FDA’s reduced nicotine plan could be game-changer in tobacco epidemic

Statement of Robin Koval, CEO and President, Truth Initiative

The Biden Administration’s bold decision to include a plan on its agenda to reduce nicotine in cigarettes to non-addictive levels, a policy that has been considered for many years but never implemented, has the potential to be a significant and momentous game changer as we work to end the decades of death and disease tobacco has caused for Americans. Today’s announcement on nicotine goes to the heart of the ongoing tobacco epidemic and addresses it at its core — dismantling a deadly product that has been engineered to be more rapidly addictive and harder to quit.

We encourage Commissioner Califf to move quickly and purposefully as the FDA begins the rulemaking process on this measure. Previous plans to reduce nicotine in cigarettes, most recently in 2017, have started with promise, only to lose momentum. The need is urgent as there is evidence that suggests combustible tobacco use may have increased during the pandemic, including increased cigarettes sales for the first time in years. We will also watch the tobacco and nicotine industry closely for any efforts to disrupt or unduly influence the process to protect their profits, which are predicated on the addictive nature of their products. If tobacco and nicotine companies truly desire a “smoke-free world,” as they have stated, they should robustly support all proposals that would do just that such as eliminating menthol in cigarettes, graphic warning labels, increases in tobacco taxes, as well as the potentially powerful tool of making all tobacco products non-addictive. Unfortunately, we suspect that this latest announcement will be met with the same well-known and standard industry tactics of opposition, distortion, litigation, and delay.

Most smokers—nearly 70%—want to quit, and this move has the potential to help them do so and save millions of lives. In fact, according to a 2019 Truth Initiative^® study, 62% of adult smokers said they would quit if the Food and Drug Administration (FDA) limited the level of nicotine in cigarettes. We are optimistic that this step will go a long way toward achieving a culture where people reject tobacco, thus preventing or freeing themselves from a lifelong and dangerous addiction. Still, it’s important for the public to understand that while nicotine reduction will make cigarettes less addictive they will still be as deadly and toxic as regular nicotine cigarettes. Public education on the myriad dangers of tobacco product use and benefits of FDA-approved nicotine replacement therapy will continue to be critical. So too, will progress on other policies such as removing flavors from all tobacco products and renewed efforts to help people quit with proven effective programs such as BecomeAnEX, our free, digital quit-smoking plan, EX Program, our enterprise-level tobacco cessation program designed for employers and health plans, and This Is Quitting, the nation’s largest program for youth and young adults who want to escape e-cigarettes and their addiction to nicotine.

To move us closer to a tobacco free future, we also strongly believe that the reduction of nicotine to non-addictive levels must ultimately extend to all tobacco products, including e-cigarettes. Youth vaping, driven by cleverly engineered products that quickly deliver very high levels of nicotine, remains at epidemic levels, with over 2 million middle and high school students vaping, according to the 2021 National Youth Tobacco Survey. Research shows that young e-cigarette users who vaped products containing higher levels of nicotine were more dependent on nicotine than even young cigarette smokers.  This is not surprising given the fact that a Truth Initiative and Centers for Disease Control and Prevention study found that the average nicotine concentration in e-cigarettes sold in U.S. retailers more than doubled from 2013 to 2018. Today’s e-cigarettes often contain higher levels of nicotine than a typical combustible cigarette.

As the FDA has acknowledged, a comprehensive approach to tobacco and nicotine is needed in order to continue combatting both the physical and mental health impacts of these products, including cigarettes, which remain the number one cause of preventable death in America. That includes prohibiting youth-appealing flavors, including menthol, from all tobacco products, continuing to restrict marketing to youth, and capping nicotine levels in all products, among other important policies. Commissioner Califf and the FDA deserve credit for attempting to tackle many of these issues, and we are hopeful that this period will be viewed in the future as a pivotal point in ending the tobacco epidemic.