Thursday, February 28, 2013

Imagining Tobacco Without Nicotine: Chapter 2



A February 23 Winston-Salem Journal article about Mitch Zeller, the new director of the FDA Center for Tobacco Products (here), reported that “Brad Rodu, a professor of medicine at the University of Louisville and a smokeless-tobacco advocate, said he is concerned that Zeller’s work with GlaxoSmithKline could create a regulatory bias against manufacturers’ smokeless products.  He urged the FDA to take an open-minded approach to smokeless innovations, ‘especially when smokers have increasing access to vastly safer alternatives.’”

That’s only part of the story. 

Over two years ago, I critiqued an article in Tobacco Control that I labeled “another thinly veiled call for reducing nicotine to ‘non-addictive levels’ in cigarettes” (my blog post is here). 
Zeller was one of the authors of that article.  In the press release from the University of Minnesota (still available here), Zeller commented: “Imagine a world where the only cigarettes that kids could experiment with would neither create nor sustain addiction.”

I said then that … “it doesn’t take an active imagination to appreciate the disaster that would result from radical reduction (prohibition) of nicotine in cigarettes.”  Zeller and his coauthors did not understand the effects of radically reducing nicotine in cigarettes. Yet, they make nicotine prohibition sound like the perfect solution for the nation’s 45 million smokers.

I am less concerned that Zeller used to work with GlaxoSmithKline than I am with the possibility that he might steer the FDA to reduce nicotine levels in tobacco products to the nonaddictive level in GSK’s nicotine medicines.  Those levels, the data show, don’t satisfy smokers and result in a 93% failure rate for smoking cessation (discussed here).

6 comments:

Anonymous said...

Interesting topic. But I see cessation vs. initiation here. Do you believe there is a role in nicotine reduction as a part in preventing initiation, however? Have you taken a look at this?

Chris Price said...

Presumably the idea behind removal of nicotine from any consumer product is to move all those who need nicotine onto pharmaceutical products, in the same way as the need for additional vitamin B3 is satisfied. Theoretically, in this way smoking could be reduced to near-zero and consumers would go to pharma for all their supplementation. The perfect solution for the pharmaceutical industry.

It sounds good, but all that would happen is a large black market would be created. All black market products are unregulated and/or counterfeit, so it becomes a major negative for public health. All tax revenue would also cease.

Where do they find these people?

S. Nolan said...

This also has the potential to be a public health disaster. There is a hypothesis that nicotine is the limiting factor in smoking - ie if can only smoke up until the point nicotine levels reach the point the smoker starts to feel ill.

Without the nicotine, or with dramatically less nicotine, wouldn't it therefore be possible to smoke more before your body tells you to stop?

Anonymous said...

There is more to tobacco than nicotine anyway. It's amazing how ignorant the pharmaceutical industry chooses to be on this subject.

Wouldn't it make greater sense to increase nicotine levels in order to decrease exposure to carcinogens. Less smoking more delivery of pharmacological agent? Tobacco is an effective medication in its whole state due to the complex interplay of multiple alkaloids. Nicotine only being the main one.

Many people find it a more effective medication than other ADHD drugs. Nicotine alone isn't as effective and reduced nicotine isn't helpful either.

The focus should be lowering risks not effectiveness.

Anonymous said...

There is more to tobacco than nicotine anyway. It's amazing how ignorant the pharmaceutical industry chooses to be on this subject.

Wouldn't it make greater sense to increase nicotine levels in order to decrease exposure to carcinogens. Less smoking more delivery of pharmacological agent? Tobacco is an effective medication in its whole state due to the complex interplay of multiple alkaloids. Nicotine only being the main one.

Many people find it a more effective medication than other ADHD drugs. Nicotine alone isn't as effective and reduced nicotine isn't helpful either.

The focus should be lowering risks not effectiveness.

Brad Rodu said...

Regarding the role of nicotine reduction in preventing initiation: please see my original post on this subject (http://rodutobaccotruth.blogspot.com/2010/10/imagining-tobacco-without-nicotine.html ), which describes the failure of near beer during Prohibition.