Biden administration proposes capping nicotine in cigarettes to reduce addiction

In its final days, the Biden administration is expected to propose a historic rule to limit nicotine levels in cigarettes. This last-minute effort seeks to challenge the tobacco industry after the administration failed to fulfill a long-standing promise to ban menthol cigarettes. The proposal, which could be announced as early as Monday, is expected to focus on traditional cigarettes and exclude products like e-cigarettes and nicotine replacement therapies such as patches and lozenges. “This is a Hail Mary from the Biden administration to move forward with a meaningful proposal or at least get one started in the administration’s waning days,” said Erika Sward, assistant vice president of national advocacy for the American Lung Association. While toxins in combustible tobacco are responsible for chronic illnesses and smoking-related deaths, nicotine is the addictive substance that hooks people and keeps them smoking. Details of the proposed nicotine cap have not been released, but studies suggest nicotine levels may need to be reduced by as much as 95% to make cigarettes minimally or non-addictive. “This would be a historic action by the FDA with the potential to have an enormous impact on public health,” said Dr. Rose Marie Robertson, the chief science and medical officer for the American Heart Association. Cigarette smoking is the leading cause of preventable disease and death in the United States, according to the Centers for Disease Control and Prevention (CDC), killing more than 480,000 Americans every year. Nearly all smokers begin as teenagers, and reducing cigarette addictiveness could save millions of lives, Sward noted. A 2018 study by the FDA estimated that a nicotine cap could prevent 16 million people from becoming addicted to cigarettes by 2060. By 2100, that number could rise to more than 33 million. If the Biden administration announces the proposed rule next week, it could still take years to finalize. “Limiting nicotine in cigarettes would be game-changing,” said Yolonda C. Richardson, president and CEO of the Campaign for Tobacco-Free Kids, in a statement to NBC News. “Few actions would do more to fight chronic diseases like cancer and cardiovascular disease, which the incoming administration has indicated are priorities.” The FDA first explored regulating nicotine levels during President Donald Trump’s administration. In 2017, then-FDA Commissioner Dr. Scott Gottlieb introduced a “comprehensive plan” to limit nicotine in combustible cigarettes and make them minimally or non-addictive. The plan also aimed to encourage adult smokers to switch to less harmful alternatives, like e-cigarettes, and proposed regulating e-cigarette flavors and banning menthol cigarettes. While a federal ban on most e-cigarette flavors was implemented in 2020, menthol cigarettes remain on the market. Reflecting on the issue this week, Gottlieb stressed the importance of addressing smoking rates to improve public health. “Reducing smoking rates could be one of the most impactful steps we take to combat chronic disease,” he said.