Cigarette Smoke

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Cigarettes are the most common form of tobacco used in most of the world (World Health Organization [WHO] 2006) and cause 443,000 deaths in the United States each year (U.S. Department of Health and Human Services [USDHHS] 1986, 1988; National Cancer Institute [NCI] 1997; Centers for Disease Control and Prevention [CDC] 2008). The primary short- and long-range strategies for reducing deaths associated with tobacco use are cessation and prevention, respectively, along with reduction of secondhand smoke exposure (Warner et al. 1998; USDHHS 2000; Stratton et al. 2001; WHO 2003a). Another concept that has been considered is changing the cigarette itself to make it less toxic. The concept of modifying conventional cigarettes to be potentially less harmful is not new. Beginning in the 1950s, the tobacco industry embarked on efforts to modify cigarettes in response to growing public awareness of the health hazards of tobacco use, primarily through reducing machine-measured tar and nicotine content (NCI 1996). However, evidence now demonstrates that these modifications did not reduce the risk of cigarette smoking and in addition may have undermined efforts to prevent tobacco use and promote cessation (NCI 2001). In recent years, a range of new products have been introduced and marketed to smokers as an alternative to conventional cigarettes, sometimes accompanied by messages, explicit or implied, that they offer reduced exposure to toxic substances or risk of disease (Pederson and Nelson 2007). The focus of this chapter is on the health consequences of changes in cigarette design over time. Coverage of novel cigarette products is not intended to be comprehensive or current, because this market is rapidly…...

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