Low nicotine versions might increase smoking

A useful little trick in trying to improve the world is to understand why something is happening before attempting to change that world. Our response to little old ladies falling over and breaking their hips is going to be different dependent upon our analysis of whether it’s gravity or that the world sucks. If we’re to deal with the opioid crisis we need to know whether it’s clean prescription pills killing people or the lack of them. That second can’t be dismissed out of hand, at least some of those overdose deaths come from people not being able to get pills anymore and thus graduating up to black market heroin laced with fentanyl.

Solutions can only be found when causes are known. Which brings us to this idea of low nicotine cigarettes in order to save lives:

Cigarettes would contain less addictive nicotine — making them less attractive to smokers — under an “unprecedented” plan the Food and Drug Administration announced Thursday.

Stripping cigarettes of all or most of their addictive power could lead 5 million adults to quit smoking within a year of the plan going into place and another 8 million to quit within five years, according to an analysis published Thursday in The New England Journal of Medicine.

By 2100, the plan would prevent 33 million people who are now children or young adults from ever taking up tobacco, saving 8 million lives.

The idea of reducing nicotine to non-addictive or “minimally addictive” levels is the “cornerstone” of a comprehensive tobacco control plan announced in July by FDA Commissioner Scott Gottlieb.

It’s an idea, certainly, but the question is whether it’s a good one? Will it achieve that target, for example, of fewer people smoking fewer cigarettes?

My reading is that Gottlieb is full of it here. Because he’s got matters entirely the wrong way around – this will lead to more deaths from cigarette smoking, not fewer.

So, why is it that people smoke cigarettes? Yes, that’s right, because they produce a nicotine dose and nicotine is, as noted, addictive. So, what’s likely to happen as we reduce the dose of nicotine in any one cigarette? People will smoke more cigarettes to gain their desired dose, won’t they? Note that we do know this could happen. The introduction of light cigarettes led to a change in the location of smoking induced cancers. Doctors started to see more in the lower lungs as people were taking deeper drags….

Which is a problem. For it’s not the nicotine which is the dangerous part of smoking. It’s all the other crud that fills the lungs as a result of the nicotine delivery method. This is why vaping is so much less dangerous than smoking itself. So, people smoke more to gain their dose and harm done by smoking rises or falls? As I say, I’d plump for rises.

Another observation is that if people wanted low or no nicotine they’d simply stop smoking anyway, wouldn’t they? So lowering the content of cigarettes isn’t going to change that either way.

Finally, we’ve an entirely practical consideration, consider that vaping again. So, in order to do this we go out and buy nicotine containing liquid. Which, well maybe, could be added to a cigarette and then dried, right? So that smokers would be able to make their own high nicotine cigarettes. Obviating the very control method being proposed.

Bringing us neatly around to, well, what do we do about all of this? The answer being that we all know smoking kills. So, those who wish to smoke should be left alone to get on with it. It is their life to end after all.

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  1. Reminds me that back in the 70s or 80’s one of the tobacco companies produced a non-nicotine cigarette containing something catchily named as NSM. NewSmoking Material. Whatever happened to that? Didn’t exactly catch on like…a Marlboro on fire, did it? Although bystanders commenting “Has someone a bonfire going round here?” might have contributed.
    They must have warehouses still full of the stuff. Is this a plot to re-launch it?

  2. ‘Solutions can only be found when causes are known.’

    First you have to have a problem to solve.

    Smokers don’t have a problem. Some busy body non-smokers have a problem. The solution must apply to the problem. I prescribe heavy doses of STFU.

  3. ‘So, why is it that people smoke cigarettes?’

    – to keep hands occupied in company
    – to fulfil mammalian instinct to suck
    – to be ‘grown-up’
    – to be like your mates, not left out
    – like the taste
    – habit rather than addiction
    – feminism… we can do what the men do
    – minors: because it is the forbidden fruit

    And that’s before considering the effect of nicotine.

    ‘Stripping cigarettes of all or most of their addictive power could lead 5 million adults to quit smoking within a year of the plan going into place…’

    Didn’t some 18th Century guy cover that in his book… that Man of System thinks people can only behave as he has predicted in his perfect plan?

  4. I discussed these and other problems with Gottlieb’s proposal here (http://continentaltelegraph.com/2018/03/17/trumps-new-prohibition/) – such as his attempt to pass off a guess of results at the end of the century as measurement.

    Salon doesn’t want smoking to end, as badly as they want Altria et al to go bankrupt.

    Sometimes “lives saved,” when the target audience is people who believe we own our lives, is replaced by “lower national health costs” (a concept that assumes we don’t own our lives). Even here, it’s claimed that smokers commit low-cost suicide compared to the medical needs at the end of a long and healthy life.

  5. The public campaign against smoking has been probably one of the most successful imaginable. A couple of generations ago perhaps 75% of Americans smoked. Today it’s about 20%. That is a remarkable achievement. However, it’s interesting to observe that when the government wants to change its population’s behavior it may indeed achieve results, but there will be some number of stubborn holdouts and the inclination will then be to stop educating and start cracking down.

    • In fact, the population does not belong to the government. You are again cheerleading for totalitarianism; “the most successful…public campaign…imaginable” would be one that did not leave 20% still smoking. Ah, but those “stubborn holdouts” (how dare they not cooperate with a government campaign!) will be a reason to “start cracking down.” In fact, they are fellow Americans who own their own bodies and enjoy their habit.

      Your unsupported assumption that none of those ex-smokers would have given up the weed except for your unimaginably successful public campaign, is the same fallacy as when my small town’s fire chief assumes we are all eager to burn down our own homes, and would have done, were it not for his department’s prior restraint on us.

      • I agree that the government does not own its population, so if I could edit that comment I would change the possessive “its population” to a neutral “a population”. I will bear that in mind in future so thanks for pointing it out.

        While I agree that some portion of today’s non smokers would have either given it up or never taken it up whether the government sponsored anti smoking programs or not, it seems that you may be on thinner ice asserting that it may have had little effect.

        Also, I’m not supporting totalitarianism at all. I’m the one who noted that the holdouts are being cracked down upon. I (a nonsmoker) would not have prohibited smoking in bars, for example (but I only go into a bar perhaps three or four times a year). I think the authorities in my area have gone too far when they ban or try to ban smoking in private apartments.

        But is it or is it not the role of a population’s government to take on the role of educating people about health risks or other issues? That is an argument open to fair debate, but it appears to me that in this case the government may have largely accomplished something worthwhile. You could argue that government should not undertake these actions because what is worthwhile was not worth the eventual crackdown on the stubborn holdouts, and that such overreach should have been seen as inevitable. It’s a debatable point.

    • “A couple of generations ago perhaps 75% of Americans smoked. Today it’s about 20%. That is a remarkable achievement.”

      I don’t care how many people smoke. I smoked for 19 years. I quit 31 years ago. If someone else chooses to smoke, it’s their choice. It’s not good or bad. If someone quits, or if forty million quit, it’s not good or bad.

      “A couple of generations ago perhaps 75% of Americans died their hair. Today it’s about 20%. That is a remarkable achievement.”

      Same difference.