F.D.A. Set to Propose Lower Nicotine Levels in Cigarettes

[BumRushDaShow]

Source: New York Times

The Food and Drug Administration is planning to require tobacco companies to slash the amount of nicotine in traditional cigarettes to make them less addictive, a move intended to reduce smoking, according to a notice posted Tuesday on a U.S. government website. According to the notice, “this proposed rule is a tobacco product standard that would establish a maximum nicotine level in cigarettes and certain finished tobacco products.

Because tobacco-related harms primarily result from addiction to products that repeatedly expose users to toxins, F.D.A. would take this action to reduce addictiveness to certain tobacco products, thus giving addicted users a greater ability to quit.” The proposal would put the United States at the forefront of global antismoking efforts by taking an aggressive stance at significantly lowering nicotine levels. Only one other nation, New Zealand, has advanced such a plan. The headwinds, though, are fierce, with a powerful tobacco lobby already indicating any plan with significant reductions in nicotine would be untenable and with conservative lawmakers who would consider government overreach that could spill over into the midterm elections.

Asked about news reports on a new policy on Tuesday, the White House press secretary, Karine Jean-Pierre, reminded reporters that agencies routinely post agenda plans on the website for the Office of Management and Budget. And in this case, she said no policy decision had been made. Few specifics were released on Tuesday, but an announcement has been expected. Last week, Dr. Robert Califf, commissioner of the F.D.A., told an audience he would be speaking more about reducing nicotine addiction soon. Few specifics were released on Tuesday, but an announcement has been expected.

Last week, Dr. Robert Califf, commissioner of the F.D.A., told an audience he would be speaking more about reducing nicotine addiction soon. Similar plans have been discussed to lessen Americans’ addiction to products that coat the lungs with tar, release 7,000 chemicals and lead to cancer, heart disease and lung disease. Nicotine is also available in e-cigarettes, chews, patches and lozenges, but this proposal apparently would not affect those products. “This one rule could have the greatest impact on public health in the history of public health,” said Mitch Zeller, the recently retired F.D.A. tobacco center director.

Read more: https://www.nytimes.com/2022/06/21/health/fda-nicotine-cigarettes.html

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A Rule notice was posted at OMB by FDA's CTP (Center for Tobacco Products).

[Hugh_Lebowski]

1. If someone's addicted to 20 x 20mg/nicotine cigs per day

And suddenly they can only get 5mg/nicotine cigs, what do you think is going to happen?

They just might smoke 80 cigarettes instead.

Keep in mind, it's really not the nicotine that kills you, at least not directly.

This has the potential to perhaps lower teen addiction rates, but it's probably gonna do fuck all for adults already addicted.

A good % will just smoke more. Which is even worse for them.

Not saying I'm coming down on either side of this, just that there's a real potential for it to backfire.

Depending on priorities, I suppose.

[Effete Snob]

2. what do you think is going to happen?

I would imagine there are qualified people who have studied this question, and that the research was considered in the process of this particular rulemaking.

There is a massive amount of literature on this topic.

But, hey, some guy on the internet has an opinion based on no evidence whatsoever.

[speak easy]

6. CDC: "Most people who smoke are addicted to nicotine. They may compensate

They may compensate when smoking low-yield cigarettes in order to take in more nicotine" (with footnotes)

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/low_yield_cigarettes/index.htm

[Hugh_Lebowski]

7. I'd bet most people will smoke at least (some) more ...

with very little positive health benefit from the reduction of nicotine.

Maybe make it a bit easier to quit, but someone who wants to do so can already buy lower-nicotine cigs to wean themselves off if they want to, can't they now?

[Effete Snob]

8. Science is highly over-rated

There’s a lot of research on this.

We actually pay people to get answers to questions like this, so not everything is a matter of what Clem at the diner thinks.

[Hugh_Lebowski]

10. Very funny ...

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/low_yield_cigarettes/index.htm

Most people who smoke are addicted to nicotine. They may compensate when smoking low-yield cigarettes in order to take in more nicotine.1,5,6

Many people who smoke block the ventilation holes, thus inhaling more tar and nicotine than measured by machines.
Many people smoking low-yield cigarettes inhale longer, harder, and more frequently to get more nicotine.
People who smoke may get as much or more tar and nicotine from cigarettes with low-yield ratings as from regular cigarettes because of the ways they compensate when smoking them.

I've say 'may', 'I think', etc, all along. I admit I'm 'Clem at the Diner' in this case. But I'm a Clem who's been addicted to nicotine for 20 years now, and for shorter periods in my past.

I'll buy into the supposition that it's an overall 'good thing' because it could lower initial addiction rates, and that's likely enough to make it worthwhile.

But even if it's true in practice that in many cases people wouldn't do compensatory smoking with actual low nicotine cigs (as opposed to what they often do now when using low-yield cigs, which are different in design principles), that's not the same thing as proving reducing nicotine will trigger the already addicted to quit altogether at higher rates ... or, more to my point, have better health outcomes in the long term.

Not saying that's NOT true, it just doesn't prove it.

[Effete Snob]

3. Oh, waddya know, actual science

The internet is an amazing thing, which makes so much information easily available, that it reduces the need to just spitball simple propositions such as "does reducing nicotine result in increased smoking to compensate".

Remarkably, there is an entire set of references (as noted in this review paper) addressing that question in particular.

https://tobaccocontrol.bmj.com/content/22/suppl_1/i14


Reducing the nicotine content to make cigarettes less addictive

One of the concerns in reducing the nicotine content of cigarettes is that smokers would smoke more cigarettes per day and/or smoke cigarettes more intensively, thereby increasing their exposure to harmful tobacco smoke toxicants. It is well known that smokers adjust their smoking behaviour when switched from regular to light cigarettes so as to maintain their desired level of nicotine intake.2 ,7 Increased exposure to tobacco toxicants could result in increased health risks. Research on reduced nicotine content cigarettes suggests that smokers do not take in more smoke when the level of nicotine is lowered. Benowitz et al19

...

The explanation for the lack of compensatory smoking with very low nicotine content cigarettes is most probably because it is difficult to obtain more nicotine (because less nicotine is available in the tobacco rod) and because of the satiating effect of the tar, chemical irritants and related taste, the levels of which were unchanged in reduced nicotine content cigarettes. Subjects smoking very low nicotine cigarettes did not report nicotine withdrawal symptoms, although they did gain weight, the latter presumed to be related to lower nicotine intake. Other researchers have also shown that there is little compensation when switching from regular cigarettes to reduced nicotine high-tar cigarettes.21 ,22

[questionseverything]

5. Shhhh

[Snellius]

9. Nicotine doesn't kill you. The smoke does.

Lower the nicotine you just have to smoke more tar. If they really want to reduce cancer deaths, they should increase the nicotine and lower the number of puffs. Cigarette makers have known for years that if you lower nicotine ("lights&quot , you sell more cigarettes.