[Show abstract][Hide abstract] ABSTRACT: Nicotine is highly addictive and is primarily responsible for the maintenance of cigarette smoking. In 1994, Benowitz and Henningfield proposed the idea of federal regulation of the nicotine content of cigarettes such that the nicotine content of cigarettes would be reduced over time, resulting in lower intake of nicotine and a lower level of nicotine dependence. When nicotine levels get very low, cigarettes would be much less addictive. As a result, fewer young people who experiment with cigarettes would become addicted adult smokers and previously addicted smokers would find it easier to quit smoking when they attempt to do so. The regulatory authority to promulgate such a public health strategy was provided by the Family Smoking Prevention and Tobacco Control Act. Although it precludes 'reducing nicotine to zero', the act does not prohibit the Food and Drug Administration from setting standards for cigarette nicotine content that would prevent them from being capable of causing addiction. This paper reviews the assumptions implicit in a nicotine reduction strategy, examines the available data on the feasibility and safety of nicotine reduction, and discusses the public education, surveillance and support services that would be needed for the implementation of such a policy.
Tobacco control 05/2013; 22 Suppl 1:i14-i17. · 3.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Tobacco 'endgame' discourse has emerged in recognition of the nature of the global public health emergency created by tobacco use and tobacco promotion. This discourse is a promising development, but translating it into action requires developing some consensus, at least by countries or regions. It also requires negotiating some of the recurring tensions within the tobacco control movement, contributing to risks for the movement as visionaries clash with pragmatists. This paper outlines one combination of approaches that might hold promise for the US situation. Every significant achievement in tobacco control was preceded by many influential people saying it couldn't be done, wouldn't work, or would create new problems. The risks of not envisioning an endpoint for the tobacco epidemic are far greater than the risks of attempting any endgame solutions and failing.
Tobacco control 05/2013; 22 Suppl 1:i42-i44. · 3.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In nations with histories of declining smoking prevalence and comprehensive tobacco control policies, smoking-positive cultures have been severely eroded. Smoking, smokers and the tobacco industry are today routinely depicted in everyday discourse and media representations in a variety of overwhelmingly negative ways. Several authors have invoked Erving Goffman's notions of stigmatization to describe the process and impact of this radical transformation, which importantly includes motivating smoking cessation. Efforts to describe nations' progress toward comprehensive tobacco control have hitherto taken little account of the role of cultural change to the meaning of smoking and the many ways in which it has become denormalised.
This paper identifies a diversity of generally undocumented yet pervasive markers of the "spoiled identity" of smoking, smokers and the tobacco industry, illustrated with examples from Australia, a nation with advanced tobacco control.
We caution about some important negative consequences arising from the stigmatization of smokers.
We recommend that schemes rating the comprehensiveness of national tobacco control should be supplemented by documentation of markers of this denormalisation.
Tobacco control 05/2008; 17(2):25-31. · 3.85 Impact Factor
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