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U.S. university study says greater percentage of people who switch to e-cigarettes will eventually quit smoking

Cigarettes are the only legal consumer product that, when used as intended, cause premature death in half of all long-term users.


In response to this long-standing health threat, the Biden administration recently announced plans to set new standards for combustible tobacco products to significantly reduce their addictive properties.


The New Zealand government recently announced a similar strategy to reduce nicotine. It is a key component of the new smoke-free plan.


When implemented, it will probably reduce nicotine levels in cigarettes and cigars by about 95 percent for at least another three years. Because nicotine is the addictive substance in tobacco, it will make these products virtually non-addictive.


The goal is twofold: to prevent young people from becoming addicted and to help current smokers quit more easily.


A 2018 Food and Drug Administration study predicted that lowering nicotine standards for cigarettes could significantly reduce smoking rates from about 13 percent today to less than 2 percent by 2060, preventing 16 million people from becoming regular smokers and more than 2.8 million tobacco-induced deaths.


Smoking causes infertility, erectile dysfunction, cataracts, premature aging, hair loss and tooth loss. It is a major killer along with heart disease, stroke and cancer.


Light cigarettes, which have been on the market for decades, often contain the same amount of nicotine as regular cigarettes, 10 to 15 milligrams. To meet the new standard, a cigarette may contain less than 0.5 mg. So-called light flavors have small holes in the filter that allow air to flow into the filter to thin the smoke.


When puffed by a machine, lightly flavored cigarettes contain less e-liquid and nicotine per puff. However, when held, these holes are usually blocked by the finger and the smoker can easily puff a little to inhale equal amounts of nicotine and e-liquid.

Some skeptics of nicotine reduction proposals have raised the concern that smokers may simply smoke cigarettes with reduced nicotine levels more intensely, just as they do with lighter cigarettes.


However, dozens of studies have shown that for cigarettes with very low nicotine content, smokers do not increase their smoking. Instead, within a very short period of time, they find the new versions less satisfying and begin to taper their use.


In randomized trials, those who used cigarettes with very low nicotine levels were also more likely to quit smoking.


When the Trump administration initially proposed reducing the nicotine content of cigarettes, Zeller and former FDA Administrator Scott Gottlieb recognized that one of the major challenges to the program's success was that the regulation could lead to high nicotine illegal market cigarettes. Zeller and Gottlieb understood that a key way to prevent this from happening was to allow non-smoking nicotine products, particularly vapes stay on the market.


Compared to regular cigarettes, e-cigarettes provide smokers with satisfactory levels of nicotine while exposing users to significantly lower levels of toxic substances. As a result, vapes are likely to be much less harmful.


A new study recently conducted by our team and colleagues at Virginia Commonwealth University found that a greater percentage of smokers eventually quit when they switched to cigarette-like nicotine delivery e-cigarettes.


The potential of e-cigarettes to help replace smoking explains why the FDA surprised many when it announced an effective ban on all JUUL sales two days after Biden proposed a significant reduction in the amount of nicotine allowed in cigarettes, the top-selling e-cigarette brand for the past five years. When JUUL appealed the decision, the FDA suspended the denial order until additional review is completed, which is expected to take several months.


Health authorities in other parts of the world, including the United Kingdom and New Zealand, also recognize the important role e-cigarettes can play in reducing smoking. As a result, New Zealand's nicotine reduction program explicitly includes the provision of alternative nicotine products such as e-cigarettes.


Studies have shown that e-cigarettes are much less harmful than cigarettes and have been shown to help smokers transition away from highly toxic cigarettes. Therefore, in order to protect public health, it is likely appropriate to keep various e-cigarette brands on the market until a successful cigarette nicotine reduction program is implemented.


In my opinion, the implementation of nicotine reduction standards for combustible tobacco represents the possibility of finally ending cigarette addiction in our lifetimes.