Can limiting the amount of nicotine in cigarettes keep people from getting addicted to smoking?
The FDA thinks it just might.
This week, Commissioner Scott Gottlieb announced that the agency is taking steps to cap the amount of nicotine in combustible tobacco products. It’s the first time in its history that the FDA has attempted to regulate what can — or cannot — be in a cigarette.
Research suggests the strategy could work. Gottlieb cited an FDA study in the New England Journal of Medicine that found new regulations could prompt millions of Americans to quit smoking — and drive the smoking rate down from 15% today to as low as 1.4%.
Former California Congressman Henry Waxman, who famously grilled tobacco company CEOs during congressional hearings in the 1990s, applauded the announcement.
“It is clear nicotine is what keeps people smoking,” said Waxman, a former smoker. “It’s a drug that is delivered when cigarettes are inhaled and the reason why so many people find it impossible or difficult to give them up.”
Waxman spoke with the Los Angeles Times about the significance of the proposed regulations, how they might improve public health, and why he’s not in favor of banning nicotine altogether.
Is limiting the amount of nicotine in cigarettes a good strategy?
I think if this could be implemented, it could be a tremendous boon for public health. Many people would like to give up smoking, and this may be one of the ways to do it.
Are there any downsides?
What I fear is that some people think that we should make cigarettes so unattractive that smokers will turn to other substances like vaping products in order to get their nicotine input.
I have real questions about trying to get people to quit one habit to take up another, even if in theory it is less dangerous.
Legislation you helped craft said the FDA is not allowed to ban nicotine entirely. Why?
We did not want to support the prohibition of nicotine. Prohibition of alcohol failed, and banning nicotine from cigarettes, which is the product smokers enjoy, would have amounted to a prohibition as well.
We wanted the FDA to look at whether cigarette smoking could still be enjoyable with less nicotine. That was our thinking on it.
Has the FDA ever regulated ingredients in cigarettes before?
No. It has only had the power to regulate cigarettes since 2009 because Republicans blocked legislation to give the FDA that legal authority for years.
Obama was willing to sign legislation to give the FDA regulatory power over cigarettes. But they have never used it to designate the amount of any ingredients in cigarettes.
Is it hard to reduce the amount of nicotine in cigarettes?
In our investigations in Congress, we found out that cigarette companies were manipulating the nicotine levels in cigarettes to make them more addictive to people.
If they can change nicotine levels to make them higher, they can certainly do it to make them lower.
How hard is it going to be for the FDA to implement these new rules, if they go into place?
This action could be taken by the FDA without further legislation or approval by Congress. But a regulation can always be reviewed to see if the scientific record backs it up.
Still, this is a big step, and I want to congratulate Dr. Gottlieb for taking it. It means he is taking this matter seriously.
This interview has been edited for length and clarity.
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