Study: FDA should cut nicotine in cigarettes

Randolph E. Schmid

WASHINGTON — The Food and Drug Administration should regulate tobacco and develop a plan to reduce nicotine levels in cigarettes, the Institute of Medicine urged last Thursday.

Its report calls on Congress and the president to give FDA the authority to enforce standards for nicotine reduction and to regulate companies’ claims that their products reduce exposure or risk.

“We propose aggressive steps to end the tobacco problem — that is, to reduce tobacco use so substantially that it is no longer a significant public health problem. This report offers a blueprint for putting the nation on a course for achieving that goal over the next two decades,” said Richard J. Bonnie, director of the Institute of Law, Psychiatry and Public Policy at the University of Virginia School of Law. Bonnie was chairman of the committee that prepared the report.

“Unfortunately, cigarettes are one of the most dangerous consumer products ever marketed,” Bonnie said at a briefing.

The report notes that cigarettes are unique in that they contain carcinogens and other dangerous toxins and would be banned under federal law if these statutes did not expressly exempt tobacco.

A bill currently before Congress would give FDA authority to regulate tobacco, but the head of the agency has expressed skepticism.

Dr. Andrew von Eschenbach said that if the FDA reduced nicotine levels in cigarettes, people would change their smoking habits to maintain current levels of the addictive drug.

“We could find ourselves in the conundrum of having made a decision about nicotine only to have made the public health radically worse. And that is not the position FDA is in; we approve products that enhance health, not destroy it,” von Eschenbach said in an AP interview in March.

Cigarette maker Philip Morris USA has been supporting the legislation that would give FDA power to regulate the industry.

“FDA regulation creates a uniform set of federal standards for the manufacture and marketing of all tobacco products,” Michael E. Szymanczyk, chairman and chief executive officer of Philip Morris USA, said earlier this year.

In addition to requiring a cut in nicotine, the institute — a branch of the National Academy of Sciences — called for higher taxes on tobacco, nationwide indoor smoking bans and other steps to reduce smoking.

Also last Thursday, the American Academy of Pediatrics called for the elimination of smoking from movies accessible to children and young people.

Cigarette smoking is largely a 20th century development, the report noted. Prior to that Americans consumed tobacco primarily as chewing tobacco or cigars.

In 1900, adults smoked approximately 54 cigarettes per year, the report said. By 1963, per capita consumption had risen to 4,345 cigarettes per year.

The report said that while smoking in the United States has declined by more than 50 percent since 1964, tobacco use still claims about 440,000 lives every year and secondhand smoke causes another 50,000 deaths annually. Smoking-related health costs are estimated to be $89 billion a year.

Other recommendations of the report include:

• Dedicating $15 to $20 per capita annually of the proceeds from higher taxes or other resources to fund tobacco control efforts in each state;

• Requiring all health insurance plans to provide smoking cessation program benefits;

• Licensing retail outlets that sell tobacco products;

• Launching additional efforts aimed at curbing youth interest in smoking and access to tobacco, including bans on online sales of tobacco products and direct-to-consumer shipments;

• Limiting tobacco advertising and promotional displays to text-only, black-and-white formats;

• And requiring new, large pictorial warnings on the harmful effects of smoking — similar to those required in Canada — on all cigarette packs and cartons.

The National Academy of Sciences is an independent organization chartered by Congress to advise the government on scientific matters. The report was sponsored by the American Legacy Foundation, the anti-smoking organization established in 1999 as part of the settlement between state attorneys general and the tobacco industry.

(Associated Press)