Throughout the month of June, the ACC submitted a series of comment letters to Scott Gottlieb, MD, commissioner of the U.S. Food and Drug Administration (FDA) in response to three Advance Notices of Proposed Rulemaking (ANPRMs) issued by the agency in March as part of an effort to implement comprehensive tobacco and nicotine regulations.

The first letter of the series addressed the development of a standard for the maximum level of nicotine permitted in cigarettes. The College called for Gottlieb and the FDA to maximize the public health benefits by reducing the level of nicotine currently permitted in cigarettes to a minimally addictive or non-addictive level. Additionally, the letter called for the nicotine product standard to be extended to all combustible tobacco products to prevent users from turning to alternative methods to satisfy their nicotine addiction or allowing exempted products to become a vehicle for youth initiation.

The College further addressed this issue by partnering with more than 35 fellow health care organizations and public health advocates, including the Campaign for Tobacco-Free Kids, to submit a joint letter to the FDA reiterating the urgency with which the agency should issue a final regulation reducing the nicotine level permitted in cigarettes and pushing for the product standard to extend beyond traditional cigarettes.

The College also submitted comments on the agency's request for information on the effects of using flavors in tobacco products. The letter called for the FDA to prohibit the sale of all flavored tobacco products, including menthol, to cease the mass initiation of youth smokers and lessen the toll of tobacco-related death and disease for future generations.

The College's final letter of the series pushed for the inclusion of premium cigars in the implementation of tobacco product regulations. The letter encouraged the FDA to exert its full regulatory authority over all tobacco products, including cigars of all varieties, to avoid misleading consumers to believe that premium cigars are less harmful than other cigars.

The ACC stands in strong support of implementing a nicotine product standard for all combustible tobacco products, regulating flavors in tobacco products and regulating premium cigars in the interest of public health. The College appreciates the FDA's openness to stakeholder input throughout its ongoing initiative to lessen tobacco-related harm and welcomes the opportunity to provide further input as needed.

Keywords: ACC Advocacy, Nicotine, Tobacco, Menthol, Public Health, United States Food and Drug Administration, Tobacco Products, Tobacco Use Disorder, Flavoring Agents, Behavior, Addictive, Social Responsibility

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