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Toward Less Hazardous Cigarettes Current Advances Gio Z. Gori, P'hD„ Cornelius J. Lynch, PhD _. 0 Ctitical levels of'. setectedl cigarette smoke constituents have beeni txpressed Im terms of maximum numbers of pre-1960 cigarettes that a, simoker'mayconsurne daily without increasing his mortality risk substantially above.that of'a nonsmoker. T1his could sti111impiy an important'risk, although It may be difficuitto detect. We relate these leveis to the y,ieids of 27'current fow tar andl nicotine commercial cigarettes, as measured at the Oak Ridge, C. atlonal Laboratory: in additioni the yields of these selected constituents concomitant with the yield of 1 mg ofinicotine are provided as a guide forthe smoker who titrates or adjusts his smoking pattern, to accommodate.a fixed daiiy, intakwof' nicotine. . (JAM,A!240s1255'*1259, 1978) STFICE' the Surgeon General's report' on smoking andi health,' considerable " attention has been focused on ciga- 1 1 . rette smoke constituents implioated ~y in the cause of tobac¢o-relat'ed dis- '' ~ h t h ave i eases: any suc eomponen s, been considered, the most frequently For edltorJal comment see p 127'1. cited being total particulate matter (tar), nicotine, carbon monoxide (CO);, nitrogen oxides (NO',~,; hydrogen cya- nide (HCN), and acrolein. Several' investigations document the contribu- tion of these components to cancer, chronic pulmonary disease, or cardio+ vascular impairment-y"' Many studies also: indicate that there, is ad'ose response beta+een the number of ciga- rettes smoked and disease: incidence and morbidity.""" Since publication of'the Surgeon General's report, aver- age tar values of' commercial ciga- rettes have decreasedi by 29%, and nicotine yields have decreased by 21.°0, indicating a continuing preoccu- pation toward reduced ha¢ard." Evaluation of health benefits re- sudting, from these reductions would be premature because of the long latent periods involvedl Available data suggest that, for the present; smoking-related diseases have not abated substantially,,, with the possi- ble! exeeption: of' cardiovascular dis+ eases. However, factors contributing to the decline in these latter diseases are not y,et cib.a,r. On the other hand, From the National Cancer lnatitute; BethesdYl Md (Or G,ony, and Enviro Control, Inc; Rockviil* „ )6Vd (Or Lynch). Ths v4ws axprsssed herein are those of the authors andldo not,necssaarily reflect the views~ or polkiss of the Natlonai Canoer InstlriAe. Pub1i0. Naalth Sisnnes. / Reprint rnQualtl to DNriston of CYne.r Causa, d Prevention, Nstional Cancar Instituls. BldO ~ .i„Room.11AO3, esthesda, MO 20014 (Dr Gon). Jr\INA, Sept 15, 15A8r-Vol1240, No. 122 mortality from tracheal; bronchial, and lung cancer hascontin:zad to rise; projections for the immediate future indicate: that further increases may be expected. This probably is because smokers now in the age groups in which cancer is most likely to develop have spent a~ considerable part of their smoking, history using high tar and nicotine cigarettes. As younger smokers who are exposed to lower tar and' niicotine cigarettes approach cancer-susceptible ages, a reduction in, morbidity and mortality rates could be expected. However, consider- ing tar an& nicotine: alone may give an incomplete and misleading,picture of hazard reduction: the full'impaet of low tar and nicotine cigarettes on health effects should be evaluated in Table i.