Dinesh Kamath's Editorial 'Good move by US FDA' that was published in Newsband

Good move by US FDA

The U.S. Food and Drug Administration has announced a comprehensive proposal to reduce the amount of nicotine in cigarettes to non-addictive levels. This is aimed at striking at the root of the problem of smokers getting addicted.  Nicotine exposes them to nearly 7,000 chemicals, many of them deadly, every time they smoke. This move can cut smoking-related disease and death burden overall.

The FDA, however, has no plans to regulate nicotine content in electronic cigarettes and other nicotine-replacement products, which are seen to be alternatives to help smokers quit the habit. A “substantial increase” in e-cigarette use among adult smokers had led to a “significant increase” in the quitting rate among smokers.

Threatened by the dwindling number of young smokers, there is the possibility that tobacco companies will target developing countries such as India with renewed vigour.

Because nicotine lives at the core of both the problem and the solution to the question of addiction, addressing the addictive levels of nicotine in combustible cigarettes must be part of the FDA’s strategy for addressing the devastating, addiction crisis. The idea of gradually reducing the addictive ingredient of cigarettes, nicotine, looks attractive on the surface. But unless nicotine is pretty much eliminated quickly and comprehensively in all available tobacco products – which seems unlikely – it runs a serious risk of making things worse as smokers smoke cigarettes harder in order to get the nicotine they need, leading to more exposure to the harmful tar.

The move could end up exposing smokers to higher levels of toxins. Reducing nicotine levels could also have other unintended consequences including people smokers smoking more cigarettes, or even an increase in black market activity. It’s not the nicotine but the smoke in cigarettes which makes them so deadly. The smokers who are unable to quit should be allowed to switch to less harmful nicotine products.”

Nicotine is the highly addictive tobacco constituent that is primarily responsible for the maintenance of cigarette smoking. Our society values personal freedom of choice; however, addiction undermines freedom of choice with respect to stopping or not stopping the use an addictive drug. When nicotine addiction develops, it is difficult to stop using tobacco products. Furthermore, while adolescents and young adults may have a general awareness of the risks of cigarette smoking, they underestimate the harm and the addictive nature of cigarette smoking.

There is a need to develop guidelines for testing, measuring, and regulating the contents and emissions of tobacco products, to contribute to a regulatory framework to reduce the dependence potential of tobacco products. A nicotine reduction policy will be very likely to increase tobacco cessation efforts in anticipation of the policy and as it is implemented. It would be important to increase access to treatment for tobacco dependence and withdrawal, including behavioural counselling, smoking cessation medications and broad coverage by insurance programmes. This should include individualised services for special populations such as people with co-morbid psychiatric disorders who may warrant extra assistance.