Tuesday, June 22, 2010

Should the FDA Lower Nicotine in Cigarettes?

On June 17, 2010, the Washington Post printed a story titled "FDA should use its power to lower nicotine in cigarettes, former chief says". Following is an excerpt:

David A. Kessler, a former FDA commissioner, said Wednesday that the agency's efforts to date are laudable but "marginal" compared with what the agency has the legal authority to do -- reduce nicotine levels to the point where a smoker no longer craves cigarettes.

"If you do this, you can save 200,000 to 300,000 lives a year," Kessler said. "Everything else pales in comparison."

The Washington Post story is referenced by an allgov.com post titled "Is It Time to Limit Nicotine Levels in Cigarettes?". The first comment to this post begins as follows:

We need to be extremely careful here. While the one year-old Family Smoking Prevention Act forbids the FDA from "requiring the reduction of nicotine yields of a tobacco product to zero," common sense screams that unless the reduction is as close as possible to zero, that smokers will compensate by smoking more cigarettes harder, sucking the smoke deeper and holding it longer.

The remainder of this post contains my response to this statement:

Screaming common sense sometimes turns out to be a screaming misconception. About twenty years ago, I was smoking Kool Mild cigarettes and I bought a book titled "Switch Down & Quit: What the Cigarette Companies Don't Want You to Know About Smoking", by Dolly D. Gahagan. The book gives a method for stopping smoking that involves switching to a slightly lighter brand of cigarette every three weeks or so. I explain it more fully at http://www.econdataus.com/smoke.html. As the book predicted, I did compensate somewhat when I initially switched to a lighter brand. This was especially true for the most difficult switch from 0.3 milligrams nicotine and 3 milligrams tar to 0.1 milligrams nicotine and 1 milligrams tar. But also as the book predicted, I adjusted to every switch within a week or two and slipped back to my old habits as far as the number of cigarettes that I smoked. I also believe that I slipped back to sucking the smoke to the same depth and for the same length of time. What I do know is that the first time that I tried Carltons (0.1 milligrams nicotine and 1 milligrams tar), it was like sucking on air. When I finally switched down to them and adjusted, however, they did taste like normal cigarettes.

Now this method may not work for many people. In fact, when I finally did quit, I had the additional motivation that my company had gone smokeless and I could no longer smoke in the office. However, I did feel as though I had relatively little physical withdrawal when I quit. In fact, it seemed like I had more physical withdrawal when I made the difficult switch described above. I did still have to deal with the strong psychological addiction but I believe that the relatively weak physical addiction made quitting easier. Also, switching down did give me the confidence that I did not NEED a certain level of nicotine and that my body could adapt to a lower level (or, eventually, none at all).

A 2007 story on the Journal of the National Cancer Institute titled "Can Reducing Nicotine Help Wean Smokers?" suggests that, at the very least, the charge that smokers will fully compensate for drops in nicotine is questionable. It states:

If you remove nicotine from tobacco and do it gradually, it may be possible to reduce nicotine dependence, so when adolescents first start smoking, they won't become addicted," he says. But the data appear to point in contradictory directions. Some show that when people smoke lower-nicotine "light" cigarettes, they take bigger, longer puffs. Yet other studies show that sometimes people do not inhale more to compensate when their cigarette has less nicotine.

This suggests that we need to depend on careful research and open debate, not screaming common sense.