Earlier this month Bloomberg reported that Philip Morris had asked FDA to convince Americans that nicotine isn’t that bad, citing research showing that most wrongly think that nicotine causes cancer. This effort seems part of Philip Morris effort to promote its IQOS heated tobacco product as well as Juul e-cigarettes (in which Altria, parent of Philip Morris holds a major stake).
Philip Morris is correct that nicotine does not seem to cause cancer. The thing Philip Morris ignores is that nicotine makes cancer worse.
For example, nicotine promotes cancer metastasis (spread beyond the original tumor) among people with breast cancer, lung cancer metastasis to the brain, lymph node metastasis and resistance to chemotherapy. In other words, while nicotine may not start cancer, nicotine makes cancer worse and harder to treat.
It causes birth defects and other reproductive harm.
Nicotine can be lethal if consumed in high doses and exposure to liquid nicotine in e-cigs and e-liquids has resulted in thousands of calls to poison control centers.
Indeed, the major “positive” use of nicotine is to treat nicotine addiction with FDA-approved tobacco cessation therapies. (No tobacco product – including e-cigs or IQOS has been approved by FDA as a cessation product.)
This effort by the tobacco industry to minimize the dangers of nicotine is nothing new. In the late 1980s and 1990s, the industry created and promoted “Associates for Research in the Science of Enjoyment” in which nominally independent experts toured the world promoting the health benefits of the use of legal substances, including tobacco, for stress relief and relaxation. Industry also funded studies of the benefits of nicotine on cognition and then promoted their research findings through public relations campaigns, often minimizing nicotine’s health risks by comparing it to caffeine or coffee. This messaging continues today.
Philip Morris is basically asking FDA to make claims that it the FDA has forbidden it from making itself. In its order authorizing the sale of IQOS with a “reduced exposure” claim, Philip Morris can say IQOS “reduces your body’s exposure to harmful or potentially harmful chemicals,” but is explicitly forbidden from claiming that IQOS is “less harmful.”
Given everything else that FDA has on its plate – including getting rid of menthol and processing tens of thousands of applications to sell e-cigs and other new products – FDA should not waste its time on Philip Morris’ request.