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Implementing a nicotine cap to make America Healthy Again.

Created on 25 Sep 2026

Authors

Dana Mowls Carroll, Dorothy K Hatsukami, Olivia A Wackowski, Francis Joseph McClernon, Eric Donny, Mitch Zeller

Published in

Health affairs scholar. Volume 4. Issue 9. Pages qxag239. Epub Sep 03, 2026.

Abstract

The US Department of Health and Human Services' (HHS) "Make America Healthy Again" initiative cannot eradicate the root causes of the nation's chronic disease epidemic without tackling cigarette smoking, which kills over 480 000 Americans and costs $600 billion annually. This commentary reinvigorates a pivotal 2017 FDA framework by urging the current administration to finalize the proposed rule establishing a maximum nicotine cap in all cigarettes and selected combusted tobacco. Evidence demonstrates that capping nicotine at nonaddictive levels (∼95% reduction) rapidly decreases dependence and accelerates smoking cessation. The FDA projects that a nicotine cap will prevent 4.3 million smoking-related deaths by 2100 while saving $1.1 trillion annually in healthcare and productivity costs over 40 years. To maximize these gains, we outline 2 supporting strategies. First, the administration must substantially fund the nation's under-resourced smoking cessation infrastructure to meet the inevitable surge in quitting. Second, provide adults who smoke evidence-based information on the full spectrum of quitting smoking options by communicating the tobacco/nicotine continuum of risk, that is, that combusted products (eg, cigarette) carry the greatest risk of disease, non-combusted products (eg, e-cigarettes) are likely to pose less risk than cigarettes, and medicinal nicotine products (eg, patches) are the safest option.

PMID:
42787616
Bibliographic data and abstract were imported from PubMed on 25 Sep 2026.

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