-/Averape Critical Levels of Pre~L960 Ci9arette Consumption'' 04sssv No. oR Pre-i8eo Clparettss Cancer of the oral eavily 6.8 Pharyp0eal csncsr 2.5 EsopnaQeel cancar 7.3 Penueatic cancer 9.0 Laryngeal canc« a.s Lung cancer 6.7 Blsdder and kidney caneer 9.5. Coronary artery diseasr 4.2 Coronary heari d4eaae 3.5 Aorttc aneuryare 4.3 Emphysem., brorxhitls, or Iwtln . 10.0 AII causes for current smokers 2.0 Less FNUzardous Clqarettes-Gori & Lynch 1255 '

terms of all ' the major toxic smoke eDmponents mentioned previously. Critical levels of daily smoke inhal- ation have been discussed recently in terms of the maximum number of pre-1!960 cigarettes' that may' be smoked daily without detectable' in- crease to the average smoker's risk off mortality beyond that of a nonsmok- er.n'These are by no means safe levels' but merely imply that„ for a smoker' whose daily consurnption does not exceed these levels, any attendant t'obacco4elated mortality risk may be epidemiologically indiscernible from : that of a nonsmoker. This could still imply a substantial although less readily apparent risk. '`For instance, if' the smoker's risk of developing' lung cancer could': be reduced from the present level of approximately 10:1 to some value less than 21, this risk, while considerable; cDuld'i be difficult to establish epide- miologically. The inability to verify this reduce& risk might lead to. its' being considleredI socially tolerable. Average critical levels relative to diseases'tD which smokers are partic- : nlarly susceptible are listed in Table "1, expressed as daily numbers of pre- `19I60 cigarettes: The last entry in Table 1, "Alli causes for current smok- : ers," is -a comprehensive category ^` representing the effect of cigarette i~` tonsu'rpt'ion on mortality in generaL These values are based on, typical yields per cigarette of pre-1!960 ciga. w-: i'retzea 43 mg of tar, 3.0 mg, of nico- -s ,., , tine, 23 mg of CO, 270 jig of hi4„ 410 ' ~'.'~ig of HCN, and 13iD'Kg of'acroleiia." ->'COMMERClAL CIGARETTES '-': Most commercial brands' today '•~ have yields_that are below the typical pre•1'960' levels;, with' particular inter- est in lowered tar and nicotine yields. A recent publication from the' Oak Ridge' Ida'tional Laboratory' lists the yields'of'the six constituentsi referred to previously for 32 brands of com- mercial low tar and nicotine ciga- rettes. Twenty-seven of these brands have measured tar: yields' that do not exceed 10.0 mg, by more than two SEs. Results of testing for these 27 brands are suRne;narizedl in Table 2. The lowest' measured tar yield is 12 mg, and the highest is 10.3 mg (SE; 0.40 mg). Table 3' presents' the percentage. T'able 2:-Melytical Data for SefectedlLow Tar and!Nicotine Ciparettes "' Bhnd Carbon Nit'oqen Nydro9ea Tar, Nlbotlne, Monoxide, Oxidas+;' Cyanid.,Arxolahi, te9/clgt' mq.Yctq- mp/elq a9/rlg aq/cl9 s9ye/q eiensann & HWqes Lights 1a1i 0.8t 12.1 13S 1/e et i Carlton 115' 0.15 2:6' 34 18 18 Carlton Menthol 13 0.14 2.0 12 12 10 Decade 5.5' 0.48 4.3' 67 49 38 Decade Mentholl 646 ' 0.69 4.4 61 60 47 Iceberg 100'!. 