Little and filtered cigars meet the legal definition of cigarettes and should be included in nicotine reduction regulation

The US Food and Drug Administration (FDA) has invested tens of millions of dollars in clinical trials examining the effectiveness of very low nicotine cigarettes for smoking cessation among smokers, including vulnerable populations, with promising results.1 Trials indicate that very low nicotine cigarettes reduce dependence and increase quit attempts in comparison with standard nicotine cigarettes.2–8 Subsequently, in 2017, the FDA announced a new, nicotine-centred framework for tobacco regulation that includes greatly reducing the nicotine in combustible cigarettes and encouraging innovation in safer forms of nicotine.9 Then, in 2018, the FDA released an advanced notice of proposed rulemaking on cigarette nicotine reduction.10 The aim is to reduce nicotine to minimally addictive or non-addictive levels in order to reduce smoking initiation and aid smoking cessation.11 The tobacco control community is cautiously optimistic that a…

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