The broader availability and promotion of effective treatments for tobacco dependence, specifically nicotine gum and patch, increase the number of smokers availing themselves of the medications. This increased use is estimated to contribute substantially to the number of former smokers in the United States.

The goal of tobacco control has always been to reduce death and disease due to tobacco use. Recent discussions have broadened the concept of tobacco control beyond cessation and prevention to include concepts such as the use of medications to achieve reduction in tobacco use, chemoprevention to reduce disease, modifications of tobacco products to reduce toxicity, and behavioral approaches to change smoking and tobacco use behavior. Within each of these broad domains, diverse approaches have been suggested. To facilitate clear discussion and analysis, and to avoid confusion among approaches, we catalog 19 approaches to harm reduction, distinguishing and discussing them on 11 dimensions, including their objectives, mechanisms, toxicology, expected population risks, and consumer appeal. Because there have also been so many suggested applications of medicinal nicotine to smoking intervention, we separately catalog and analyze nine applications, some of which constitute new approaches to harm reduction. The suggested framework is intended to clarify the debate, provide for common nomenclature, and facilitate analysis of diverse approaches to tobacco harm reduction.

A great deal is now known about the prevalence and natural history of adolescent smoking. The literature on smoking intervention, drawn from theoretically based experiments, shows that most programs are unlikely to become widely disseminated because of the extensive resources required. More thoughtful strategies for research and targeting of interventions are examined. They may yield coordinated and comprehensive approaches to moving more quickly and effectively from the behavioral laboratory into the field.

No abstract

A random sample of employees was surveyed 20 months after a non-smoking policy was implemented at the New England Telephone Company in 1986. Overall, 21 percent of respondents who were smoking at the time they heard about the policy had quit smoking; 42 percent of quitters said they stopped smoking because of the policy. Cessation was highest among those who reported less smoke in their work area, but was not related to participation in cessation programs. This study suggests that worksite nonsmoking policies may have favorable effects on smoking cessation.