Unnamed smoker at 4th Street Live in Louisville, KY.
Jahi Chikwendiu | The Washington Post | Getty Images
In its last few days of power, the Biden administration is expected to officially propose a limit on nicotine in cigarettes. It’d be a last-minute move to push back against the tobacco industry after President Joe Biden failed to finalize a long-standing pledge to ban menthol cigarettes.
The proposal, which could come as soon as Monday, is not expected to include tobacco products like e-cigarettes or nicotine replacement patches and lozenges.
“This is a Hail Mary from the Biden administration to move forward with a meaningful proposal, or at least to jump-start one in the waning days of the administration,” said Erika Sward, assistant vice president of national advocacy for the American Lung Association.
While it’s the toxins released by combustible tobacco that cause chronic illnesses and death associated with smoking, it’s nicotine that first gets people hooked, and then keeps them coming back.
Precise details of the proposal to cap nicotine levels have not been released. Multiple studies have suggested, however, that levels may have to be slashed by up to 95% to make them minimally or non-addictive.
“This would be a historic action by the FDA that has the potential to have an enormous impact on public health,” said Dr. Rose Marie Robertson, science and medical officer of the American Heart Association.
Cigarette smoking is the leading cause of preventable disease and death in the U.S., according to the Centers for Disease Control and Prevention, killing more than 480,000 people each year.
Nearly all smokers started as teenagers. Making cigarettes less addictive would save millions of lives, Sward said.
A 2018 study from the Food and Drug Administration estimated that a nicotine cap would result in 16 million fewer people becoming addicted to smoking by the year 2060. That number would increase, per the study’s projection, to 33.1 million by 2100.
If the Biden administration releases the proposed rule next week, it would still likely take several years to become final.
Limiting nicotine in cigarettes would be “game-changing,” Yolonda C. Richardson, president and CEO of the Campaign for Tobacco-Free Kids, said in a statement to NBC News. “Few actions would do more to fight chronic diseases such as cancer and cardiovascular disease that greatly undermine health in the United States and that the incoming administration has indicated should be a priority to address.”
It was during President-elect Donald Trump’s first term when the FDA — which has authority to regulate tobacco — first publicly discussed a plan to limit nicotine levels.
In 2017, then-FDA Commissioner Dr. Scott Gottlieb set the wheels in motion by unveiling a “comprehensive plan” that included an idea to “regulate nicotine in combustible cigarettes and render them minimally or non-addictive.”
It was intended, in part, to redirect adult smokers to noncombustible products such as e-cigarettes. The 2017 plan also included the potential for regulation of e-cigarette flavors and a ban on menthol products. A federal ban on most flavors went into effect in 2020, however, menthol remains on the market.
In an interview this week, Gottlieb said that addressing smoking rates would have to be “at the top of the agenda” in any effort to improve public health and reduce chronic disease.
“There could be perhaps no more impactful thing we can do than to dramatically reduce smoking rates in this country,” he said.
