Oncology Nursing Society's Support For Reducing Nicotine Levels In Cigarettes.pdf

The Oncology Nursing Society (ONS) submits its perspective on the FDA's advance notice of proposed rulemaking regarding a tobacco product standard for nicotine levels in combustible cigarettes. ONS supports the initiative due to its critical role in cancer prevention and cessation efforts. They highlight that while cigarette smoking is a leading preventable cause of death, many smokers are unfairly blamed for their cancer diagnoses.

Key Points:

1. Scope: ONS advocates for a standard covering all tobacco products, including e-cigarettes, as both adults and adolescents use these products, with dual use being common. They express concern over the growing prevalence of non-combustible tobacco products and their potential health risks.

2. Maximum Nicotine Level: The society recommends a maximum nicotine level of 0.4mg or lower in all tobacco products, aligning with WHO recommendations to reduce addiction. However, they caution against additives like sugar that can counteract reduced nicotine levels.

3. Analytical Testing: Independent lab testing is crucial for accurate nicotine measurement as machine measures can be influenced by factors like air dilution. ONS favors the Canadian testing method for its accuracy.

4. Reduction Techniques: While not their area of expertise, ONS acknowledges potential in exploring new agricultural practices to reduce nicotine levels, including genetically modified tobacco.

5. Countervailing Effects: To mitigate potential negative impacts, FDA should educate the public on the continued health risks of smoking even with lower-nicotine cigarettes and discourage adding nicotine to reduced products. Adolescents, in particular, need clear information about the dangers of these products.

6. Adolescent Concerns: ONS emphasizes the need for educational campaigns to dispel misconceptions about reduced-nicotine cigarettes' addictiveness and inform consumers about their health risks. They also caution against adolescents turning to alternative tobacco products due to lower nicotine standards.