The United States Food and Drug Administration's (FDA) proposal to reduce the nicotine in cigarettes is part of a wider harm-reduction approach that also includes alternative, safer nicotine delivery technologies (Cigarettes may have less nicotine in future; Aug 14).
Scientific studies have shown that reducing nicotine in cigarettes reduces the number of cigarettes smoked, but there are a number of issues with these studies.
First, they do not reflect real-life smoking situations since the study participants were paid to take part, given free cigarettes and closely monitored by researchers.
Second, many still smoked their own full-nicotine cigarettes, and the number of cigarettes smoked was not significantly reduced.
Finally, past attempts by tobacco companies to sell low-nicotine cigarettes have not been commercial successes; in 2003, one company spent US$25 million on advertising for its low-nicotine cigarettes before abandoning the product.
Another major concern is that low-nicotine cigarettes will increase the number of contraband cigarettes, as the demand for them increases. Smokers may also simply roll their own using pipe tobacco.
Thus, lowering the nicotine level in cigarettes as a standalone initiative may not be effective in materially reducing smoking.
This is why the FDA is linking nicotine reductions with easier access to alternative safer nicotine delivery technologies.
These alternatives may include heat-not-burn products, e-cigarettes and snus (a form of snuff that is usually tucked inside the upper lip, where its nicotine payload can be slowly absorbed across the mucous membranes of the mouth).
This could be a recipe for success, given the association between faster reductions in smoking prevalence and the offering of alternative technologies, as seen in countries like Britain, the US, Japan and Sweden.
Andrew John da Roza