We appreciate the thoughtful comments and concerns of Giovino, who was intimately involved in the Institute of Medicine’s (IOM’s) assessment of the scientific basis for tobacco harm reduction. We did not state, nor did we intend to imply, that the IOM report was primarily about less hazardous cigarettes. Further, we took care to describe the report as “endorsing harm reduction only ‘as a component of a comprehensive national tobacco control program that emphasizes abstinence-oriented prevention and treatment.’ ”
We recognize that the term “safer cigarette” is problematic. But our purpose in the article was to analyze the historical evolution of public health thinking about “safer” products. The belief that such products were possible was central to that history, as was the use of the term “safer cigarettes.”
We believe that others who, like us, are interested in how broadly the public health community defines harm reduction in the coming years and what place tobacco products will occupy within that framework will appropriately read the IOM report as stating the need to face squarely the challenge of tobacco-based products.