To the Editor The proposal to cap nicotine concentrations in combustible cigarettes is based on sound scientific evidence that cigarettes with very low levels of nicotine will significantly reduce smoking- and tobacco-related harm. However, we believe that a proposal presented in a recent Viewpoint for a federal nicotine cap on e-cigarettes is misguided and runs contrary to current evidence. The focus on e-liquid nicotine concentrations alone is problematic because these restrictions fail to consider that e-cigarettes, unlike cigarettes, offer users ways beyond nicotine concentrations to control nicotine delivery, including manipulating device power and compensatory puffing. In fact, the best evidence suggests that this proposed policy would lead to a product that is as addictive as e-cigarettes with higher nicotine concentrations, which may be more appealing to young people, and more harmful.
