The Food and Drug Administration’s (FDA) proposed plan to cap the nicotine content of cigarettes at 0.7mg (typical cigarettes have 10 to 12mg) would dramatically reduce smoking in people with depression and prevent millions of premature deaths, according to a
study in
Tobacco Control.
Why It’s Relevant
While studies have shown that reducing the nicotine content of cigarettes to very low levels would boost smoking cessation and reduce mortality in the United States, tobacco companies have argued that the
FDA proposal—introduced in January 2025 and currently in a state of limbo—would exacerbate symptoms among people with mental illness, who smoke at higher rates than the general population.
By the Numbers
- Researchers simulated the lives of 4 million individuals born between 1900 and 2100 (20,000 people each year) under both the status quo and an assumption that the proposed nicotine cap goes into effect in 2027. Rates of smoking, vaping, and depression were calculated using existing epidemiological data.
- Under the FDA plan, smoking rates among people with depression are predicted to fall to 0.6% by 2040, compared with 11.3% for the status quo.
- Vaping rates are projected to briefly rise among people with depression after 2027 but then decline along with smoking rates.
- The reduction in tobacco use under the plan would prevent 1.6 million premature deaths and 8 million diagnoses of depression by 2100.
What’s More
The improved life expectancy among all smokers as a result of the FDA plan is projected to increase medical costs by $336 billion from 2027 to 2100, but this would be offset by a $298 billion increase in worker productivity and a $1.3 trillion increase in consumer spending.
The Other Side
As there are no real-world data on the impact of a very low nicotine standard, the policy effects in this model were solely based on “expert elicitation.” Further, this analysis did not consider the potential effects of a black market for full-strength cigarettes, which is another concern voiced by groups opposed to the FDA proposal.
Takeaway Message
These simulations support the case that a mandated nicotine reduction strategy is a cost-effective intervention that can benefit a broad range of smokers. While the fate of the federal nicotine plan remains unknown, the researchers noted that individual states have the authority to pursue nicotine reduction through sales restrictions. This would provide much needed real-world evidence on the effects of very low nicotine cigarettes.
Related Information
Source
Sarah Rivero Skolnick, et al. Impact of reducing nicotine in cigarettes on mortality, economic costs and major depression in the USA.
Tobacco Control. Published July 15, 2026. doi:
10.1136/tc-2025-059896
(Image: Getty Images/iStock/ATINAT_FEI)