The 13th World Conference on Tobacco OR Health

One of the more significant public health mistakes of the last century was the public health recommendations that smokers who could not quit could reduce their risk by switching to low tar and nicotine yield cigarettes. This recommendation was based on the valid scientific principal that lower exposure produces less risk and the erroneous assumption that lower machine measured tar and nicotine yields reflect lower tobacco smoke exposure to those who smoke low yield cigarettes. Making what appeared to be a reasonable assumption, that machine yield of a brand reflected the human exposure of that brand, led to thirty years of mistaken public health advice. Understanding the scientific steps that will avoid a repeat of this mistake with newer “reduced exposure” tobacco products is the focus of this presentation. Issues to be discussed include: limitations of epidemiological assessment of self selected use of lower yield products, the need of measures of exposure in human populations, the effect of marketing claims on who chooses to use the product, and the need to base evaluation of future exposure and harm reduction claims on actual evidence rather than assumptions.