WASHINGTON (Oct. 24, 2017) – Dr. Scott Gottlieb, commissioner of the U.S. Food and Drug Administration (FDA), recently committed his agency to focusing on reducing nicotine in tobacco cigarettes as an effort to address the underlying cause of smoking-related diseases and deaths. In a new report from the R Street Institute, Harm Reduction Policy Manager Carrie Wade and Associate Fellow Clive Bates explore some of the issues facing the FDA and proponents of the nicotine-reduction strategy, and suggest a potential way forward.

The focus on nicotine as an effort to address the underlying cause of smoking-related diseases and deaths is rationalized on the basis that people smoke tobacco primarily to consume nicotine. The thinking is, by lowering nicotine levels in cigarettes to nonaddictive levels, we will decrease the likelihood that future generations become addicted to cigarettes and allow more currently addicted smokers to quit. But as Wade and Bates point out, the reduced-nicotine policy option is only one of several that should compete for regulatory and scientific resources and political capital. In fact, it should be evaluated against alternative strategies that degrade the appeal of smoking and provide low-risk alternatives.

“If the coercive reduced-nicotine strategy is to retain any credibility at all, it will be necessary to have alternative low-risk nicotine delivery systems readily available, so that these products can play a significant role in the behavioral response to the rule,” Wade notes. “These low-risk alternatives should also be regulated proportionately and in ways that support diversity and innovation, rather than creating excessive regulatory barriers to entry that would establish a new tobacco industry oligopoly.”

Accordingly, the authors maintain the superior and more urgent strategy is to promote the migration of smokers from combustible to noncombustible “alternative nicotine delivery systems” by choice. As the policy paper demonstrates, this is both a prerequisite for the FDA’s reduced-nicotine strategy and, if successful, will render that strategy unnecessary.

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