Table of Contents
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Front Matter	i-xx
Executive Summary	1-18	(skim)
1 Introduction	19-37	(skim)
2 Principles of Harm Reduction	38-59	(skim)
3 Historical Perspective and Lessons Learned	60-81	(skim)
4 Products for Tobacco Exposure Reduction	82-139	(skim)
5 The Scientific Basis for Pres Assessment	140-179	(skim)
6 Surveillance for the Health and Behavioral Consequences of Exposure Reduction	180-200	(skim)
7 Implementation of a Science-Based Policy of Harm Reduction	201-230	(skim)
8 Principal Conclusions	231-240	(skim)
9 Nicotine Pharmacology	241-282	(skim)
10 Tobacco Smoke and Toxicology	283-308	(skim)
11 Exposure and Biomarker Assessment in Humans	309-366	(skim)
12 Cancer	367-469	(skim)
13 Cardiovascular Disease	470-499	(skim)
14 Nonneoplastic Respiratory Diseases	500-542	(skim)
15 Reproductive and Developmental Effects	543-559	(skim)
16 Other Health Effects	560-580	(skim)
Appendix A: Presentations and Submissions	581-585	(skim)
Appendix B: Committee Biographical Sketches	586-592	(skim)
Appendix C: Time Line of Tobacco Events	593-606	(skim)
Index	607-636	(skim)

Description

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.

Reviews

"The report provides a first rate review of the literature and important insights... I would urge readers to read the full report and use it as a starting point for debate."
-- Tobacco Control, Summer 2001

"This book contains a wealth of useful scientific data that informs a thorough analysis of hte issues raised by 'potential reduced exposure products' (PREPs). It is essential reading for anyone who is interested in the future of tobacco and, increasingly nicotine, control policies."
-- Addiction, 2002

"If you are looking for a summary of the evidence showing the dangers of tobacco you need look no further. This comprehensive volume is packed with evidence and references."
-- Vernon Coleman's Newsletter, March 2002

Authoring Organizations

• Institute of Medicine (IOM)
• More Titles from IOM

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