Reducing Nicotine Levels in Tobacco Products
Experts from the National Cancer Institute's Tobacco Harm Reduction Network are urging for more intensive research of reducing the levels of nicotine in tobacco products. After an extensive review of the U.S.’s current scientific policy and strategies on tobacco regulation in meetings with non-tobacco industry scientists, government agency leaders, and tobacco control policymakers, the tobacco research and policy experts have concluded that nicotine reduction in tobacco products is not just feasible, but has the potential to dramatically reduce the nation’s rate of tobacco-related morbidity and mortality.
Dorothy Hatsukami, Ph.D. of University of Minnesota’s Medical School, Department of Psychiatry, and Mitch Zeller, J.D. of Pinney Associates in Bethesda, MD served as co-chairs of the National Cancer Institute's Tobacco Harm Reduction Network and oversaw the meetings with industry leaders in their effort to formulate an effective nicotine reduction strategy. Hatsukami, Zeller, and their colleagues have published their findings in the latest issue of the journal Tobacco Control.
In their report, the authors state that the nicotine yields in cigarettes and other tobacco products can be reduced to low and seemingly non-addictive levels. First proposed in 1994, the attempt to reduce nicotine levels in tobacco products has made steady progress since undergoing scientific scrutiny and the passage of several federal regulations. According to the U.S. Family Smoking Prevention and Tobacco Control Act (FSPTCA) passed in 2009, as well as Articles 9 11 of the World Health Organization’s (WHO) Framework Convention on Tobacco Control established in 2005, the U.S. Food and Drug Administration (FDA) now has the authority to regulate tobacco products and their constituents, including nicotine content. However, the FSPTCA does not allow the FDA to completely eradicate the presence of nicotine in tobacco products, yet the FDA can still require the reduction of nicotine levels to non-addictive levels.
Currently, the U.S. Center for Disease Control and Prevention (CDC) estimates that as many as 46.6 million American adults (20.6% of the population) are cigarette smokers. Every day, about 1,000 Americans under the age of 18, and 1,800 American adults will begin smoking on a regular basis. Tobacco use remains the world’s leading cause of preventable death and disease. In the U.S. alone, tobacco use causes approximately 443,000 deaths per year, including the effects of secondhand smoke. Because nicotine is as addictive as other illicit substances, such as cocaine or heroin, cigarette smokers face difficult odds when attempting to quit or remain abstinent. Even though 70% of cigarette smokers nationwide wish to quit completely, and 45% attempt to quit each year, smoking cessation often requires several attempts before becoming permanently effective since smokers can experience severe withdrawal symptoms and related health issues during cessation.
By regulating nicotine yields in tobacco products to non-addictive levels, the report proposes that the prevalence of smokers in the U.S. could eventually be reduced to as little as 5% of the adult population. Without the addictive element in tobacco, the report also suggests that the number of annual deaths related to tobacco use would progressively and substantially drop overtime. Not only would current smokers of all demographics become better capable of quitting, but adolescents would be less likely to experiment and develop a dependency on the substance. The regulation could have a significant overall impact on public health.
During their meetings, the health experts also considered several recent studies on the use of low-nicotine cigarettes by current smokers. Clinical investigations have shown that by reducing the level of nicotine in cigarettes does not cause smokers to consume more cigarettes than usual in an effort to compensate for the loss. Rather, smokers were likely to consume less cigarettes overtime when they used low-nicotine cigarettes, which led to increased success with smoking cessation and abstinence.
The authors recommend continued collaboration among the government agencies, research organizations, and scientific communities as they move forward in realizing successful nicotine reduction. Hatsukami is also the director of the University of Minnesota’s Tobacco Use Research Center and the Masonic Cancer Center’s Cancer Control and Prevention Research Program.
