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Logo of pubhealthrepPublic Health Reports
Public Health Rep. 2008 Sep-Oct; 123(5): 552–553.
PMCID: PMC2496949


I read with some considerable confusion the recent article by Richter and colleagues1 on reducing toxicant levels as a new Healthy People 2010 objective. I have great respect for these authors but was confused by their position, as it is now clear that smoke yields (tar, nicotine, or the toxicants proposed by the authors) expressed per cigarette have no meaningful relationship with human exposure or risk. The 2004 Surgeon General's report,2 NCI Monograph 13,3 and the World Health Organization4 have all made it clear that differences in these measures expressed per cigarette do not reflect differences in human exposure or differences in actual delivered dose to smokers of different brands. Therefore, it makes little sense to use them to set a reduction in toxicant level goal for Healthy People 2010. Indeed, when similar reductions were mandated for tar, nicotine, and carbon dioxide by the European Union, compliance by the tobacco manufacturers was largely achieved by increasing the amount of filter ventilation,5 a change known to have little or no effect on actual exposure due to compensatory changes in smoking behavior.

I am hopeful that this is simply a case in which newer evidence has overtaken an older recommendation, but I would earnestly ask the authors (and the Healthy People 2010 process) to reconsider their position.


1. Richter P, Pechacek T, Swahn M, Wagman V. Reducing levels of toxic chemicals in cigarette smoke: a new Healthy People 2010 objective. Public Health Rep. 2008;123:30–8. [PMC free article] [PubMed]
2. Department of Health and Human Services (US) The health consequences of smoking: a report of the Surgeon General. Washington: DHHS, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health (US); 2004.
3. National Cancer Institute (US) Smoking and Tobacco Control Monograph No. 13. Bethesda (MD): Department of Health and Human Services, National Institutes of Health National Cancer Institute (US); 2001. Risks associated with smoking cigarettes with low machine-measured yields of tar and nicotine.
4. World Health Organization Study Group on Tobacco Product Regulation (TobReg) The scientific basis of tobacco product regulation: report of a WHO study group. Geneva: WHO; 2007.
5. O'Connor RJ, Cummings KM, Giovino GA, McNeill A, Kozlowski LT. How did UK cigarette makers reduce tar to 10 mg or less? BMJ. 2006;332:302. [PMC free article] [PubMed]

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