The past is not the future in tobacco control

In this paper we have attempted to identify missed opportunities to change the trajectory of smoking and smoking caused diseases in America over the past 100 years. Many of the missed opportunities identified are due to the actions of cigarette manufacturers who misled the public about the dangers o...

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Bibliographic Details
Published in:Preventive medicine 2020-11, Vol.140, p.106183-106183, Article 106183
Main Authors: Cummings, K. Michael, Ballin, Scott, Sweanor, David
Format: Article
Language:English
Subjects:
Cigarette smoking prevalence
Electronic cigarettes
Electronic Nicotine Delivery Systems
Harm reduction
Humans
Nicotiana
Nicotine addiction
Product regulation
Quit ratios
Smoking
Smoking Cessation
Smoking initiation
Tobacco control
Tobacco Industry
Tobacco Products
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Summary:In this paper we have attempted to identify missed opportunities to change the trajectory of smoking and smoking caused diseases in America over the past 100 years. Many of the missed opportunities identified are due to the actions of cigarette manufacturers who misled the public about the dangers of cigarette smoking, the addictiveness of nicotine, and the feasibility of providing lower risk alternative nicotine delivery products to addicted smokers. An important lesson learned from the past is that treating all tobacco/nicotine products as equivalently harmful is counterproductive to public health as it only serves to protect the most lethal nicotine product – cigarettes. Since 2000, the evolving marketplace of lower risk nicotine products combined with regulatory authority over tobacco products represents a new opportunity to dramatically transform the cigarette business in ways that were never imagined when the war on tobacco was raging decades ago. However, this requires embracing risk-proportionate regulation, taxation policies, and providing consumers with accurate public messaging on product relative risks. A regulatory framework based on sound science that encourages and rewards new or existing manufacturers to invest in consumer acceptable lower risk products to replace cigarettes needs to be encouraged. The past is indeed not the future in smoking control, but it may be difficult to escape the past unless a realignment of market forces and policies can be achieved. •Treating all tobacco/nicotine products as equivalently harmful is counterproductive to public health goals.•Public health needs to embrace the concept of regulating tobacco products based on the continuum of risk.•The Tobacco Control Act needs to be updated to adapt to the evolving marketplace of lower risk nicotine product.•We should encourage product innovation and support civil dialogue on issues related to smoking harm reduction.
ISSN:0091-7435
1096-0260
DOI:10.1016/j.ypmed.2020.106183