3.1 0.32 &7' 44 44 42 Kent Golden Liqhts 8A' 0.711 9:2' 81 6'1 47 Kent Golden Lights Menthol 8:3' 0.68' 8.3 71 62 37 King Sano 6:8 0.29 11.6 195 79 35 King Sano Menthol 5.3 035' 13.6 205 102 44 LdM FlbvorLiqhts (King) 7.2 0.80 4.8 40 65 30 L3M Long Liphts (100'a) 6.5 0:67 5.5 41 69 47 Lark 11 7.5 0J61 7.3 • 83 84' 44'. Lucky 100 3.1 0:28' 5.3 88 34 28 Merit 8.8 M80 12.1 188 161 49 Merit Menthol 8.4 0J61 10.2 172 140 BZ'. Newport Lights Menthol 10.3 0J85' 12.5 88 133' 57' Now 1.9 0:19, 2.4 25 te' 1S'. Now Menthol 1.8 0:18' 2.1 30 9 13! Pall MaI1 Extra Mild 5.1 0:47 6.8 78 65 38' Rea/ 10.2 1.0 1 12.9 99 155 76 Real Menthol 7.9 0.181 10.2 84 105 44 Stride 3.3 0.38 118 66 <10 12 Tarsyton Liqhts 7.8 OA2 2.8 85' 75 ' 31 Tempo e.9 0.56 10.1 168 98 31 True 4.8 0.46 5.2 72 34 29 TrurMenthol: 5.2 0.42 5.7 84 43 31 'Data analyzed by Oak Ridge National Laboratory. tAbbreviation cig indicaterciqarette. *Total oxides ot nitrogen. Table 3.-Reduction inYieids as Percent of Pre-1960 Cigarette Yields Brand: Tar, m9/clq1 Carbon. Nicottne~ Monoxide. mq/clq mq/cldi Nltroqrtn Hydroqen. Oaides, Cyanide, u9/ciq uq/clq IAcroieln, Kq/ciq Benson 8 Hledpes Liphts 77. 73, 47 50 72 53' Canton 97 96,. 89 e7' 96 88. Carlton Menthol' 97 . 95 91 98' 97 921 Decade 87 85 81 79 a8 71 Decade Menthol 86 77 at 77' 88 64 keberq 100's 93 89 75 84 89 68' Kent Golden Lights 79 78 e0 77 88 64 Kent Golden Liphts t:lentho/ 8II 78 54 74 85 72' Kinq Sano 87' 90 50 27 81 73 King Sano Menthol 88 92 41 24 75 88 L8M Flavor Lights (Kinq) i 83' 73 79 65 84 77 LdM Long Lights (L00's) 85 78 70 BS 83 84 Lark ll 83 80 88 69 80 88 Lucky t00 93 91 77 75 92 78 Merit 80 80 47 38 63 62 Meri1 Menthol i 80 80 56 38 68 60 Newport Liphts Menthol 76 72 46 88 88 56 Now 96 94 90 91 9e a6 Now Menthol 9S 95 91ti 89 98 90 Pall Mall Extra Mitd 86 84 75' 72 84' 7'1 Real' 78 Be 44' 63 82 42 ReallMenthoh 82 73 58' 89 74 98 Stnde 92 Btl 92' 98 >98 91, Tareyton Lights 82 76 89 69 82 78 Tempo 84 8t 58 39 76 78 True 83 85' 77' 73' 92' 78 True Menthol 88 8tt 75 78' 90 76 Averaqe 88' 63 69' 64' 83 71 •Ylbbreviation clg indicates ciqerette. 1258 JAMA, Sept 15; 1978'-Vol 240, No. 12' -1005052885 Less Hazardous Ctqarettes-Goni & Lynch

Table 4,-Critica! Levels of Selected Smoke Constituents' ~ Btand Tar Nfcotine• Carbon Monoxide No. of G4ar.ttes Requlred' NitropenHydro9en Orldee Cyanlde Atuoleln Lowest Row'Entry Hlqheat Row Entry 8enson &Hedges Lights' 9'' 7 4t 4tl 7 4t' 4 9 Cadton 57'•' 40 t6 t6t, 51 17 t6 57 Carlton Menthol 72' 43 23t 45 89 26' 23 72' Decade 16 13 11 9 171. 7t 7 17 Decade Menthol 13 9 10' 9 16"' 8t 6 16' Iceberg 100's 28" 19 8 12 19 8t 6 28' Kant'Golden Lighta'. 10 a St 9 18"' 6: 5 16'. Kent Goldentights Menthol 10 9 8t a 13" 7 6 13' King Sano 15. 21' 4 3t' 10 : 7 3 21 King Sano Menthol 16' 24' 3tl 3t 8 6 3 24 L&M Flavor Lights (Kinq)i 12'. 8t 10 14" 13: 9 8: 14 LdM Long Lights (100's) 13' 9 8 13" 12' 6t tY 13 Lark ll tt• 10 8t~ 7 10 8t 6 11 Lucky 100 28' 2!t', 9 8R 24' 9 8 2& Menf 10, 10" 4 3$ 5' 5 - 3 10 Merii Menthol 10' t0' 6 3t 6 5 3 t0', Newport Lights Menthot' 8f 7 4!tr 6' a 5 4' 8 Now, 45 32' 19 22 51' 17'tI 17' 51 Now,Menthol 48'. 38 22 1811 91' 20 18 91 Pcll Ma11 Extra Mild 17' 13' 8, 7t' 13' 7} 7' 17 Real af 6 4 51 5~ 3t 3! 8 Raal Menthol 11 • 7' st 8'. 6 5I 1 t Stride 28 1Tt' 26 108p >82' 22 17' 108 I TareytonLiqhts, 11 8! 18"' 8t' 1/ 8 tli 18 Tsmpo 12' 11 5' 3t 8i 8 3 12 True 16 13' 9 8t 24-' 9 8 24 I True,Menthot 17 14 sif Bt 19? 