Lowering nicotine levels in cigarettes could save millions of lives – University of Minnesota Twin Cities

Advancing Public Health and Sustainable Development Through Nicotine Reduction Policy

Executive Summary

A proposed national policy in the United States to reduce nicotine content in all commercially sold cigarettes presents a significant opportunity to advance key United Nations Sustainable Development Goals (SDGs). Research from the University of Minnesota’s Masonic Cancer Center indicates that such a policy would not only curb the leading preventable cause of premature death but also address critical health inequalities, directly aligning with SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities). This initiative, a result of multi-stakeholder collaboration (SDG 17), is projected to save millions of lives by facilitating smoking cessation and preventing addiction.

Policy Impact on Sustainable Development Goals

SDG 3: Good Health and Well-being

The primary objective of the proposed policy is to enhance public health outcomes, a core target of SDG 3. By making cigarettes less addictive, the policy aims to substantially reduce the incidence of non-communicable diseases.

• Target 3.4: Reduce by one-third premature mortality from non-communicable diseases through prevention and treatment. The policy directly addresses this by targeting chronic tobacco use, the leading preventable cause of 18 cancer types, heart disease, and pulmonary disease.
• Target 3.a: Strengthen the implementation of the WHO Framework Convention on Tobacco Control. A federally mandated reduction in nicotine serves as a powerful implementation of this framework at a national level.
• The policy is expected to prevent young people from developing a lifelong addiction and make it significantly easier for current smokers to quit.

SDG 10: Reduced Inequalities

A crucial aspect of the policy is its potential to mitigate health disparities among vulnerable populations, contributing directly to SDG 10.

• The research, highlighted by Dr. Dana Carroll, an associate professor at the University of Minnesota Medical School, suggests the policy will disproportionately benefit communities that have been most harmed by smoking.
• Populations expected to see the greatest gains in life-years and reductions in smoking-related deaths include:
  1. Rural communities
  2. Native American communities
  3. Black and African American communities
• By closing these health gaps, the policy serves as a mechanism for promoting health equity within the nation.

SDG 17: Partnerships for the Goals

The development and promotion of this policy exemplify a successful partnership between academia and government, a key component of SDG 17.

• The U.S. Food and Drug Administration (FDA) proposed the policy to address the nearly half-million annual deaths from smoking.
• This proposal is founded on over a decade of scientific research led by University of Minnesota researchers, including Dr. Dorothy Hatsukami and her team at the Masonic Cancer Center.
• This collaboration demonstrates how academic research can inform evidence-based public policy to achieve shared sustainable development objectives.

Research and Institutional Context

Dr. Dana Carroll, Masonic Cancer Center

Dr. Carroll, an epidemiologist and director of tobacco research programs for the Masonic Cancer Center, emphasizes that lung cancer remains the leading cause of cancer-related death, primarily caused by smoking. Her research focuses on evaluating smoking cessation strategies, with a particular focus on American Indian and rural populations, ensuring that efforts to achieve SDG 3 and SDG 10 are inclusive and effective.

About the Masonic Cancer Center, University of Minnesota

As the Twin Cities’ only National Cancer Institute-designated Comprehensive Cancer Center, the Masonic Cancer Center is central to the research underpinning this public health initiative. Its work in discovering the causes, prevention, detection, and treatment of cancer directly supports the global agenda for health and well-being.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article primarily addresses two Sustainable Development Goals (SDGs) by focusing on public health, tobacco control, and health equity.

• SDG 3: Good Health and Well-being

  This is the most prominent SDG in the article. The entire discussion revolves around the negative health impacts of tobacco use, such as being the “leading preventable cause of 18 cancer types, heart and pulmonary disease, and premature death.” The proposed policy to reduce nicotine in cigarettes is a public health intervention aimed directly at improving health outcomes and saving “millions of lives.”

• SDG 10: Reduced Inequalities

  The article explicitly connects the proposed tobacco control policy to reducing health disparities. It states the policy could be a “major step toward closing health gaps” and is expected to have an “especially strong benefit for communities that have been most harmed by smoking — including rural communities, Native American communities, and Black and African American communities.” This focus on achieving more equitable health outcomes for vulnerable populations directly aligns with the goal of reducing inequalities.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the specific issues discussed, the following SDG targets can be identified:

• Target 3.4: Reduce by one-third premature mortality from non-communicable diseases through prevention and treatment.

  The article’s central theme is preventing premature deaths caused by smoking, which leads to non-communicable diseases (NCDs) like lung cancer and heart disease. The proposed policy is a preventative measure designed to “curb the nearly half-million deaths caused by smoking each year,” directly contributing to the reduction of premature mortality from NCDs.

• Target 3.a: Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries.

  The article discusses a “national policy to reduce nicotine content in all cigarettes” proposed by the U.S. Food and Drug Administration. This is a clear example of a government-led tobacco control measure. Such policies are the primary mechanism for implementing the WHO Framework Convention on Tobacco Control, making this target highly relevant.

• Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… race, ethnicity, origin… or other status.

  While this target often refers to social and economic inclusion, its principle applies to health equity. The article highlights that the policy will disproportionately benefit specific marginalized groups (rural, Native American, Black and African American communities) by reducing their burden of smoking-related diseases. This action promotes more inclusive health outcomes and works towards reducing the inequalities that these communities face.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

The article implies several indicators that could be used to measure progress, even if it does not use the official SDG indicator terminology.

• Indicator for Target 3.4: Mortality rate from smoking-related diseases.

  The article directly mentions the “nearly half-million deaths caused by smoking each year” and that lung cancer is the “leading cause of cancer-related death.” A reduction in these numbers would be a direct measure of progress. The statement that people in specific groups will “avoid more smoking-related deaths” further implies that tracking mortality rates is a key metric.

• Indicator for Target 3.a: Prevalence of tobacco use.

  The policy’s stated goals are to “make it easier for people to quit smoking and preventing young people from becoming addicted to smoking.” Progress towards this can be measured by tracking the prevalence of smoking among the general population and specifically among young people. A decrease in the number of smokers would indicate successful implementation of tobacco control measures.

• Indicator for Target 10.2: Disparity in health outcomes between different population groups.

  The article implies the use of disaggregated data to measure the closing of “health gaps.” It suggests that certain communities “are likely to gain more years of life.” An effective indicator would therefore be the measurement and comparison of smoking-related mortality rates and life expectancy gains across different demographic groups (e.g., rural vs. urban, or by race), with the goal of seeing the gap between these groups narrow over time.

4. Table of SDGs, Targets, and Indicators

Source: twin-cities.umn.edu