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Editorial
Accepting premature deaths from smoking
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  1. W A Farone
  1. Correspondence to:
 W A Farone PhD
 Applied Power Concepts, Inc., 411 East Julianna Street, Anaheim, CA, 92801, USA; faroneappliedpowerconcepts.com

https://doi.org/10.1136/tc.2004.007443

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    Could partial reduction of some toxic components in cigarettes lead to reductions in premature deaths from smoking?

    If one analyses the suggested means of solving the problem of premature death and disease caused by smoking, the strategies break down into four broad groups. Listed in the order in which I perceive these to have the highest probability of resulting in the most reduction in death to the least these are:

    1. Smoking cessation

    2. Replacement of the pharmacologic (pleasurable) sensations of nicotine in cigarette products with non-cigarette products that can be viewed as providing either medicinal nicotine or analogue chemicals with similar function

    3. Reduction in toxic components of cigarette smoke immediately to levels that are suggested by current science as “acceptable” based on existing dose–response data for cumulative lifetime exposure. (This is a central part of the theme of the California Environmental Protection Agency’s requirements—that is, that there are levels of chemicals for which the risk is not more than “background”.)

    4. Partial reductions in some toxic components over time to eventually lead to products with reduced premature death rates

    Should the last strategy be regarded as acceptable in light of the more definitive reductions in the other strategies? Is the reduced level of premature death hypothesised to follow a slow response to reducing toxicity for cigarettes something that should be supported?

    REDUCING NITROSAMINES

    In the paper by Gray and Boyle1 in this issue, a case is made for the reduction of one class of known carcinogen in cigarette smoke, the tobacco specific nitrosamines (TSNAs). They argue that the known global variations in TSNAs among cigarette brands are unacceptable and that the lowest levels able to be produced should be required. The fact that lower levels in some cigarettes have been achieved implies that all cigarettes could have the same lower levels.

    Would there …

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