From The New England Journal of Medicine

In 1976, tobacco researcher Michael Russell wrote that “People smoke for the nicotine but they die from the tar” — suggesting a potential regulatory pathway for eliminating the key harms arising from tobacco use. That is, by reducing or eliminating nicotine from combustible-tobacco products, we might be able to dramatically reduce their use and smokers' dependence on them, averting the harm they caused.

More than 30 years later, in June 2009, President Barack Obama signed legislation that permits the reduction of levels of nicotine, tobacco's primary addictive agent. Section 917 of the Family Smoking Prevention and Tobacco Control Act states that the Tobacco Products Scientific Advisory Committee of the Food and Drug Administration (FDA) shall provide advice, information, and recommendations to the secretary of health and human services on several issues, including “the effects of the alteration of the nicotine yields from tobacco products” and “whether there is a threshold level below which nicotine yields do not produce dependence on the tobacco product involved.” The legislation also contains a provision that prohibits the FDA from “requiring the reduction of nicotine yields of a tobacco product to zero.”

Benowitz and Henningfield first proposed a systematic reduction in nicotine content as a means of weaning Americans off cigarettes, estimating in 1994 that a limit of 0.4 to 0.5 mg of nicotine per cigarette might prevent or limit the development of addiction. Such very-low-nicotine cigarettes would be fundamentally different from earlier “light” or “low-tar-and-nicotine” cigarettes in that the tobacco itself would contain so little nicotine that smokers could not extract substantial levels no matter how they smoked. By contrast, “light” cigarettes developed and marketed by the tobacco industry in the 1970s and 1980s included design features for which smokers could compensate (e.g., by covering ventilation holes) in order to obtain more nicotine.

our take

Nicotine in cigarettes causes addiction to a product that will kill half of all regular smokers. The new evidence that low nicotine products can reduce addictiveness and lead to quitting, all without the unintended consequence of prompting more smoking to compensate for lower nicotine, could be a game changer. The FDA should be jumping on policy options for reducing nicotine to non-addictive levels.
Robin Koval
CEO and President
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