In response to the Surgeon General’s report in 1964, governments, at all levels, deployed a range of strategies to encourage smokers to quit and to discourage smoking initiation. Smoking rates have reached historic lows. Specifically, adult smoking has declined significantly from 42.4 percent at its peak to 15.1 percent (1965–2015). However, despite near-universal awareness of the health risks associated with cigarettes, the CDC reports that 37 million American adults continue to smoke.

Recently, some members of the public health community have advocated that tobacco harm reduction be included as part of a more comprehensive strategy for reducing the health risks associated with cigarette smoking. Harm reduction encourages public health initiatives that have the potential to decrease the harm associated with a particular behavior without necessarily eliminating that behavior. That is not to say that the alternative behavior does not pose some risk, but they believe that the alternative behavior likely poses less risk. Common harm-reduction efforts that minimize the impact risky behaviors have on society include laws concerning road safety (e.g. seatbelt, helmet and cell phone/texting laws), and needle exchanges for intravenous drug users.

Given the success of harm reduction strategies with other risky behaviors, a growing number of scientists and public health officials are embracing tobacco harm reduction as an additional tool to reduce the harm associated with cigarette use. Many believe that migrating smokers who are not interested in quitting smoking from cigarettes to non-combustible tobacco products and nicotine replacement therapies presents a public health opportunity.

Research indicates that the combustion of tobacco (i.e., cigarette smoking), rather than nicotine, is what exposes tobacco consumers to the most risk. Indeed, there is a scientific consensus that smokeless tobacco products present less risk than cigarettes. There is a growing body of scientific evidence that other non-combustible tobacco products such as vapor products may present less risk than cigarette smoking as well. Encouraging smokers to switch to products that reduce the risk, or have the potential to reduce risk, from smoking cigarettes can play a valuable role in public health.

• Conducting research and evaluating the growing body of scientific evidence to better understand the relative risks of different tobacco products;
• Engaging with legislators, regulators and other stakeholders with a goal of having the elements of tobacco harm reduction reflected in future legislation and regulation; and
• Creating new and innovative products to meet the changing expectations of adult tobacco consumers.