FDA Plan to Reduce Nicotine Levels in Cigarettes Would Save Millions of Lives – Agency Must Quickly Implement It

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
March 15, 2018

WASHINGTON, D.C. – The U.S. Food and Drug Administration today formally requested public input on its proposal to reduce nicotine in cigarettes to minimally or non-addictive levels, a bold plan that is the centerpiece of the comprehensive tobacco regulatory strategy announced in July by FDA Commissioner Scott Gottlieb. The benefits the FDA cites for this proposal are extraordinary. The FDA estimates that this plan would prevent more than 33 million youth and young adults from becoming regular smokers this century, prompt 5 million smokers to quit within one year (rising to 13 million in five years) and save more than 8 million lives by the end of the century.

Given these enormous public health benefits and the millions of lives that would be saved, it is critical that the FDA move as quickly as possible to turn this plan into reality. There is no other single action our country can take that would prevent more young people from smoking or save more lives. This is truly a once-in-a-lifetime opportunity to greatly accelerate progress in reducing tobacco use – the nation’s No. 1 cause of preventable death –and bring us closer to eliminating the death and disease it causes. Today’s action is a first step, but it will only have an impact if the FDA quickly develops and implements a final regulation. The FDA should issue a hard deadline for doing so.

For this proposal to have maximum impact, the FDA should reduce nicotine levels in all combustible tobacco products, not just cigarettes, to prevent switching to other harmful products. It is encouraging that the FDA recognizes this concern, noting in today’s regulatory notice that “if a standard were to apply to cigarettes only, it could be substantially less effective.”

There is growing scientific evidence that limiting nicotine in cigarettes to minimally or non-addictive levels can help more smokers quit and prevent kids from becoming addicted. Research also shows that reducing nicotine content in cigarettes is technologically feasible and can be done without unintended consequences, such as causing smokers to compensate by smoking more cigarettes. As the FDA noted in its regulatory notice, “Some studies of VLNC [very low nicotine content] cigarettes with nicotine levels similar to what FDA may consider including in a nicotine product standard have not resulted in compensatory smoking and have demonstrated reductions in cigarettes smoked per day and in exposure to harmful constituents.”

It is also essential that the FDA not depend entirely on this proposal to reduce the death and disease caused by tobacco use. In addition to reducing nicotine in cigarettes, the FDA should take several other strong actions. These include requiring large, graphic health warnings covering at least half of cigarette packs (as mandated by the 2009 law establishing FDA authority over tobacco products); prohibiting menthol cigarettes and other flavored tobacco products, which have been shown to promote youth tobacco use; and supporting the development of innovative new products to help more smokers quit, an important process the agency has initiated.