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The cigarette industry has managed to avoid any real harm reduction in their products over the years
Much has been written in recent issues of Tobacco Control concerning harm reduction products as part of a public health strategy for dealing with tobacco use. The editorial by Kozlowski and colleagues1 advocated medicinal nicotine as part of the plan and discusses risks from other alternatives. They correctly point out that small changes in elimination of toxic ingredients are not very effective in reducing the dangers of smoking. Such small changes in a smoking product that is supposed to be a potentially less risky version of cigarettes actually perpetuate the continued marketing of very hazardous products, especially if the marketers insist that they leave the more risky product on the market. In this issue Breland and colleagues2 discuss another marginally reduced harm product called Advance™. The name is somewhat ironic given that the advance in harm reduction from the viewpoint of chemical exposure appears marginal at best.
When I joined Philip Morris in 1976 the plan to make cigarettes that caused less disease seemed relatively straightforward. Harm reduction could be achieved through practical application of dose–response concepts. Through a series of manoeuvres the cigarette industry has managed to avoid any real harm reduction making small steps of limited impact. In many cases tar levels for many popular brand versions such as various “Lights”, “Ultra Lights”, and “Low Tar” cigarettes have actually increased over the last 20 years. The illusion of lower sales weighted tar averages is based on a very small difference in actual Federal Trade Commission (FTC) tars in closely related versions of the major brands.
To illustrate the minor difference in tars between “Lights” and “Low Tar” versions of cigarettes, and also the confusion surrounding the use of descriptors …
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