At some point in the next few years, the 30 million smokers in the United States could wake up one day to find that cigarettes sold at gas stations, convenience stores, and smoke shops contain such minuscule amounts of nicotine that they cannot get their usual fix when lighting up.
Would the smokers be plunged into the agonizing throes of nicotine withdrawal and seek out their favorite, full-nicotine brand on illicit markets, or would they turn to vaping, nicotine gum, and other less harmful ways to get that angst-soothing rush?
Such scenarios inched closer to the realm of possibility in June when the Food and Drug Administration said that it would move toward slashing nicotine levels in cigarettes in an effort to reduce the health effects of an addiction that claims 480,000 lives a year.
The agency set next May as its timetable for introducing a fully developed proposal. But many experts hope regulators will champion an immediate 95% reduction in nicotine levels — the amount federally funded studies have determined is most effective for helping smokers kick the habit.
It could be years before any new policy takes effect if it survives opposition from the tobacco industry. Even so, health experts say any effort to decrease nicotine in cigarettes to non-addictive levels would be a radical experiment, one that has never been carried out by any other country.
The science of nicotine addiction has come a long way since 1964, when a U.S. surgeon general report first linked smoking to cancer and heart disease, although it would take another two decades for the mechanics of nicotine dependence to be understood and widely accepted.
Tobacco contains more than 7,000 chemicals, many of them harmful when burned and inhaled, but it is nicotine that keeps smokers coming back for more. Nicotine stimulates a surge of adrenaline in the brain while indirectly producing a flood of dopamine, the chemical that promotes feelings of contentment and relaxation. The effects, however, are short-lived, which is why heavy smokers need a fresh injection a dozen or more times a day.
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