8t 8 •19 tLowesttow entry. > '1(lghest row entry. Table 5:-Yieldsof Selected Constituents Concomitent With Yleldlof' f mg Nicotine• Brand No: oR'Ctgaratter Necsssary to Yield I mg Niootine• Tar, m9 Nicotlnr m9 Carbon I Monoxlde. mq Nitrogen lDxldes, p9 HYdfogan Cyanide, µy Acroleln, Ya' Benson & Nedges LigMs 1.2 12.11 1.0 14:5 182' 139 73: Canton e.7 10.1 1:0. 17.4. 22a 107 101 Carlton Menthol. 7.1 • 8.5. 110 14.2 85 85 71 Decade 2.2 12.1 1!0 9:5' 125 108 84 Decade Menthol- 1.4 9.2 ti0 6.2I 85 70 666 keb.ng 100'a 3.1 9.6 L0 17.7' 138 135 130 Kent!Golden Lights 1.4 12.3' t:0 12:9 83 7'1 68 Kent'Golden Lights Minthol 1.5 12.5' 1.0 12.5 107 93 56 King Sano; 3.4 19.7' 1.0 39.4 688t 269 119 Kinq Sano Menthoi 4.0 21.2' 1.0 54.41 820f1 408 17e L&M Flavor Lights (Kin9) 1.3 9a 1.0 BJ2" 52 85' 39- L3'M Long Lights (100's1• 1.5 9.8 1.0 &3' 82 , 104 ' 71 Larx u 11e 12:0' 1.0 11.7 133 134' 70 Lucky' 1001 3.6 11.2 1.0' 9.1 245 122 101 Ment 117 15.0 1.0' 20.8 288 257' 83 Ment Menthol 118 13.4 1.0 18.3 275 224 83 Newport LighH Manthol i 1,2' 12.4 1.0 1'5.0 103 160 ®8 Now 5:3' 10.1 1.0 12.7 133 85 80 NowMenmhol. 8.3. 11.3 1.0 13.2 189: 57 82 Pan.Mail ExtraiMild 2.1 10.7 1.0. 12,2 160: 137 80 Real 1.0' 10.2 1_0 12.9 99 155 7e Real MenthoU 1.2I 9.5 1.0 12.2 101 126 53 Sfnde 2:8~ 9.2 1.0 5.0 14 <28 34 Tareyton Lights 1.4 10.9 1.0 3.6 119 105 43 Tempo 1.8 12.4. 1.0 18.2 299' 170 58' True 2.2 10:8 1.0 11141 15& 75 84 Tiue Manthol 2:4 12.5. 1.0 13.7 154 103 74 Critlea/1V.luec Not'Applicab0a 86.0 e1.0 46.0 540: 820 260 ~= 'Eaeh ealumn also gives eonstituentVnicottne ratio~,For esamp0e; entrles under column headed "Tar" phre tarlmicotine.:ratio.. tEtcceeds critical wehte. JJ1M11'. Sept 15. 1978-Vol 240. Nta.. 12 L'ess.FFazardbus: Cigarettes- Gori & Lynch 1257'

reductions in yields of these b'rands mmpared' with yields of'typical pre- 1980 dgarettes Reductions range from a,high of more tban i9g°,'e (Stride HL4 yield) to a low of 24% (King ;~ Saao Sfenthol'NQ; yield). On the aver- age, the brands under consideration bave bad the greatest percentage : reduction in tar yield (68%) and the least,percentage reduction in CO and N0, yields (69%')'oompared with pre- 1960 cigarettes. The numbers of' these cigarettes smoked daily withont exceeding eriti-. eal levels have been calculated from the data in Tables l and 2, as in the following example: since the eritical -'- level' for all eanses is ; two pre-1960 dgarettes: eath;yielding 48mg of'tar, the number of Bensow & Hedges Lights (101 mg:of tar,each) with the equivalent tar yield is g.S. Thus, g.5 Benson & Hedges Lights have a total tar yield equal to the critical level for the "All causes for current'smokern"' category. a-- Similar values for all of'the b'rand! ~` and constituents considered in this article~are given in Table 4, rounded oS' to the nearest integer. Critical levels were calculated under the assumption of a smoking pattern ttniformly distributed over a ten-hour period for any,gives day. Deviations from such a smoking pattern could' alter some critical values, such asi those associated with CO effects." The lowest entry in each row of' t!j1Table 4 represents the maximum number of cigarettes of that brand that if smoked daily would not exceed thecritical':level forany of'the smoke 