The great majority of smokers tell the same story. They started smoking during adolescence, got hooked on nicotine and became lifelong smokers even though they would very much like to quit if they only could.
Tobacco industry scientists have worked hard to enrich nicotine content and to manipulate its chemistry to enhance potency. The Food and Drug Administration’s proposal to reduce nicotine content of traditional tobacco products to nonaddictive levels would have a major positive health impact and would be its single most effective measure in lessening cigarette use among Americans.
Nicotine reduction is a huge threat to tobacco industry’s business model. This was recognized by investors who drove down tobacco company stock prices dramatically after the FDA’s announcement. And there is ample reason for skepticism that our government will have the political will to resist the influence of the powerful tobacco lobby, which has a long history of suppressing regulation through pseudoscience, litigation and generous political contributions.
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Evaluating the role of flavors, including menthol, in encouraging youth addiction to nicotine is belated. Eight years ago, Congress banned flavors other than menthol from traditional cigarettes based upon convincing scientific data. Removing flavors in other tobacco products such as mini-cigars (strawberry, wine grape) and e-cigarettes (chocolate, gummy bear, cotton candy) ought to be achieved without lengthy delay.
The FDA’s other major announcement, a delay of three to four years in reining in the excesses of the e-cigarette industry, is a disappointment as sensible regulation of this rapidly growing product is much needed.
While the delay was justified by the goal of fostering innovation in products that satisfy nicotine addiction with less exposure to toxics, there is concern that e-cigs will be a pathway to nicotine addiction among teens.
The FDA’s plans to focus on nicotine reduction, flavored tobacco and harm reduction products is certainly welcome. Given stout resistance by the industry and the anti-regulatory stance of the present administration, achieving these laudable goals may be a long time coming.
Robert K. Jackler is a professor at the Stanford University School of Medicine. He can be contacted at firstname.lastname@example.org.