Nicotine wars
Saturday, July 29, 2017 at 9:30
Simon Clark

Yesterday's announcement by the US Food and Drug Administration that it aims to lower nicotine levels in combustible cigarettes took many people by surprise, myself included.

I got the news from a friend in Dublin who was watching Bloomberg News. Thirty minutes later the story began to trickle in from other sources.

As it happens it was a big story in the States but there has been relatively little coverage over here. (Reports in the UK have focussed mostly on the "plummeting" fall in the price of tobacco shares, although that had rallied a bit by the close of play.)

The lack of interest was due partly to the time difference - the FDA announcement broke late afternoon in the UK - but the significance of the story may have been lost on Britain's news editors.

The first thing to note is that the announcement marks a major shift in US policy.

In particular, and more significant perhaps than the headline grabbing nicotine story, the FDA also declared that it would delay implementation of deeming regulations on e-cigarettes by four years.

If I understand it correctly, products that may have been taken off the market in 2018 now have a stay of execution. Likewise smaller e-cigarette companies that may have struggled to bring new products to market because of the proposed regulations, and the red tape involved, can breathe a little easier.

Vaping advocates are overjoyed, naturally, but I would issue a word of caution. I've long argued that the public health endgame is not a world that is smoke free but one that is nicotine free as well, and far from challenging that view the FDA announcement would appear to confirm it.

By announcing that it aims to reduce nicotine in cigarettes to "non-addictive" levels, the FDA has effectively declared war on the drug (if it hadn't before).

The justification is of course that while nicotine itself may be relatively harmless it hooks people to a product that is potentially bad for them.

Nevertheless the underlying message - the one that will be picked up by the media and the general public - is that nicotine itself is the enemy.

Furthermore, and despite the apparently favourable outcome for vapers, the FDA announcement is probably no more than a stay of execution.

Like it or not the long-term aim of the FDA, the World Health Organisation and every other public health body is to eradicate any form of nicotine addiction.

To achieve that goal the first stage is to lower the nicotine levels in all products that contain the drug.

It's a process that has already started. The EU's Tobacco Products Directive includes strict regulations on the nicotine strength of e-liquids and there's only one direction that's going to go.

The good news for confirmed smokers is that combustible cigarettes, in one form or another, are going to be around for a long time to come.

Unlike the manufacture of petrol or diesel cars, for example, prohibition is not an option because the authorities know full well what would happen.

Criminal gangs - bootleggers - would step in to meet demand and the government would lose control of the market and the huge amounts of revenue cigarettes generate.

As for lower nicotine cigarettes, I would fight attempts to make them compulsory for the same reason I would oppose excessive restrictions on the strength of alcohol in wine or beer or restrictions on the strength of caffeine in coffee.

The issue, as I keep saying, is one of choice. Offer consumers a range of products, including lower nicotine and nicotine-free cigarettes (and e-cigarettes), and let the market decide.

Driven by health considerations I suspect many consumers will opt, ultimately, for lower strength nicotine but that's speculation on my part.

What I do know, based on research, is that nicotine is not the only reason people smoke, hence Forest's response to yesterday's announcement:

"The FDA assumes wrongly that people only smoke for the nicotine. There are numerous reasons people start smoking or continue to smoke and nicotine is only one of them.

"If smoking was just about the nicotine hit the overwhelming majority of smokers would have switched to safer alternatives such as electronic cigarettes.

"What many people like most about smoking is the ritual and the taste and smell of tobacco. Lowering nicotine levels won't change that."

We also pointed out that according to a survey of over 600 "confirmed smokers" by the Centre for Substance Use Research in Glasgow nearly all respondents (95%) gave pleasure as their primary reason for smoking:

Well over half (62%) liked the physical effect of nicotine, 55% liked the way smoking provided “time for oneself”, 52% liked the taste or smell of tobacco, and 49% liked the ritual involved in smoking.

Although a majority (56%) felt that they were addicted to smoking, many described the habit as a personal choice rather than behaviour determined by their dependence on nicotine.

See Forest's response to FDA announcement on lowering nicotine levels in combustible cigarettes.

Last night I also posted this on the Friends of Forest Facebook page:

"Question to smokers: would a reduction in nicotine levels encourage you to quit?"

Of those who commented not one said they would stop smoking.

Ironically, the biggest losers following the FDA's announcement could be the pharmaceutical industry.

After all, the biggest threats to Big Pharma's smoking cessation market are e-cigarettes and heated tobacco.

Given time to develop and mature, the market for non-pharma harm reduction products is potentially huge, 36.5 million people in the USA alone.

Far from being a death knell for the tobacco industry, yesterday's announcement by the FDA gave the companies what they need - time.

As for consumers - smokers and vapers - the jury, I think, is out.

If a product is legal consumers have a right to be tolerated and their choices treated with respect.

Neither the FDA nor a myriad of other public health bodies seem willing to acknowledge a very simple fact.

Millions of people worldwide smoke and vape not because they are hopelessly addicted to nicotine but because they enjoy it.

The war on nicotine is a war on ordinary people, legitimate consumers of a legal drug.

Yes, there are different degrees of risk between combustible cigarettes, electronic cigarettes, heated tobacco and other nicotine products, but adults have a right to choose.

Educate and inform but discrimination and denormalisation must end. Freedom of choice, that's the battle ahead, for vapers as much as smokers.

Article originally appeared on Simon Clark (http://taking-liberties.squarespace.com/).
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