The Food and Drug Administration (FDA) has announced a plan to set a maximum nicotine level in cigarettes and other tobacco products sold in the U.S. If enacted, this proposal would essentially reduce the amount of nicotine in these products, making them less addictive.

While the number of people who smoke tobacco products has declined over time, about 12 percent of U.S. adults still smoke cigarettes, and almost 25 percent of construction workers smoke. Almost half a million people in the U.S. die each year from smoking-related diseases, making smoking the leading cause of preventable death.

Public health groups and organizations supporting tobacco cessation have applauded the plan. A spokesperson for the American Lung Association called the move “an important step forward for public health.” Others went even further. “It will transform public health in the United States and literally do more to reduce cancer, cardiovascular disease and respiratory disease than any other set of actions the government could take,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids.

The Benefits of Reducing Nicotine

Studies show that almost 70 percent of adult smokers in the U.S. want to quit, and though about 55 percent of smokers try to quit each year, only about five percent of people succeed. That’s largely because of the highly addictive chemical nicotine, which keeps people who want to quit tobacco coming back for more. When people do try to quit, they often turn to nicotine replacement therapies like patches and gums, which aim to reduce dependence on nicotine over time.

The FDA-funded study on the potential public health effects of reducing nicotine levels in cigarettes notes that nicotine itself isn’t the direct cause of most smoking-related diseases. Cancer, COPD and other smoking-related diseases are caused by many other toxins in cigarettes. However, the FDA is taking aim at nicotine because it’s the chemical that sustains the smoking habit.

“Nicotine is powerfully addictive,” said FDA Commissioner Robert M. Califf, M.D. “…About two-thirds of adult daily smokers began smoking daily by 18 years of age. 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.”

The FDA estimates reducing nicotine levels in tobacco products would prevent more than 33 million people from becoming regular smokers and that five million additional smokers would quit within a year. This would prevent eight million cases of premature death from tobacco use and add up to 134 million extra years of life for those nonsmokers.

Even for those who don’t quit, reducing nicotine levels in tobacco products could bring benefits. Studies show that when nicotine levels are reduced, people don’t smoke more to make up for the missing nicotine. Similarly, lower nicotine levels also reduce withdrawal symptoms, which could result in people who don’t quit smoking fewer cigarettes overall.

Early Steps Toward Regulation

Like OSHA, the FDA has to follow a strict regulatory process, and this plan to reduce nicotine levels in tobacco products is still in the early stages. Next, the FDA has to submit a notice of proposed rulemaking and allow time for public comment, a process that’s estimated to take at least a year. It’s almost guaranteed that tobacco companies will lobby extensively against this change during the rulemaking process and even sue the federal government if the proposal is enacted.

Despite these expected challenges, this proposal represents the most significant step forward in nationwide tobacco cessation efforts we’ve seen in decades. Its passage would save lives and improve public health for both smokers and nonsmokers exposed to harmful tobacco smoke.

The LHSFNA provides a variety of publications and additional resources to LIUNA signatory contractors and other LIUNA affiliates to help members and their families become tobacco free. The Fund offers Quit Tobacco Kits, develops tobacco cessation programs and assists in the design of tobacco-free worksite policies upon request. Visit our Tobacco topic page or contact the Fund’s Health Promotion Division for more information.

[Nick Fox]