The Nicotine Reduction Strategy

In my last post I mentioned a “regulated nicotine reduction strategy” that has been proposed numerous times over the past 10 years or so, but most consistently by Professor Neal Benowitz of the University of California at San Francisco. I mentioned some potential pros and cons to the strategy, and also mentioned an alternative strategy that could be called a “regulated toxin reduction strategy”, whereby cigarette manufacturers are required to reduce the permissible toxin deliveries from cigarettes (i.e. carbon-monoxide, NNK, lead etc) while potentially leaving the nicotine delivery stable. The logical end-point of this strategy is a product that does not require burning of tobacco or inhalation of smoke, but is capable of delivering sufficient nicotine to feed the smoker’s addiction.

It is fairly easy to present these two strategies as competing with each other, as they may be considered as mirror images of each other. One aims to take the addictive agent out of cigarettes, and the other aims to take out the toxins while leaving nicotine intact. Some may accuse these strategies of being “prohibition” in disguise. In determining whether either really involves prohibition it’s worth comparing them to the prohibition of alcohol that was attempted in the United States 1920s. That law prohibited the manufacture, sale and transportation of alcohol (not its consumption). Note it was the drug – alcohol – that was banned, not beer or whiskey per se. So the analogous prohibition relating to tobacco would involve a ban on the manufacture, sale or transportation of products containing nicotine. In fact no one has proposed such a law (that I’m aware of). The Benowitz proposal involves reductions to extremely low levels of the nicotine allowed in cigarettes, but may allow nicotine to be available in other forms (e.g. pharmaceutical nicotine gum). This is therefore not prohibition of nicotine.

The other point I want to make is that the 2 strategies could end up in a very similar situation if they focus on reducing permissible nicotine levels in smoked products but allow nicotine to remain in smokeless products (whether they be nicotine gum or snuff). With each strategy a point will come when cigarettes and other forms of smoked tobacco can no longer sustain their place in the market, and people who want to continue to take nicotine will have to do so in a smokeless form (and therefore avoid the very high risks of lung cancer and emphysema caused by inhaling smoke into the lungs).

At this moment this is something of an academic debate, because tobacco remains relatively unregulated in the US, and even if an agency like FDA were given the power to regulate tobacco one cannot be sure how or even if they would exercise that power. For the foreseeable future, smokers should focus their attention on trying to quit smoking completely. Hopefully some of the tips in my previous posts will help increase the chances of success.

Labels: nicotine regulation reduction smoking smokeless

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