the potential rule change represented a “once in a lifetime” opportunity to impact public health, and urged the FDA to set a deadline for changes.

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

Myers also urged the FDA to push for other regulations now common in the western world, including graphic warning labels on cigarette packs and prohibiting flavored and menthol tobacco.