Avoiding missteps in nicotine regulation: what can we learn from patterns of nicotine intake from cigarettes?

Policies to shift the market for nicotine from cigarettes to non-combustibles (as, for example, the mooted FDA proposal to reduce the absolute bioavailability of nicotine from cigarettes to non-reinforcing levels) have as an essential component the development of consumer-acceptable alternative novel nicotine products. Regulators may seek to set limits for the nicotine dose available from non-combustibles at their peril, as this may seriously constrain the chances of developing successful alternatives to the cigarette.

This presentation will consider data from major national surveys in the USA (National Health & Nutrition Examination Survey) and UK (Health Survey for England) to examine how patterns of nicotine intake from cigarettes can help guide the specification for new products.  Key themes concern the overriding importance of consumer behaviour, as opposed to product characteristics in determining dose; extreme elasticity of the cigarette in dose titration and response to secular market change, as well as marked variations in preferred dose across ethnic and demographic groups.