A proposed rule announced by the FDA to limit the nicotine concentration in combustible cigarettes ignores the delivery device used most commonly by youths: e-cigarettes. According to Viewpoint authors, “In decoupling cigarettes from the addictive compound nicotine, this rule could end more than a century of illness and death from traditional cigarettes. But that proposal leaves out youths: only 2% of US high school students smoke, yet 14% of them use e-cigarettes.… FDA should consider capping nicotine levels in e-cigarettes as well.”
The authors conclude: “Although cigarettes were once the main product of concern for youths, tobacco companies have pivoted to e-cigarettes. If the FDA caps nicotine in e-cigarettes, tobacco companies might shift again—to chewing tobacco, snuff, roll-your-own tobacco, cigars, candies, or some other product. Given this possibility, the FDA should at some point consider limiting nicotine in all nonmedical tobacco products to try to end the tobacco epidemic.… Failing to include e-cigarettes runs the risk of reversing decades of public health progress against tobacco.”