The 2009 law lays out the possibility for both, prescribing a scientific approach to improve public health. But the challenge and opportunity is for the agency to "come up with a comprehensive nicotine regulatory policy aimed at shifting tobacco users down the continuum from the most harmful to the least harmful," Zeller said, who also co-chairs the National Cancer Institute's Tobacco Harm Reduction Network.
"This is a game-changer," said former FDA Commissioner David Kessler, who championed the anti-tobacco public health movement in the 1990s. "He really has committed his career to understanding tobacco at all levels. ... This is a guy that knows how to get things done."
The FDA's measured approach hasn't stopped it from making changes prescribed by the law: limiting marketing, especially to children; banning flavored cigarettes except for menthol; removing labels such as "light," ''mild" and "low-tar" from cigarette packs; and increased the size of warning labels on smokeless tobacco.
It has also begun to look at the ingredients in cigarettes as well as the health impacts of menthol cigarettes and dissolvable tobacco products. The agency also has said it plans to expand its regulatory authority to include cigars and electronic cigarettes.
Still, attempts to regulate the industry haven't come without battles. Several tobacco makers are challenging various marketing restrictions and proposed graphic cigarette warning labels, and a review by the AP in December uncovered that the agency had not ruled on thousands of tobacco product applications, a majority of which have lingered for more than a year.
The nation's largest cigarette maker, Marlboro manufacturer Altria Group Inc., said, "We believe that, under Dr. Deyton's leadership, the Center for Tobacco Products has been focused on establishing a science- and evidence-based approach to regulating tobacco products, and we will continue to engage with the Agency to further this regulatory focus on science and evidence."
Michael Felberbaum can be reached at http://www.twitter.com/MLFelberbaum.