Jun 22, 2022 - Health

Biden administration wants to take the buzz out of cigarettes

Illustration of a pack of cigarettes as a downward trending bar chart.
Illustration: Allie Carl/Axios

The Biden administration wants to make the tobacco industry cut back the amount of nicotine in cigarettes sold in the U.S. to non-addictive levels.

Why it matters: The bid to essentially take the buzz out of smoking cigarettes would be unprecedented in the long-running public health fight to curb tobacco use, which the FDA says leads to more than 480,000 deaths a year.

  • But it's sure to face vigorous opposition from tobacco interests, as well as libertarian-leaning consumer freedom groups.

Driving the news: The FDA can't actually just ban cigarettes, but can create "product standards" that make them less attractive, experts say. So on Tuesday, the agency proposed a rule to establish a maximum nicotine level in cigarettes and other certain finished tobacco products. It is unclear if they would do it at once or gradually.

  • "Because tobacco-related harms primarily result from addiction to products that repeatedly expose users to toxins, FDA would take this action to reduce addictiveness to certain tobacco products, thus giving addicted users a greater ability to quit," regulators said.
  • The cap on nicotine would also discourage young people from getting a cigarette addiction to begin with, they said.

What they're saying: "This would be really historic," Dorothy Hatsukami, a professor at the University of Minnesota who researches tobacco policy, told the Wall Street Journal. She's among a number of researchers who study tobacco regulatory science — much of it funded by the FDA— and examined the positive impact of low-nicotine cigarettes on consumer behavior and health, per WSJ.

  • One such study led by Rachel Cassidy, an associate professor in the Center for Alcohol and Addiction Studies at Brown University, looked at the impact of gradual or immediate switches to low-nicotine cigarettes.
  • Smokers who switched immediately to the lowest content of nicotine smoked fewer cigarettes per day and had lower nicotine intake. Younger smokers, in particular, indicated they did not like the cigarettes, she said.
  • "We don't want to create a prohibition on nicotine. What we want is for people to shift from combustible cigarettes, which are incredibly harmful — they kill half the people who use them past the age of 40 — to other forms of nicotine which are far less harmful," Cassidy said.

The other side: Critics say the policy move would make little sense.

  • "The most harmful parts of smoking will remain legal," Guy Bentley, the director of consumer freedom at the libertarian think tank Reason Foundation, told Axios. The non-profit, which is supported in part by private contributions, does get some funds from tobacco manufacturers which it says accounts for less than 2% of its annual budget.
  • He also called a nicotine limit a practical "ban" of cigarettes in the U.S. which would almost certainly fuel a black market of illegal cigarettes that would ultimately fail.
  • He questioned the value of findings showing the benefits that low-nicotine cigarettes would have in the real world, saying smokers often find their full-strength cigarettes in the midst of those studies. Directly promoting products that reduce harm would be far more effective, he argued.

Between the lines: One thing backers and critics agree on is the reduction in nicotine could cause confusion among smokers who think cigarettes will become safer.

  • "We're very concerned about that. In some of my own research, we've seen teens might think they're safer, which they are not. They're less addictive but they’re not safer," Cassidy said. "That can be hard for people to grasp."

The big picture: The FDA first weighed setting a maximum nicotine level in cigarettes in 2018, elevating tobacco regulation to a level not seen since the George H.W. Bush and Clinton administrations.

  • The agency got the authority to regulate nicotine levels through the 2009 Tobacco Control Act.
  • The new plan comes just two months after the FDA proposed rules that would ban menthol cigarettes and flavored cigars saying the flavors "makes it more difficult for people to quit smoking."
  • Supporters told the Washington Post this fits well with the goals of the cancer moonshot he launched earlier this year, which calls to reduce the age-adjusted death rate from cancer by 50% over 25 years.
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