The cigarette is the only legal consumer product that – when used as intended – causes the premature death of half of long-term users.
To address this long-standing health threat, in late June 2022, the Biden-Harris administration announced a plan to move forward with a new standard for cigarettes and other combusted tobacco products that would make them minimally or nonaddictive.
A similar nicotine-reduction strategy has also recently been announced by the government of New Zealand and was described as the key component of the country’s new smoke-free plan.
The Biden-Harris proposal was predated by an earlier plan in 2017 during Trump’s presidency to reduce the permissible nicotine content in cigarettes. Mitch Zeller, the director of the Food and Drug Administration’s Center for Tobacco Products from 2013 to April 2022, stated in 2019 that “this one rule could have the greatest impact on public health in the history of public health.”
So what does the proposal mean in practice? When implemented – likely not for at least another three years – it would mean that all cigarettes and cigars sold in the United States will have to contain approximately 95% less nicotine than they currently do. As nicotine is the addictive substance in tobacco, this would mean that these tobacco products would become pretty much nonaddictive. No more young people would become addicted to cigarettes and current smokers would find it much easier to quit.
As a professor of public health sciences who has been doing research on smoking cessation for over 30 years, I am impressed by any intervention that increases the quit rate among smokers with no plans to quit. In one of our recent randomized clinical trials of very low-nicotine cigarettes, my research team at Penn State, along with colleagues at Harvard, found that those assigned to use them were more than four times as likely to quit smoking as those who smoked normal nicotine cigarettes.
Research suggests that the full public health benefits of a successfully implemented reduced nicotine standard for cigarettes could be enormous.
A 2018 FDA study projected that by the year 2060, a reduced nicotine standard for cigarettes could reduce the smoking rate dramatically – from around 13% now to below 2%, preventing 16 million people from becoming regular smokers and preventing more than 2.8 million tobacco-caused deaths.