In July 2017, the FDA announced new plans for regulating tobacco, including:
Discussions about lowering nicotine levels in cigarettes to non-addictive levels; and
A 4-year extension for tobacco manufacturers to submit applications for FDA review of e-cigarettes and other products released since 2007 (now due in 2021 and 2022). Until then, these products will remain unregulated with unknown ingredients.
A reduction in nicotine levels in cigarettes has been recommended by scientists for more than 20 years. Less nicotine = less addiction = less death and disease. While the benefits of such an action seem clear, the availability and popularity of other tobacco products have made the equation more complicated. We have more questions than answers. For example:
Why is the discussion limited to lowering nicotine levels in cigarettes? Steps to reduce nicotine in other tobacco products (e.g., e-cigarettes) would also serve the goal of harm reduction, as would steps to reduce other ingredients, like formaldehyde.
How widespread will cigarette smoking be in 4 years? We have already seen a quick and drastic shift from youth cigarette use to vaping. From 2012 to 2016, the proportion of Florida youth reporting current cigarette use dropped from 6% to 3%, while the proportion reporting current e-cigarette use grew from just 2% to 12%.
How will this policy impact public perception of various tobacco products? Will people think certain products are safe?
Will cigarette smokers switch to e-cigarettes to feed their nicotine addiction? Will they seek traditional cigarettes through a black market?
Will reduced levels of nicotine in cigarettes set a precedent for the FDA to reduce nicotine in other tobacco products?
Tobacco remains the leading cause of preventable death and disease. New regulations that have the potential to prevent addiction and save lives are needed today. Information about the ingredients and the long-term health impact of e-cigarettes and other tobacco products are urgently needed, as well. We invite you to join us in sharing questions and recommendations once the FDA invites public comment on these new regulatory actions.