'eonstituents considered. The highest row entry represents the maximum number of cigarettes of'thaY brand tliat'if smoked daily would Inot eaceed! at least one of the smoke constituents considered. The range,from highesttoo lowest row entries provides the smok- er with,intermediate goals for grad- aally reducing his smoking habit through progtxssively less hazardous smoking, suges proceeding, in this manner; he would gradually reach the lowest row entry as a daily ma omum cigarette consumption level. At this point, the smoker is likeiy to be more receptive to taking, the final step toward totalicessation." Similar con- siderations apply to brands not'ez- plicitly addressed in this article. If' the majority of smokers proceeded along these lines, it' would be reason- able to predieYa substantial decrease In tobaroo-related morbidity and mortality.. It should be noted from Table 4 that the highest row entries for 14 brands are for tar yields, whereas the lowest row entries for 13 of the brands are for N0; yields. In addition, lowest row entries for nine brands occur for CO and aerolein. These values suggest that the cigarette manufacturers should,coneentrate on the further reduction of ND, yields, while still attempting to reduce further the yields of'other constitu- ents, particul4rly C0'and'acroiein. QV'ith the,introduction of'relatively low nicotine yields, it bas been suggested that' some smokers may compensate by increasing, the total number of ugarettes,smoked to main- taiw a fixed daily level of nicotine intak'e.° The daily intake of' otherr constituents for such a person would depend on the nicotine compensation rate.Table 5' lists the yields of selected smoke constituents eoncomi- tant with the yield of 1 mg of nicotine for the brands under consideration:. For example, for Benson: &' Hedges Lights;,about 1':2'cigarettes yield l,mg of nicotine_. This same number of' cigarettes yields 121 mg of tar, 14.6' mgofCCD;162kgofN0,139agof HCN, and 73 Ng of acrolein. Thus, a smoker compensating to I mg of nico- tine would bei exposed also to these yields of'other smoke constituents: Compensating,to other nicotine val- nes would affect associated yields~ proportionately. Table 5' allows a smoker to estimate his smokeiconstit- nent' intake, depending on his own nicotine compensation rates; The 1 mg,of nicotine yield (one sixth or 17% of'the critical'value)'is aecompanied by an NO, yield that exceeds the criti• cal level for two brands and by a CO yield that exceeds it Sor one of these brands. For the remaining brands, the nicotine intake can exceed 1 mg before eoncomitant yields of other constituents exceed critical values. COMMENT' Prr19i60' cigarettes have contrib- uted most to the current epidemic of tobacco-related diseases„ and epide- miologic studies show a relationship between number ofcigarettes smoked daily and the risk of the development' 1258: JAMA.Sept. 15. 