Cigarettes and addiction

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6987.1082 (Published 29 April 1995) Cite this as: BMJ 1995;310:1082
  1. Jack E Henningfield,
  2. Neal L Benowitz
  1. Chief Clinical Pharmacology Branch, NIDA Addiction Research Center, PO Box 5180, Baltimore, MD 21224, USA
  2. Professor of medicine Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, CA 94941, USA

    Regulation of tobacco products is inconsistent with their effects on health

    Unless the prevalence of smoking falls substantially, 0.5 billion of the world's present population will die prematurely from disease caused by tobacco.1 Without considerable changes in the regulation of products that deliver nicotine it will be difficult to achieve substantial further falls in mortality in the United States or to reduce tobacco consumption worldwide. Under the direction of its commissioner, David Kessler, the United States Food and Drug Administration is taking on this challenge. The federal agency is considering taking over regulatory responsibility for tobacco products and developing new regulatory approaches for tobacco. What has brought about its involvement, and what can it do? We provide some insight into these issues from the perspective of public health scientists who do not represent the Food and Drug Administration or other federal agencies.

    Tobacco products are not regulated in a way that is consistent with their adverse effects on health and their addictiveness.2 Ironically, in the United States the present system of regulatory oversight of products that deliver nicotine makes it easier to get tobacco products, which cause dependence and disease, than to obtain potentially lifesaving drugs. Thus the most toxic and addictive formulations delivering nicotine—cigarettes and other tobacco products—are readily …

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