Moving Beyond Smoking
"For decades we have been committed to offering adult smokers better alternatives and ensuring a regulatory framework to determine if those products offer lower risk and how to appropriately communicate about them. That future is here and, at Altria, we embrace it.
Senior Vice President
- timely scientific review and authorization of potential reduced risk-tobacco products;
- monitoring manufacturers' post-market surveillance data and quickly identifying and remediating emerging issues (e.g., uptick in underage use of a newly authorized product);
- helping to correct nicotine misperceptions and communicate the relative risks of different products to encourage adult smoker transition to smoke-free products; and
- investing in proven tactics to prevent and reduce underage tobacco use.
The FDA is the only federal agency with the Congressional mandate and the necessary authority and resources to advance tobacco harm reduction. That's why the Agency's ability to coordinate federal strategy and drive efficient resource allocation towards these efforts is crucial for reducing the death and disease associated with cigarettes.
Nicotine Misperceptions & The "Risk Cliff"
As the FDA states on its website: "Most people know that cigarettes and other tobacco products are addictive, but many people do not understand the role of nicotine in tobacco addiction, disease, and death. Nicotine is what addicts and keeps people using tobacco products, but it is not what makes tobacco use so deadly. Tobacco and tobacco smoke contain thousands of chemicals. It is this mix of chemicals–not nicotine–that causes serious disease and death in tobacco users, including fatal lung diseases, like chronic obstructive pulmonary disease (COPD) and cancer."4
The FDA and other public health authorities agree that there is a broad "continuum of risk" among tobacco products, with cigarettes at the highest end of that spectrum and complete cessation at the lowest end.5 In fact, when the FDA announced its Comprehensive Plan in 2017, then-FDA Commissioner Gottlieb stated FDA policy should be used as a vehicle to "move addicted smokers down that continuum of risk to these less harmful [innovative] products."6 The then-Commissioner also shared his concerns regarding the widespread misperceptions around nicotine among the American public.
While there may be differences in risk profiles between specific smoke-free products, it will take years of epidemiology to quantify those differences. The body of evidence, does however, indicate a profound risk differential between combustible and smoke-free product categories. Data suggest that a two dimensional "Risk Cliff" model is a useful description of the relative risk between combusted products (such as cigarettes and cigars) and smoke-free products (such as moist smokeless tobacco, heated tobacco, e-vapor and oral nicotine pouches).
The millions of U.S. adult smokers seeking less harmful alternatives to cigarettes deserve to be informed about the role of nicotine and the relative risks of different tobacco products.
The FDA, the public health community and tobacco manufacturers all have a role to play in addressing misinformation that hinders progress on harm reduction. We believe it is our responsibility to help create the conditions for harm reduction to succeed – through education, awareness and advocacy – as we build a strong portfolio of smoke-free products that satisfy adult smokers’ evolving interests and preferences.
2 O'Brien, E. K., Nguyen, A. B., Persoskie, A., & Hoffman, A. C. (2016). U.S. adults' addiction and harm beliefs about nicotine and low nicotine cigarettes. Preventive Medicine, 96, 94-100. doi:10.1016/j.ypmed.2016.12.048