Nicotine is the addictive component of cigarettes, and tobacco companies have long been aware of its power. As a result, they've carefully controlled nicotine levels for decades to keep smokers dependent. But now, the United States Food and Drug Administration (FDA) is taking steps to lower nicotine levels in cigarettes to non-addictive levels in an effort to reduce the smoking rate.
The new ruling expected in the first half of 2023 would establish a maximum nicotine level in cigarettes and other tobacco products. The aim is to encourage established smokers to quit and discourage young people from starting. It's a major shift in the agency's approach to regulating tobacco, and it could have a profound impact on public health.
The proposed ruling comes as the Biden administration is stepping up its efforts in fighting cancer-related deaths. They aim to reduce these deaths by at least 50% over the next quarter of a century.
The toxins in cigarette smoke
All tobacco products contain toxic chemicals that are harmful to your health. Cigarettes, cigars, and loose tobacco are all made from natural, dried plant leaves. However, they are fertilized with harmful and radioactive materials, and manufacturers add other substances to improve the smoking experience.
As the tobacco and its additives burn, they release a complex mixture of thousands of chemicals. At least 70 are carcinogens, meaning they can cause cancer.
Nicotine is an addictive chemical that produces a temporary feeling of pleasure and encourages smokers to continue, even if they know it's harmful to their health.
Other harmful chemicals in tobacco smoke include:
- Hydrogen cyanide
- Radioactive elements
- Carbon monoxide
Many of these substances cause serious and deadly health complications.
The health effects of smoking
Smoking causes extensive damage throughout the body, and it's the leading cause of preventable disease, disability, and death in the U.S.
For every individual who dies because of smoking, at least 30 more live with a serious smoking-related illness, equating to more than 16 million people.
These smoking-related illnesses include:
Smoking also increases the risk of tuberculosis, autoimmune diseases, and eye diseases.
The costs of smoking
Nearly 40 million American adults smoke cigarettes, and every day, around 1,600 people under 18 years old smoke their first cigarette.
Besides harming the smoker's health, smoking also imposes a huge financial burden on society. In the U.S., smoking-related illnesses cost more than $350 billion yearly. $225 billion of this cost is direct medical care for smokers, while $156 billion is lost productivity due to premature death and second-hand smoke exposure.
Currently, state spending on smoking prevention and control doesn't meet recommendations by the Centers for Disease Control and Prevention (CDC).
Although states make billions of dollars from tobacco taxes, they only use a small portion to fund tobacco prevention programs.
The FDA's proposed ruling
By lowering nicotine levels, the FDA hopes to make cigarettes less addictive and reduce the number of smokers in a move that would save lives. However, this is only the beginning of a lengthy process before a final rule is drafted.
The FDA must first issue a proposed rule, which would be open to public comment. They'll then consider these comments before issuing a final rule.
The process could take years, and it's unclear how effectively the ruling would reduce smoking rates.
Most smokers begin during their teenage years and by the time they reach adulthood, quitting is extremely challenging. Reducing nicotine levels to minimally or non-addictive levels will decrease the chances of having a future generation of smokers. It will also motivate current smokers to quit.
In 2018, the FDA published an analysis in the New England Journal of Medicine. They projected that by 2100 the ruling would prevent 33 million citizens from becoming regular smokers, and around 8 million lives would be saved. The smoking rate would sit at just 1.4% rather than the current rate of 12.5%.
The FDA had previously issued a proposal banning menthol as a flavoring agent in cigarettes. Menthol is a natural compound found in peppermint and other similar plants. It can change how the brain registers taste and pain. When used in cigarettes, it creates a cooling sensation in the throat and airways, making the smoke feel smoother and easier to inhale.
Because of these effects, menthol in cigarettes and other commercial tobacco products makes it more difficult to quit smoking.
The FDA hopes that banning menthol cigarettes will decrease the number of smokers, especially Black people, who are more likely to smoke menthol cigarettes than other population groups.
E-cigarettes also targeted
The FDA also has Juul Labs Inc. in its sights. Juul is an electronic cigarette company that's come under intense scrutiny for its marketing practices and the high nicotine levels in its products. Juul contributed to the skyrocketing popularity of e-cigarettes in recent years.
The company marketed a range of fruit and dessert-flavored nicotine liquids for e-cigarettes, which appealed to young people. However, they denied this was their intention.
Juul stopped selling sweetened vaping liquids in 2019 before the FDA banned similar products industrywide in 2020. Despite this, Juul is still the subject of an ongoing FDA investigation.
It's currently unclear how the FDA will regulate nicotine in e-cigarettes and what this means for the broader vaping market. Juul is just one player, and many other companies make and sell electronic cigarettes.
Some people do not support a potential ban on e-cigarettes as they believe it's a harm-reduction tool for current smokers who want to quit.
However, e-cigarettes are not currently approved by the FDA as cessation devices, and there's no conclusive evidence that they help people quit smoking in the long term. In fact, some studies suggest that people who use e-cigarettes are less likely to stop smoking cigarettes.
The FDA's decision to crack down on nicotine levels in cigarettes is a positive step forward in the fight against tobacco addiction. However, it's just one part of a larger effort to reduce smoking rates and save lives.
Other measures, such as education and prevention programs, increased taxes on tobacco products, and stricter regulation of marketing practices are also needed to achieve this goal.