Reduction of tobacco health hazards in continuing users: individual behavioral and public health approaches.

For those smokers who will not stop using tobacco, methods are discussed for reducing the risks to health of continued tobacco use. Overall, tobacco users are encouraged to reduce their exposure to tobacco toxins as much as they can tolerate. The boundary model of nicotine regulation implies that it is practical to prevent so-called "needless" excesses of nicotine intake. For continuing smokers of cigarettes, fewer cigarettes per day and very-low-tar cigarettes are encouraged, provided filter-vents are not blocked by the smoker. Better yet would be a switch to smoking one or two non-inhaled pipes or cigars each day. Even better would be a switch to use of the minimum acceptable amount of smokeless tobacco or nicotine-containing gum. Of course, the best course would be abstinence from any form of tobacco or nicotine use. Since relatively few tobacco users voluntarily engage in substantially less hazardous ways of using tobacco, public health measures (e.g., social restrictions, differential taxation, changes in package size) may be the most important means of bringing about less hazardous tobacco use among continuing users.