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THE NATIONAL ACADEMIES
Institute of Medicine
Board on Health Promotion and Disease Prevention
Committee to Assess the Science Base for Tobacco Harm Reduction

*****

Congressional Briefings
Wednesday, February 21, 2001
428 Dirksen Senate Office Bldg. – 9:30 a.m.
and
417 Madison Bldg., Library of Congress – 4:00 p.m.

on

CLEARING THE SMOKE:
ASSESSING THE SCIENCE BASE FOR TOBACCO HARM REDUCTION

by

STUART BONDURANT, M.D., Professor, Department of Medicine, University of North Carolina, Chapel Hill, and Chair, Committee to Assess the Science Base for Tobacco Harm Reduction, Board on Health Promotion and Disease Prevention, Institute of Medicine

ROBERT WALLACE, M.D., M.Sc., Professor, Department of Epidemiology and Internal Medicine, University of Iowa Colleges of Public Health and Medicine, and Vice-Chair, Committee to Assess the Science Base for Tobacco Harm Reduction, Board on Health Promotion and Disease Prevention, Institute of Medicine

The continuing toll of tobacco use has prompted the search for a way to reduce the harm caused by smoking.

In 1999, the U.S. Food and Drug Administration (FDA) called on the Institute of Medicine (IOM) to provide a framework for assessing "harm-reduction" products that allow the user to continue to smoke. The array of such products includes modified tobacco and cigarette-like items that deliver smaller amounts of toxicants. It also includes drugs -- such as an antidepressant and nicotine in gum, patches, inhalers, and nasal spray. Although these latter are strictly regulated by the FDA for short-term use to help people quit smoking, they are not approved for long-term use in harm reduction, while modified tobacco and cigarette-like products are not regulated by the FDA or any federal agency for their potential to reduce tobacco-related disease.

The IOM's response to this issue entitled, Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction, outlines how tried-and-true public health tools -- research, surveillance, communication, and regulation -- should be used to ensure that the availability of these products confers less risk to the individual and to the population as a whole compared with conventional tobacco products. It also recommends a regulatory strategy to assure that these products reduce risk of disease.

This series of briefings were for members of Congress and congressional staff only. The report was publicly released on February 22, 2001 and can be found, in its entirety, on the Web site of the National Academies Press.