Taking the Craving Out of Smoking

In Healthcare On

A lightning bolt struck the tobacco world last Friday when the Food and Drug Administration announced a plan aimed at reducing the nicotine in cigarettes to a nonaddictive level. Within an hour, the value of global tobacco stocks plummeted — and for good reason.

The new F.D.A. chief, Dr. Scott Gottlieb, didn’t mince words in making the announcement. He noted that tobacco remains the leading cause of preventable disease and death in the United States, resulting in nearly half a million annual fatalities. And he pointed out that the cigarette is the only consumer product that kills when used as directed — half of its long-term users, in fact — and that nicotine is the root cause of cigarette addiction.

Reducing nicotine in cigarettes so that they are “minimally or nonaddictive,” he asserted, “is a cornerstone of our new and more comprehensive approach to effective tobacco regulation.”

This is exceptionally good news for tobacco control, and for human health. A legal cap on the nicotine in cigarettes could be one of the most important interventions in human health history. The point is not that nicotine itself causes cancer (it’s the other chemical compounds in the smoke), but rather that by rewiring the brain, nicotine acts as the driver to keep smokers smoking. Nearly everyone who smokes long-term is addicted.

. . .

The beauty of the Tobacco Control Act signed by President Barack Obama in 2009 is that while the F.D.A. is barred from requiring the removal of all nicotine from cigarettes, or from banning cigarettes altogether, the agency can set a maximum nicotine level in the interest of public health. So though the tobacco industry cannot be forced to reduce nicotine to zero, it could be required to cut the level by, say, 99 percent.

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