News from the Noteworthy from Tobacco Free Communities: Delaware, Otsego & Schoharie

FDA Rule Could End Smoking, Save Millions

Millions of lives could be saved if one rule by the Food and Drug Administration is enacted: reducing nicotine content in cigarettes and cigars to non-addictive or minimally addictive levels. The FDA submitted that rule to the U.S. Office of Management and Budget in mid-December. [https://www.govinfo.gov/content/pkg/FR-2025-01-16/pdf/2025-00397.pdf] If OMB approves it, the rule becomes law.

Most of us know it is the smoke in cigarettes and other tobacco combustibles that cause more than 16 million Americans to get tobacco-related diseases and about 480,000 Americans to die of them annually, 10 percent of whom did not smoke.

But it is the nicotine that hooks people and keeps them hooked for most or all of their life spans. Nicotine is one of the most addictive substances on earth—more addictive than cocaine or heroin. Two important factors have made it even harder for tobacco users, especially smokers, to quit. One is that about 90 percent of adult smokers began smoking by age 18, with 13 still the average starting age. When adolescents initiate tobacco use, they become addicted more quickly and have a harder time quitting than adults over age 18 or even 24.

The tobacco industry spends billions of dollars annually on marketing and advertising to hook kids because once they start using tobacco or nicotine products, they will often be lifelong customers. The industry profits in hundreds of billions of dollars annually because of it. Tobacco industry documents even refer to youth who start smoking as “the replacement generation”—the new, long-term smokers who will replace the ones who have died.

Lowering the amount of nicotine to non-addictive levels in cigarettes, cigars and other combustibles would upend it. The FDA estimates its rule will:

• prevent 48 million youth and young adults from becoming smokers this century;
• prompt 19.5 million smokers to quit within five years of the rule going into effect;
• save 4.3 million lives by the end of this century;
• drop the smoking rate from 11.6 percent in 2022, the Centers for Disease Control’s most current figure, to as low as 1.4 percent by 2100.

“The benefits of the FDA’s proposed rule are unprecedented,” Kristen Richardson, director of Tobacco Free Communities: Delaware, Otsego & Schoharie says. “Once the nicotine level of cigarettes and other tobacco products drops to a level low enough to no longer create or sustain addiction, they would lose their ability to hook most people into dependence.”

“The research suggests that very low nicotine content cigarettes will be even less addictive for adolescents than adults,” she adds, “although studies have also shown both adult and adolescent smokers have reduced cravings and cigarette consumption.”

Richardson estimates the rule would reduce nicotine in nearly all combustible tobacco products, including cigarettes, most cigars and pipe tobacco, by 95 percent. The average amount of nicotine would drop from 10-12 milligrams per cigarette to 0.7 mg per cigarette.

Richardson says the research also shows that smokers do not smoke more to compensate for a minimal nicotine level.

“A smoker who typically consumes 10 cigarettes per day, half a pack, would need to consume at least 100 reduced nicotine content cigarettes per day to compensate—five packs—which is unlikely. This is especially when the nicotine reduction is immediate rather than gradual,” she explains.

But Richardson cautions that reducing the nicotine will not render cigarettes harmless because smoking them will still produce 7,000 chemicals and 69 cancer-causing agents.

The FDA rule also does not ban other tobacco products, such as electronic cigarettes/vapes or other products containing nicotine, like Zyn. While using these products does not expose users to the host of known toxic chemicals in the smoke of combustible products, it is still not safe. The aerosols inhaled from vapes often contain carcinogens, metals and other toxins. Nicotine has been found to harm the adolescent brain, affecting learning, memory, and mood, among other cognitive issues. Other health risks for anyone using nicotine include increased blood pressure, increased heart rate, increased heart attack risk and a narrowing of the arteries.

Youth continue to vape at high rates, with New York high-school students vaping at 18.7 percent.

If or until OMB approves the FDA rule, quitting smoking and other high-nicotine products will continue to be hard, but not impossible. Richardson encourages smokers to:

• Discuss quitting with their doctors or healthcare provider. When smokers team up with their healthcare provider, long-term quit rates more than double.
• Healthcare providers can also help tobacco users reduce and manage symptoms of nicotine withdrawal, such as cravings, restlessness, and moodiness, by prescribing and/or recommending medications to assist in quitting.
• Contact the New York State Quitline at 1 (866) NY-QUITS or www.nysmokefree.com. It provides free and confidential quit coaching and free starter kits of nicotine replacement therapy to eligible New Yorkers.

“Smoking is an addiction,” Richardson says. “Get support. And don’t give up.”

Jennifer Hill is the community engagement coordinator for Tobacco Free Communities: Delaware, Otsego & Schoharie.