The Food and Drug Administration announced plans today to delay reviewing e-cigarettes on the market for safety — a big win for e-cig manufacturers. The agency also says it intends to look into cutting the nicotine levels in regular old cigarettes to what it calls non-addictive levels.
The move has left public health experts with mixed feelings: cutting nicotine levels in cigarettes could help curb addiction and save lives. And e-cigarettes, which heat up and vaporize liquids often containing flavors and nicotine, are generally considered less dangerous than cigarettes. But they aren’t harmless. Since vaping is a relatively new phenomenon, we don’t know what its long term effects could be. Leaving e-cigarette makers largely unregulated leaves consumers in the dark about what exactly they’re inhaling.
Scientists have been pushing the FDA to limit nicotine levels in cigarettes for more than 20 years. While the FDA isn’t allowed to require that companies make cigarettes with no nicotine at all, the agency can set a maximum level that’s permitted. To make cigarettes non-addictive — or at least, substantially less addictive — nicotine content should be cut by about 85 to 95 percent, says Eric Donney at the University of Pittsburgh, in an email to The Verge.
To be clear, these are different from the “light” brands of the 1970s. “Light” cigarettes contained typical levels of tar and nicotine, but they were made so that the tar and nicotine they emitted was diluted with air — tricking the machines measuring them into registering inaccurately low levels. Reduced nicotine or denicotinized cigarettes, by contrast, contain less nicotine to begin with, according to a 2015 review in Tobacco Control. One six week study found people ended up smoking fewer of those reduced-nicotine cigarettes and reported wanting them less. But that might also drive smokers to other sources of nicotine, Donney says — like the vast array of e-cigs and vape pens now available.
Not all e-cigarettes contain nicotine, and vaping has been shown to help people quit smoking. But because e-cigs are largely unregulated, it’s impossible to know what chemicals they contain. Some of these chemicals have been found to be cancer-causing, and vaping could put smokers at a higher risk of heart disease, just like regular cigarettes.
It may be that e-cigarettes are less addictive and less dangerous when it comes to cancer, but inhaling nicotine in any form is certainly worse than not smoking at all, says Stanton Glantz, a professor at the University of California San Francisco who studies the effects of tobacco and nicotine. “I think FDA is being overly optimistic about the public health benefits of pushing people to switch [to e-cigarettes],” Glantz says. “If people switch to them and think they’re safe, that’s a real problem.”
Last summer, the FDA gave e-cig and vape pen makers a deadline: by around the end of 2018, manufacturers had to submit any of their products that hit the market after 2007 for FDA review. That deadline has now been pushed back to 2022. The four year extension gives the FDA time to come up with new standards that would prevent, for example, products from exploding in people’s faces. But it also allows possibly dangerous products to stay on the market for people — and children — to use.
These plans aren’t set in stone yet. The process for finalizing these measures could take years, and the FDA will have to evaluate input from the public, from experts, and from the tobacco industry. Still, today’s announcement is a first step towards a tobacco regulation strategy that says some nicotine delivery systems are more dangerous than others. Dropping nicotine levels in cigarettes is a win for public health — but extending the amount of time unregulated e-cigarettes stay on the market is a loss for the people who want to use them. Without knowing what’s inside, how will consumers know whether they’re putting themselves at risk?