We have an opioid overdose crisis, but cigarettes still kill 15 times more people

Julia Belluz · Thursday, November 16, 2017, 1:41 pm

Here's what we need to do to save more lives.

Cigarettes still kill nearly half a million people in the US each year — 15 times the death toll from the opioid crisis. That’s also more than alcohol, car accidents, AIDS, illegal drugs, murders, and suicides combined.

Thanks to tobacco taxes and cigarette bans, the smoking rate in America has declined dramatically — from around 32 percent in the 1980s to 15 percent today. But over the past couple of years, the smoking prevalence here hasn’t budged while rates have continued to drop in other rich countries like the UK and Canada. Australia has even managed to reduce its smoking rate to an all-time low of 13 percent.

The picture in the US may be about to change.

In July, the US Food and Drug Administration announced a new initiative that could — if it pans out — drive down the US smoking rate much, much further. Scott Gottlieb, the commissioner of the FDA, said the agency plans to set new, much lower limits on the amount of nicotine in tobacco, essentially forcing companies to reengineer cigarettes so they’ll be less addictive.

Since tobacco use is driven by nicotine addiction, researchers who study tobacco control, like the University of Waterloo’s David Hammond, told me, “[This] would be one of the most significant tobacco control measures ever undertaken.” (It’s also an approach clinical trial data suggests helps wean people off smoking.)

The move is unprecedented — no other country has attempted to limit the nicotine content in cigarettes — and it would likely affect every brand of conventional cigarette on the market, Hammond said. But the FDA announcement hasn’t catalyzed change overnight, however; it only commenced a rule-making process that involves gathering input from the public and other stakeholders and is expected to take several years.

In the meantime, though, there are many other policies the US could pursue to bring down the smoking rate. Adding graphic picture health warnings to cigarette packs or ratifying the UN's Framework Convention on Tobacco Control are among a couple of measures America hasn’t put in place even though hundreds of other countries have. So while the new nicotine announcement is a real public health power move, we’re still missing some tobacco control basics.

Other countries have proven that making cigarette packaging plain deters smoking

Cigarette packs have long served as portable advertising for tobacco companies, with smokers conveniently disseminating branding and imagery wherever they go.

Tobacco marketing is considered a massive driver of cigarette use — which is why the industry shells out tens of billions every year pushing its products to consumers. Cigarette companies also mislead consumers about the relative harms of certain types of cigarettes through the use of colors (light colors appear to imply a product is safer) and language (think "light," "organic," or "low tar").

To counteract those marketing efforts, more than 100 countries around the world have added gruesome pictures of the health effects of cigarettes on packs. (The most recent review of the research suggests the graphical warnings are more effective than text-only warnings at curbing the appeal of smoking.)

Read more
https://www.vox.com/science-and-health/2017/8/1/16069684/fda-tobacco-regulation-nicotine-cigarette-smoking-deaths