Manufacturers of tobacco products, whether conventional or modified, should be required to obtain quantitative analytical data on the ingredients of each of their products and to disclose such information to the regulatory agency

All tobacco products should be assessed for yields of nicotine and other tobacco toxicants according to a method that reflects actual circumstance of human consumption; when necessary to support claims, human exposure to various tobacco smoke constituents should be assessed using appropriate biomarkers. Accurate information regarding yield range and human exposure should be communicated to consumers in terms that are understandable and not misleading

Manufacturers of all PREPs should be required to conduct appropriate toxicological testing in preclinical laboratory and animal models as well as appropriate clinical testing in humans to support the health related claims associated with each product and to disclose the results of such testing to the regulatory agency

Manufacturers should be permitted to market tobacco related products with exposure reduction or risk reduction claims only after prior agency approval based on scientific evidence: (a) that the product substantially reduces exposure to one or more tobacco toxicants; and (b) if a risk reduction claim is made, that the product can reasonably be expected to reduce the risk of one or more specific diseases or other adverse health effects, as compared with whatever benchmark product the agency requires to be stated in the labelling. The “substantial reduction” in exposure should be sufficiently large that measurable reduction in morbidity and/or mortality (in subsequent clinical or epidemiological studies) would be anticipated, as judged by independent scientific experts

The labelling, advertising, and promotion of all tobacco related products with exposure reduction or risk reduction claims must be carefully regulated under a “not false or misleading” standard with the burden of proof on the manufacturer, not the government. The agency should have the authority and resources to conduct its own surveys of consumer perceptions relating to these claims

The regulatory agency should be empowered to require manufacturers of all products marketed with claims of reduced risk of tobacco related disease to conduct post-marketing surveillance and epidemiological studies as necessary to determine the short term behavioural and long term health consequences of using their products and to permit continuing review of the accuracy of their claims

In the absence of any claim of reduced exposure or reduced risk, manufacturers of tobacco products should be permitted to market new products without prior approval of the regulatory agency after informing the agency of the composition of the product and certifying that the product could not reasonably be expected to increase the risk of cancer, heart disease, pulmonary disease, adverse reproductive effects or other adverse health effects, compared to similar conventional tobacco products, as judged on the basis of the most current toxicological and epidemiological information

All added ingredients in tobacco products, including those already on the market, should be reported to the agency and subject to a comprehensive toxicological review

The regulatory agency should be empowered to set performance standards (for example, maximum levels of contaminants; definitions of terms such as “low tar”) for all tobacco products, whether conventional or modified, or for classes of products

The regulatory agency should have enforcement powers commensurate with its mission, including the power to issue subpoenas. Exposure reduction and risk reduction claims for drugs that are supported by appropriate scientific and clinical evidence should be allowed by the FDA