An unprecedented anti-smoking plan designed by the Food and Drug Administration is seen by some as paving the way for an unexpected effect: opening the door for companies to sell a new generation of alternative tobacco products, allowing the industry Survive – even thrive – for generations to come.
The plan puts the FDA at the center of a long-standing debate about "reduced risk" products, such as electronic cigarettes, and whether such products should play a role in anti-smoking efforts, which have long been They have focused exclusively on getting smokers to quit smoking.
"This is the most controversial, and frankly divisive, issue I have seen in my 40 years of studying tobacco control policy." said Kenneth Warner, professor emeritus of the public health school at the University of Michigan.
The FDA's plan is twofold: to drastically reduce the levels of nicotine in cigarettes, so they essentially do not form a habit. For those who can not or do not want to stop smoking, allow lower risk products that deliver nicotine without the health risks of traditional cigarettes.
This month, the government effort is about to take off. The FDA is expected to begin soon what will probably be a process of years to control nicotine in cigarettes. And next week, the agency will hold a public meeting on a closely monitored Philip Morris International cigarette alternative, which, if authorized by the FDA, could be on sale as early as February. Philip Morris already sells the product in approximately 30 countries, including Canada, Japan and the United Kingdom.
The product, called iQOS (pronounced EYE-kose), is a pen-like device that heats Marlboro brand tobacco but does not burn. It is an approach that Philip Morris says reduces exposure to tar and other toxic byproducts of cigarette burning. This is different from electronic cigarettes, which do not use tobacco at all, but vaporize liquid that usually contains nicotine.
For anti-smoking activists, these new products can mean giving hope for a knockout in the industry. They say that there is no safe product for tobacco and that the goal should be to get people to quit smoking. But others are more open to the idea of alternatives to keep people away from cigarettes, the deadliest form of tobacco.
Tobacco companies have made claims about "safer" cigarettes since the 1950s, all of which proved false. In some cases, the introduction of these products, such as filtered and "low tar" cigarettes, boosted cigarette sales and kept millions of Americans smoking. Although the rate of adult smokers has dropped to a record low of 15 percent, smoking remains the leading cause of death and preventable disease in the nation, responsible for about one in five deaths in the United States. UU
Anti-tobacco groups also point to tobacco companies' history of manipulating public opinion and government efforts against smoking. In 2006, a federal judge ruled that for more than 50 years companies had cheated the American public about the effects of smoking. The industry rejected a 2010 proposal from the FDA to add warning labels to cigarette packs.
"We're not talking about an industry legitimately interested in saving lives here," said Erika Sward of the American Lung Association.  But some industry observers say that this time it will be different.
"The environment has changed, technology has changed, companies have changed, that is the reality," said Scott Ballin, a health policy consultant who previously worked for the American Heart Association.
Under a 2009 law, the FDA obtained authority to regulate certain parts of the tobacco industry, including nicotine in cigarettes, although it can not eliminate the ingredient altogether. The same law allows the agency to scientifically review and allow the sale of new tobacco products, including electronic cigarettes. Little has happened so far. Last year, the agency said it would delay the deadline for manufacturers to ship their steam-emitting products for review until 2022.
"We still have to provide an opportunity for adults who want to get satisfactory levels of nicotine." but without the risks of burning tobacco, said the commissioner of the FDA, Dr. Scott Gottlieb. He estimates that the FDA's plan could prevent 8 million deaths related to smoking.
Several recent studies have shown that when smokers switch to cigarettes with very low nicotine, they smoke less and are more likely to try to quit smoking. But they also look for nicotine from other sources, which underscores the need for alternatives. Without new options, smokers would probably look for regular cigarettes on the black market.
Crucial to the FDA proposal is a simple fact: nicotine is extremely addictive, but not deadly. It is the burning of tobacco and other substances inhaled through smoking which causes cancer, heart disease and bronchitis.
"It is difficult to imagine that the use of nicotine and tobacco in a way that does not burn, in a non-combustible way, is not." it's going to be much safer, "said Eric Donny, an addiction researcher at the University of Pittsburgh.
The key to the FDA's plan is the assumption that the two actions will occur at the same time: regulators cut nicotine in conventional cigarettes, manufacturers will provide alternative products.
But that assumes that tobacco companies will voluntarily separate from their main product, which remains enormously profitable.
Warner, the public policy professor, said he would be "amazed "If the industry cooperates on reducing nicotine levels.
" I do not think they will. I think they will get all their political weapons against that, and I'm pretty sure they will sue to avoid it, "he said.  Business on 01/20/2 018