197e-V6i 240. No. L2 ofdisease.,From these studies, we can define the critical Idaily smoke intake that would not appreciably increase the risk of the smoker over that of the nonsmoker. Because different cigarette brands '' deliver different amounts of smoke of' different compositions, this critical smoke intake can be met by smoking ' different numbers of cigarettes, de- pending on brand. Today, cigarettes baving toxic con- " atituent yields considerably below : pre-1960 cigarettes atx feasible, and s== forerunners of such cigarettes are commercially available. Twenty sev `= en brands that: fall into this category i were tested at the Oak Ridge National I-::t,.'j Laboratory, andithe,numb'ers of thesei cigarettes smoked daily without ex- ceeding critical values have been esti- -~~ mated for six major toxic smoke .~_ eonstituents. These critical values : may serve as intermediate goals for a_ smoker who is intent on redhcing his ! smoking habit through progressively ~; less hazardous smoking stages. These calculations are based on ~the assump. -s r tion that the smoker of'the low tar . and nicotine cigarettes will not change his smoking habita in terms of , depth of inhalation, frequency of puffing„ and butt length. Findings of ' recent'studies support this assump- tion." Although the yields for the 27 brands are considerably below the , yields of the typical pre-1960 cigar._,: _ rettes, additional reductions are war- ,_ ranted, particularly with respect to NO., C©, and acrolein. Otherwise, smokers who compensate for fixed e, levels of nicotine intake, even thougb these levels do not exceed vitical' values for nicotine, may be subjecting, themselves to daily intakes of'other toxic smoke constituents in excess of their estimated critical values. Methodslor further reductions in .. yields of toxic smoke constituents have been developed th'rough,research ~ such as that conducted by the Nation- al' Cancer Institute's Smoking, and Health Program:'''One of'the princi- pal objectives of this program is to identify those characteristics of ciga- rettes that leadi to toxic and other adverse effects and to develop rneth- ods forreducing,or eliminating such factors. Progress has been made thus far in improving methods for reduc- ing tar yields ~ through the usa i of Less Hazardous Clparattes-Gori 8 Lynoh.

t . recongtituted tobacco sheet and in reducing nicotine yiel'ds through to- bacco extraction processes and re- I 1/~blending. Other sr.ioke yields have ~, been adjusted through selected cotn- binations of' &lters and' smoke-dilu- tion devices, the use of high-porosity paper, the use of'tobacco blends rich in nitrates, and the adjustment of the eigarette's, burning, rate. Further in.- corporation of'these and other state- of-the-art advances coupled with fta- vor acceptability characteristics can improve commercially available ciga- rettes to the point where they may properly be termed less hazardous. The rationale for developing less, hazardous cigarettes rests on the fact that despite the publicity given to the health risks associated with smoking,, more tha'n 50 million Americans still' smoke. While programs to discourage smoking should continue, these edu- cational efforts should be coupled with others directed' toward reducing the risks to persistent smokers. References ( 1. Smoking and HealtkReport of the.idvimry, Experimental' emphysema: Effects of chronic, Committee to the Surgeon General'of.'tJe'e Public nitrogen dioxide exposure and papain in normal Health Sem.aces, p,ublication,1103. Public Health and pneumoconiotic lungs. Arch Enriron Health ' Service,1'974: 16:51-58:1968: Z' Anderson E1v, Andelman EJ, Str.tuch JM, 9. Hammond' EC: Smoking in, relation to the at