Table 1 Timetable of leading tobacco control themes in the United States on absolute risk and harm reduction options

1964 -

Cigarettes are hazardous to men and likely to be for women.

Cigars and pipes are safer than cigarettes; lower-tar cigarettes may be safer; the science that put a man on the moon will develop a safer cigarette soon.

1980-

Cigarettes are lethal when used as intended and kill more people than heroin, cocaine, alcohol, AIDS, fires, homicide, suicide, and automobile accidents combined.

Cigars and pipes are safer than cigarettes; Light/lower-tar cigarettes may be safer; Snus is less harmful (in Sweden/Scandinavia).

1987-

Cigarettes are lethal (as above) and cause lung cancer, heart disease, emphysema; smokeless tobacco and cigars are not safer alternatives to cigarettes.

Avoidance of indication of harm reduction from cigars and smokeless tobacco; tar and nicotine testing stopped, but “low-tar” and “Light” claims still marketed and misleading.

2001-

All cigarettes are equally lethal; all tobacco products are unsafe.

No recognition/encouragement of less-harmful tobacco use.

2014-

“The burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products....”

An acknowledgement of the special deadliness of the smoke from combustion, primarily from smoking cigarettes and the potential for harm reduction.

All cigarettes are equally lethal; all tobacco products are unsafe.

2015- [Herein Proposed]

Cigarettes and other smoked products are the most deadly; non-combusted tobacco and alternate nicotine delivery products, including medical replacement therapies are unsafe, but relatively low in risk. Smoke for the nicotine but die from the tar.

An acknowledgement of the special deadliness of smoking and development of ways to increase harm reduction in continuing users of lethal tobacco products by displacing smoking with much less harmful tobacco or nicotine.