President Joe Biden's administration on Tuesday announced it would develop a policy requiring cigarette makers to reduce nicotine to non-addictive levels -- a move that would substantially cut nicotine levels in cigarettes and deal a powerful blow to the tobacco industry.
If successful, the new US. standard could save millions of lives by the end of the century and shape a future in which cigarettes are no longer responsible for addiction and debilitating disease.
The initiative requires the Food and Drug Administration to develop and then publish a rule that would likely be contested by industry.
"The goal of the potential rule would be to reduce youth use, addiction and death," the FDA said.
"Nicotine is powerfully addictive," said FDA Commissioner Robert Califf. "Making cigarettes and other combusted tobacco products minimally addictive or non-addictive would help save lives.
"The U.S. Surgeon General has reported that 87 percent of adult smokers start smoking before age 18, and about two-thirds of adult daily smokers began smoking daily by 18 years of age. Lowering nicotine levels to minimally addictive or non-addictive levels would decrease the likelihood that future generations of young people become addicted to cigarettes and help more currently addicted smokers to quit."
The process is expected to take several years and could be delayed or derailed by litigation or reversed by a future administration sympathetic to the tobacco lobby.
Nicotine is the "feel good" chemical that hooks people on cigarettes, chewing tobacco, vaping devices and other tobacco products.
"Addiction to nicotine in combusted products is the main driver of sustained use of these products," the FDA said.
Thousands of other chemicals contained in tobacco and its smoke are responsible for diseases such as cancer, heart disease, stroke, lung diseases, diabetes and more.
Though smoking is less prevalent in the U.S. than in Europe and has been declining for years, it's still responsible for 480,000 deaths a year in the country, according to the Centers for Disease Control and Prevention.
Some 12.5 percent of all US adults are current cigarette smokers, according to the FDA.
The announcement was welcomed by tobacco control groups.
"The American Lung Association is pleased to hear that a proposal is coming to reduce the levels of addictive nicotine in cigarettes," said the group's CEO Harold Wimmer. "Reducing nicotine to non-addictive levels in cigarettes is an important step forward for public health, and we urge FDA to extend this proposal to include all tobacco products, including e-cigarettes."
Reducing the nicotine content of cigarettes has been under discussion for years among U.S. authorities.
The FDA funded a randomized trial published in 2018 that found "reduced-nicotine cigarettes versus standard-nicotine cigarettes reduced nicotine exposure and dependence and the number of cigarettes smoked."
Another FDA-funded study found that if a nicotine reduction policy were enacted in 2020, it could result in more than 33 million people not becoming regular smokers and prevent more than eight million deaths from tobacco-related illnesses by 2100.
The tobacco industry rejects these studies and says people would in fact smoke more.
Biden has made a "cancer moonshot" a centerpiece of his agenda and a nicotine-reduction policy would fit within its goals, at minimal cost.
The total economic cost of smoking is more than $300 billion a year, according to U.S. data, including more than than $225 billion in direct medical care for adults and more than $156 billion in lost productivity due to premature death and exposure to secondhand smoke.
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