Division of Clinical Pharmacology and Experimental Therapeutics, The Department of Medicine, University of California, Box 1220, San Francisco, CA 94143-1220, USA.
Tob Control. 2013 May;22 Suppl 1(Suppl 1):i14-7. doi: 10.1136/tobaccocontrol-2012-050860.
Nicotine is highly addictive and is primarily responsible for the maintenance of cigarette smoking. In 1994, Benowitz and Henningfield proposed the idea of federal regulation of the nicotine content of cigarettes such that the nicotine content of cigarettes would be reduced over time, resulting in lower intake of nicotine and a lower level of nicotine dependence. When nicotine levels get very low, cigarettes would be much less addictive. As a result, fewer young people who experiment with cigarettes would become addicted adult smokers and previously addicted smokers would find it easier to quit smoking when they attempt to do so. The regulatory authority to promulgate such a public health strategy was provided by the Family Smoking Prevention and Tobacco Control Act. Although it precludes 'reducing nicotine to zero', the act does not prohibit the Food and Drug Administration from setting standards for cigarette nicotine content that would prevent them from being capable of causing addiction. This paper reviews the assumptions implicit in a nicotine reduction strategy, examines the available data on the feasibility and safety of nicotine reduction, and discusses the public education, surveillance and support services that would be needed for the implementation of such a policy.
尼古丁极易使人上瘾,是导致人们持续吸烟的主要原因。1994 年,本诺维茨(Benowitz)和亨宁菲尔德(Henningfield)提出了对香烟尼古丁含量进行联邦监管的设想,即随着时间的推移,逐步降低香烟中的尼古丁含量,从而减少尼古丁的摄入量和降低尼古丁依赖水平。当尼古丁水平降得非常低时,香烟的成瘾性就会大大降低。因此,尝试吸烟的年轻人中,会有更少的人成为尼古丁成瘾的成年吸烟者,而那些已经上瘾的吸烟者在试图戒烟时也会发现更容易戒掉。《家庭吸烟预防及烟草控制法案》为实施这一公共卫生战略提供了监管机构的权威。尽管该法案“不允许将尼古丁含量降为零”,但并未禁止食品和药物管理局为香烟尼古丁含量设定标准,以防止它们具有成瘾性。本文综述了减少尼古丁策略中隐含的假设,考察了减少尼古丁含量的可行性和安全性方面的现有数据,并讨论了实施这一政策所需的公众教育、监测和支持服务。