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Origins of tobacco harm reduction in the UK: the ‘Product Modification Programme' (1972–1991)
  1. Jesse Elias1,
  2. Pamela M Ling2
  1. 1 Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
  2. 2 Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Pamela M Ling, Department of Medicine, Division of General Internal Medicine, and Center for Tobacco Control Research And Education, University of California San Francisco, San Francisco, CA 94143, USA; Pamela.Ling{at}


Objective To better understand the current embrace of long-term nicotine maintenance by British governmental agencies and tobacco harm reduction by several leading British public health organisations, describe the context and deliberations of the UK’s first formal tobacco risk reduction programme: ‘Product Modification’.

Methods Analysis of previously secret tobacco industry documents, news archives and Parliamentary debate records.

Results From 1972 to 1991, the British government sought to investigate safer smoking through the ‘product modification programme'. The Independent Scientific Committee on Smoking and Health (ISCSH) advised the British government on these efforts and collaborated with the tobacco industry, with which government then negotiated to determine policy. The ISCSH operated from four industry-backed premises, which contributed to the ISCSH’s support of safer smoking: (1) reduced toxicity indicates reduced risk; (2) collaboration with the tobacco industry will not undermine tobacco control; (3) nicotine addiction is unavoidable; (4) to curtail cigarette use, solutions must be consumer-approved (ie, profitable). These premises often undermined tobacco control efforts and placed the ISCSH at odds with broader currents in public health. The product modification programme was abandoned in 1991 as the European Community began requiring members to adopt upper tar limits, rendering the ISCSH redundant.

Policy implications Endorsements of reduced harm tobacco products share the same four premises that supported the product modification programme. Current tobacco harm reduction premises and policies supported by the British government and leading British public health organisations may reflect the historical influence of the tobacco industry.

  • tobacco industry
  • tobacco industry documents
  • public policy
  • harm reduction

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  • Contributors JE acquired the data for this study and led the analysis, drafting and writing. PML obtained funding, supervised data collection, analysis and performed critical revisions. Both authors jointly conceived the study, contributed to data analysis, writing and revision and approved the final version of the article for publication.

  • Funding This work was supported by the National Cancer Institute at the National Institutes of Health under award number R01-CA-87472.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This paper is an analysis of previously secret tobacco industry documents. The data are freely available to the public at the UCSF Truth Industry Documents Library.