Considerations for High-Risk Populations: Response to Zeller's The Future of Nicotine Regulation: Key Questions and Challenges

In this issue of the Journal, Zeller provides a commentary on the US Food and Drug Administration’s (FDA) new tobacco regulatory strategy that includes a proposal to reduce nicotine levels in combustible tobacco cigarettes to very low levels and to support nicotine delivery products that deliver nicotine to smokers at lower harm levels (such as electronic cigarettes).1 Very low nicotine content (VLNC) in cigarettes reduces their addictiveness, which can help current smokers to quit and prevent youth from becoming addicted. Zeller points out that the FDA estimates in 1 year of implementation, this strategy may help an additional five million adult smokers to quit. Zeller also outlines some important challenges and issues for further consideration. One issue not outlined is the potential impact of VLNC cigarettes on high-risk population groups, with high smoking prevalence rates.