Congress in 2009 empowered the FDA to regulate tobacco, but it has taken nearly a decade for the agency to advance toward the most promising avenue of regulation — requiring cigarette manufacturers, as well as those of substitutes such as roll-your-own and pipe tobacco, to substantially reduce the amount of nicotine in their products. Cigarette makers could genetically engineer tobacco that contains no nicotine, then mix it with traditional tobacco to hit the right concentration of the addictive substance. This approach would be far more effective than producing “light” cigarettes that often failed to significantly cut the amount of nicotine smokers inhaled. Though nicotine itself is not the most toxic substance in tobacco smoke, it is the ingredient that keeps people desperately hooked. Lowering nicotine levels may promote quitting — and it would certainly prevent future generations of teenagers from developing addictions.
As it announced its intention to move forward with such a rule, the FDA highlighted a new study published in the New England Journal of Medicine on the regulation’s potential effects. The paper predicts plummeting rates of cigarette smoking, from 15 percent of Americans addicted to under 2 percent. Cigarette smoking is the deadliest form of tobacco use, responsible for more deaths each year than alcohol, drug abuse, homicide, car crashes, suicide and AIDS combined.
The study also concluded that there would be a spike in noncombustible tobacco use, such as e- cigarette use, also known as vaping. E-cigarettes’ safety profile is still under scrutiny, but it is clear the devices are less perilous than traditional cigarettes. Moreover, the study found that overall tobacco use would drop substantially under the new policy, indicating that many people would simply quit — roughly 5 million in the first year alone, the study reports. Some 33 million would never get hooked to begin with. The result would be 8 million fewer premature deaths by 2100.
The FDA has a lot of work before it. The agency must still determine precisely where to set its nicotine limit. In doing so, it must attempt to minimize side effects. A black market in full-nicotine cigarettes may emerge. Smokers may light up more often in search of a satisfying nicotine hit. As more smokers transition onto e-cigarettes, the FDA will have to keep a close watch on how those addictive products are manufactured and sold. The sooner it addresses these issues, the better.
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