Is it possible to create a nonaddictive nicotine cigarette?
That’s the question the U.S. Food and Drug Administration (FDA) hopes to answer with a new initiative to investigate the possibilities of a “low-nicotine” cigarette.
While smoking rates have continued to drop, more than 36 million U.S. adults smoke cigarettes, according to the Centers for Disease Control and Prevention (CDC).
Every year 480,000 fatalities, or about 1 in 5 deaths in the United States, are attributed to smoking-related causes.
“The overwhelming amount of death and disease attributable to tobacco is caused by addiction to cigarettes — the only legal consumer product that, when used as intended, will kill half of all long-term users,” FDA Commissioner, Dr. Scott Gottlieb, said in a statement. “Unless we change course, 5.6 million young people alive today will die prematurely later in life from tobacco use.”
The FDA pointed out that nearly 90 percent of adult smokers started smoking before the age of 18. In theory, if cigarettes are low nicotine there may be fewer teens who become addicted.
Additionally, low-nicotine cigarettes could potentially help die-hard smokers wean themselves off their daily nicotine fix.
So far, FDA officials are just investigating the option and opening up a public dialogue on the issue of “nonaddictive” cigarettes.
Additionally, FDA officials are examining the possibility of increasing access to medicinal nicotine products to help people quit smoking.
They also announced delays to new regulations for both combustible tobacco products like cigars and hookah, as well as e-cigarette devices until 2021 and 2022, respectively.
Potential pluses, minuses
Katie McMahon, policy principal at the American Cancer Society Cancer Action Network, said her organization is hopeful that this initiative could have an impact on smoking rates.
“We are excited about the prospect of addressing nicotine and cigarettes,” McMahon told Healthline.
But she pointed out that the FDA will have to consult with experts and scientists to ensure low-nicotine cigarettes don’t encourage smokers to simply turn to other methods of nicotine consumption.
“If you have different cigarettes with different levels of nicotine on the market ... how does that affect other product use such as e-cigarettes?” McMahon said. “Reducing nicotine in cigarettes can't be done in isolation.”
Laurent Huber, the executive director of Action on Smoking and Health, said he thought the initiative sounds like “a good way forward” as long as it was developed properly.
“It obviously needs to be done well,” Huber told Healthline.
Action on Smoking and Health is America's oldest anti-tobacco organization.
Huber said the FDA would have to be careful that they don’t encourage the rise of a black market for full-nicotine cigarettes from other countries.
Additionally, there’s a chance that people could assume these new “low-nicotine” cigarettes are safe to smoke.
Or people could decide to get their nicotine fix with unregulated e-cigarettes rather than be weaned off nicotine entirely.
“Nicotine addiction is not benign,” Huber said. “We don't [want] an expansion of nicotine use,” among young people.
While he’s supportive of the FDA plan, Huber said they need to take into account the possibility people could paradoxically smoke more with low-nicotine cigarettes.
“You'd have addictive smokers that try to get that nicotine high somewhere else,” Huber said. “Some have questioned if people will try to smoke more or inhale more ... with the objective to get as much cigarette smoke in the hope of getting enough nicotine.”
While low-nicotine cigarettes won’t be available for months or even years, Huber said that U.S. officials could take other steps to reduce smoking rates.
He said that warning labels in other countries are more graphic in order to deter smokers.
Additionally, some states still allow smoking in indoor public places, which can increase the risk of secondhand smoke.