Nearly two decades ago, in a seminal 1994 article in the New England Journal of Medicine, academics Neal Benowitz and Jack Henningfield proposed giving federal regulators the authority to reduce the nicotine content of cigarettes gradually until it reached a level that wouldn’t cause addiction.
Their proposal came during a period of intense debate over the role of nicotine in keeping smokers smoking. An FDA advisory panel that year rejected the tobacco industry’s long-held position that the nicotine wasn’t addictive, and the following year an internal memo from tobacco manufacturer Philip Morris surfaced calling cigarettes “nicotine delivery systems” and asserting that nicotine was “the primary reason” people keep smoking.
Despite the FDA’s efforts to regulate nicotine as a drug at the time, the agency would have to wait another 15 years for Congress to give it the ability to dictate how much nicotine companies could put in cigarettes.
During the decades of political fights over whether — and how — the government should be allowed to regulate tobacco, researchers continued building a body of research on low-nicotine cigarettes.
“What’s been found so far is that when people are given low-nicotine cigarettes, they do seem to reduce the number of cigarettes that they smoke,” said Dorothy Hatsukami, a psychiatry professor and director of the University of Minnesota’s Tobacco Research Programs, who is working with Donny on the study in Pittsburgh. “There are some promising results.”
But plenty of unanswered questions remain.
“I really don’t think we know what’s going to happen as we reduce nicotine levels,” said Gregory N. Connolly, a Harvard professor of public health and anti-smoking advocate who served on an FDA tobacco advisory panel before resigning in 2010. “Are people going to increase their smoking behavior [to compensate]? Are they going to reject the product? Tobacco addiction is very complex.”
Connolly supports cutting nicotine levels, but notes that tobacco companies use other chemicals to create tastes and smells that enhance dependence on cigarettes. Focusing solely on nicotine could leave the door open for the industry to craft other creative ways to keep smokers hooked.
Richmond lawyer Bryan M. Haynes, whose firm Troutman Sanders represents multiple tobacco firms, said the FDA should think long and hard before making major changes.
“One consideration would be whether people smoke more cigarettes” if nicotine levels fall, Haynes said. Another consideration: “If you alter the fundamental properties of a product, people will start looking toward contraband. It could create black market.”