aL• Effect of low-level,earbon monoxide expo- death rates on 1 million men and women, in sure on onset and!duration iof, angina pectoris:.A Haenszel W, (edh Epidentioiogicaf .ipproachesYo study in ten patients with ischemic heart the Study of Cancer and Other Diseases, mono• disease..4nn lntern Med 79i46-50, 1973. graph 19.1 Bethesda; Sld, Public Health Serviee, 3. Auerbach 0, Stout:IP, Hammond EID, et aL• National Cancer Institute, 1966, pp 12'1 -204. Histologic changes in esophagus in relation to 10. Kahn HiL The,©ornstudy of smoking and smoking habits. Arch Environ Afealth 11:4-1!5, mortality among US veterans: Report on 8 % 19,65.years of observation. in Haenssel «' (edl: 4. Aronow W& Smoking, nrbon, monoxide, Epidemiological Approaches to the Study of and coronary heart disease. Circulation 46:11i69- Cancer and Other Diseaaes, monograph 19. 1172,1!9?3i Bethesda, Md, Public Health Serviee, National 5 Aronow WS, SWanson, AJ: The effect of' Cancer Institute, 1966. low-nicotine cigarettes on angina pectoris. Ann 1L Krain LS: Crossing of the mortality curves lwtkrn Dfed'fIl:599-601, 1969: for stomach and pancreatio carcinoma.,Lnt,Saro & Doll R, Hill A& Mortality in relation to 57:307-310,1972 smoking: Ten yean' observations of' Bhitish 12 Morrow RC, Suarex G: 3lucosal: changes ' doctors:BrSYedJ1t1460-1467;196LL: ; - and,cancerip:intraoralemoklhg:Laryngoscope, ~ 7. Frautneni JF Jr. Cigarette smoking,°anar ' 81:102A-1028, 1!971: ' 8 Gross P, de Trexilla RTP, Baby.k SiA, atal 14 mat xJC The 19lG'~(a:cwetl repont eanaers of the urinary tsact Geographic varia, 13. 3Vyader.,E~ d!labuehi:K; M7ruehi Zf, et aL tion in the lTaited States.~,J Natl'CancersTmat ;• Epidemio~ogirLOf~'caileer of the'pancreas: :Vatf u:1205-1211. 1968 t': !.•'~tCer° Inat 50:645s 7. 1473.,,• ;- .. Persuading the smoker to wean himself to progressively less hazard- ous cigarettes may provide an alter- native w smoking cessation that is perhaps more effective than the self- denial approaches of current anti- smoking messages. Although this would not eliminate the risks tolthe smoker, it is an approach that has the potential to reduce the current epi- d'emic of smoking-associatedi diseases'o to a considerably less serious'publfic healith, problem. Tobacco,Rep 103:16'-17„ 1976: 15:, Gori GB: Low risk cigarettes: A prescrip. tion Science 194:1'243-1246, 19'+6. 16. Griest WH,- Quincy RB;, Guerin JiW: Selected Constituents in the Smoke of Domestic Low Tar Ciparettes, Oak Ridge National Labora- tory, technical memorandum No. 6144; part 1. Oak Ridge; 11enn, Oak Ridge National Labora- tory; 1971 17: Harris RtiY: How To Keep on Smoking and' Live Lincoln, ylass, Chestnut Publications, 1976. 1'8. Russell r1AH, Wilson C, Patel VA, et aL• Comparisoa of effect on tobacco consumption and carbon monoxide absorption of chang;ng, too high,and,low nicotine cigarettes. Br Al-d J 1:51Y. 1973. 19. Weber KH: Recent changes in tobacco products anditheir acceptance by,the consumer. Ptroceedings of'the 6th International Tobacco Conference, Corestn. Tokyp, 1976, pp 47-63. 20.,Gori G'B: Snwkinp and'IPeatth Prroyramr National Cancer Institute Statua,Rrpont;,Decem. ber l9TJ. Bethesda, 1Id, Public Health Service. National Cancer tnstitute, 19771 JAMA, Sep1 1s, 1978-Vol. 240', No. 12 Less Hazardous Ciqarettes-Gori't{ Lynch 1259.