Despite overwhelming evidence of tobacco's harmful effects and pressure from anti-smoking advocates, current surveys show that about one-quarter of all adults in the United States are smokers. This audience is the target for a wave of tobacco products and pharmaceuticals that claim to preserve tobacco pleasure while reducing its toxic effects. Clearing the Smoke addresses the problems in evaluating whether such products actually do reduce the health risks of tobacco use. Within the context of regulating such products, the committee explores key questions: * Does the use of such products decrease exposure to harmful substances in tobacco? * Is decreased exposure associated with decreased harm to health? * Are there surrogate indicators of harm that could be measured quickly enough for regulation of these products? * What are the public health implications? This book looks at the types of products that could reduce harm and reviews the available evidence for their impact on various forms of cancer and other major ailments. It also recommends approaches to governing these products and tracking their public health effects.With an attitude of healthy skepticism, Clearing the Smoke will be important to health policy makers, public health officials, medical practitioners, manufacturers and marketers of "reduced-harm" tobacco products, and anyone trying to sort through product claims.
Kathleen Stratton, Padma Shetty, Robert Wallace, and Stuart Bondurant, Editors, Committee to Assess the Science Base for Tobacco Harm Reduction, Board on Health Promotion and Disease Prevention
1 Front Matter; 2 Executive Summary; 3 1 Introduction; 4 2 Principles of Harm Reduction; 5 3 Historical Perspective and Lessons Learned; 6 4 Products for Tobacco Exposure Reduction; 7 5 The Scientific Basis for Pres Assessment; 8 6 Surveillance for the Health and Behavioral Consequences of Exposure Reduction; 9 7 Implementation of a Science-Based Policy of Harm Reduction; 10 8 Principal Conclusions; 11 9 Nicotine Pharmacology; 12 10 Tobacco Smoke and Toxicology; 13 11 Exposure and Biomarker Assessment in Humans; 14 12 Cancer; 15 13 Cardiovascular Disease; 16 14 Nonneoplastic Respiratory Diseases; 17 15 Reproductive and Developmental Effects; 18 16 Other Health Effects; 19 Appendix A: Presentations and Submissions; 20 Appendix B: Committee Biographical Sketches; 21 Appendix C: Time Line of Tobacco Events; 22 Index
National Research Council, Division of Behavioral and Social Sciences and Education, Institute of Medicine, and Families Board on Children, Youth, Steve Olson
Institute of Medicine, Board on the Health of Select Populations, and Transgender Health Issues and Research Gaps and Opportunities Committee on Lesbian, Gay, Bisexual
Institute of Medicine, Board on Population Health and Public Health Practice, Division of Health Promotion and Disease Prevention, Division of International Health
Institute of Medicine, Committee to Develop Methods Useful to the Department of Veteran Affairs in Estimating Its Physician Requirements, Joseph Lipscomb
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on Scientific Standards for Studies on Modified Risk Tobacco Products
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on the Public Health Implications of Raising the Minimum Age for Purchasing Tobacco Products, Leslie Y. Kwan, Kathleen Stratton, Richard J. Bonnie
Institute of Medicine, Board on Population Health and Public Health Practice, and Consequences Committee on Reducing Tobacco Use: Strategies, Barriers, Robert B. Wallace, Kathleen Stratton, Richard J. Bonnie
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on Smoking Cessation in Military and Veteran Populations, Roberta Wedge, Stuart Bondurant
National Research Council, Committee on the Illicit Tobacco Market: Collection and Analysis of the International Experience, Malay Majmundar, Peter Reuter
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on the Assessment of Agent-Based Models to Inform Tobacco Product Regulation, V. Ayano Ogawa, Amy Geller, Robert Wallace
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on Smoking Cessation in Military and Veteran Populations, Roberta Wedge, Stuart Bondurant
Institute of Medicine, Board on Population Health and Public Health Practice, and Consequences Committee on Reducing Tobacco Use: Strategies, Barriers, Robert B. Wallace, Kathleen Stratton, Richard J. Bonnie
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on the Public Health Implications of Raising the Minimum Age for Purchasing Tobacco Products, Leslie Y. Kwan, Kathleen Stratton, Richard J. Bonnie
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on the Assessment of Agent-Based Models to Inform Tobacco Product Regulation, V. Ayano Ogawa, Amy Geller, Robert Wallace
National Research Council, Committee on the Illicit Tobacco Market: Collection and Analysis of the International Experience, Malay Majmundar, Peter Reuter
Institute of Medicine, Board on Population Health and Public Health Practice, Committee on Scientific Standards for Studies on Modified Risk Tobacco Products