Move to reduce nicotine levels could reduce smoking rates, prevent 8 million deaths.

Published: April 18, 2018 | Updated: September 19, 2024

The U.S. Food and Drug Administration (FDA) is launching a plan to reduce nicotine in cigarettes, stripping them of their addictive power and helping to lower the health risks caused by smoking.

FDA Commissioner Scott Gottlieb, M.D., said in a statement announcing the nicotine plan, “Cigarettes are the only legal consumer product that, when used as intended, will kill half of all long-term users.”

Dr. Gottlieb said reducing nicotine in cigarettes to “nonaddictive or minimally addictive levels” is the cornerstone of a plan to signficantly cut smoking rates.

Tobacco use remains the single greatest cause of preventable death and disease in the United States. It kills more than 480,000 people per year nationwide, according to the Centers for Disease Control and Prevention (CDC).

Kentucky’s high smoking rates — 25 percent for adults and 17 percent for youth — consistently lead the nation, according to the CDC’s 2016 state activities report. While many people who smoke want to quit, it’s not always that easy.

How nicotine makes quitting  hard

Nicotine carries a powerful three-part addictive punch. John Renfrow, lay health navigator with Norton Healthcare Prevention & Wellness, describes three links that form nicotine’s chain of addiction.

The first link is physical. Nicotine works on brain chemistry much like other addictive substances, such as heroin or cocaine. It reaches the brain in less than 10 seconds and affects the pleasure center, where it releases chemicals that make us feel happy or alert.

“These chemicals are desired when you feel stressed, overwhelmed, sad or angry,” John said. “So when smokers or even ex-smokers have these negative feelings, they turn to a cigarette to feel better.”

The second link is psychological. This involves learned behaviors that soon become triggers to light up. These may include smoking with a cup of coffee, after a meal, while driving or when feeling stressed.

Last is the social link. Tobacco use plays a key role in how we socialize. This can involve identifying with a particular group, smoking on breaks at work or smoking with friends. It also can reflect the social norms or pressures — direct or subtle — created by parents, other family members or peers who use tobacco.

Quitting is a process

The FDA’s plan stands to make a big impact on public health. It will make it easier for those who smoke to quit and prevent future addiction from starting.

By 2100, the plan would prevent 33 million people who are now children or young adults from ever taking up tobacco. The FDA estimates this could save up to 8 million lives.

Until then, John, a trained Freedom From Smoking class facilitator, advises it’s important to remember quitting is a process.

“Smokers must manage their nicotine addiction, unlearn automatic smoking behaviors and substitute new healthy lifestyles — but the good news is it can be done,” he said.