FDA commissioner promotes effort to reduce nicotine in cigarettes to Baltimore audience

The head of the U.S. Food and Drug Administration has a bold proposal to get people to quit smoking — reduce nicotine in cigarettes to nonaddictive levels.

Dr. Scott Gottlieb, who promoted his plan Thursday at the Johns Hopkins Bloomberg School of Public Health, first announced his intention over the summer. He now faces an arduous regulatory process to try to make it happen.

Nicotine isn’t the substance that causes cancer and other diseases that can kill people; tar and other pollutants found in tobacco products are responsible for that. But nicotine, a highly addictive drug, makes people become addicted to cigarettes and other products that contain it. Nicotine products kill 480,000 people a year.

Gottlieb said he chose nicotine as a priority because of the large public health effect it could have. Opioid addiction is also a key target of his office.

The effort to reduce nicotine in cigarettes is part of a comprehensive plan by the regulatory agency to get people to stop smoking. The agency hopes to persuade people to use alternative products, such as vapes, that are potentially less harmful.

“The FDA is envisioning a world where cigarettes can no longer create a sustained addiction, and where adults who still need or want nicotine can get it from alternatives and less harmful sources,” Gottlieb said.

Getting nicotine levels reduced will likely be tough and face resistance from tobacco companies, academicians who follow the health effects of smoking said during a panel discussion after Gottlieb’s speech.

“One of the things we know will happen is the industry will be lobbying incredibly hard with lots of money behind the scenes,” said Kenneth Warner, a professor of health management and policy at the University of Michigan School of Public Health.

Smoking in the United States is now at an all-time low, with just 15 percent of the adult population using nicotine products. Smoking among youths is also down, according to the latest statistics.

But smoking remains a major health problem, Gottlieb said, adding that cigarettes are the only legal consumer product that, when used as intended, will kill half of all long-term users.

The FDA is using the Family Smoking Prevention and Tobacco Control Act, passed by the Democratic Congress and signed by President Barack Obama in 2009, to try to reduce the nicotine in cigarettes to nonaddictive levels. The legislation gives the agency the authority to regulate the manufacture, distribution, and marketing of tobacco products to protect public health.

There are challenges to the plan that Gottlieb said will need to be addressed — for instance, how to stop people from smoking more cigarettes once the nicotine levels are lowered, and how to prevent a black market for sales of higher-nicotine cigarettes from developing.



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