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CORESTA Congress, Kunming, 2018, Plenary Workshop, APSTW 04

Assessing the impact of tobacco harm reduction

ERKKILA B.E.
Foundation for a Smoke-Free World, DE, U.S.A.

The last decade has seen exponential growth in the number of products on the market as consumers around the globe transition away from traditional cigarettes. However, instead of sitting back and waiting for the public health gains to roll in, it is necessary that we predict, and hopefully shape, what the landscape may look like in the future. In the absence of the quantity and quality of long-term epidemiological data that exists for cigarettes, we must drive the innovation of validated signals of harm from emerging products and apply established risk assessment techniques to their evaluation. The fitness of existing biomarkers and a process for the efficient development and qualification of novel biomarkers should involve coordination between industry, academia, and regulators, and draw from best practices in the pharmaceutical arena. The practice of human health risk assessment is a quantitative method to predict the potential harm from an agent, it is often used by regulatory agencies to set standards for consumer products as well as environmental and occupational exposures. The nascent field of tobacco product risk assessment has evolved over recent years, but we are far from consensus on the appropriate methods, inputs, assumptions, and interpretation of the relative and absolute risks. Continuing dialogue amongst parties with relevant experience, including regulators, academics, industry scientists, and the greater public health community will inform standardization of methods as well as identify and resolve existing data gaps. In addition, robust study into best practices for communicating relative and absolute risk to the consumer are paramount to the continued uptake of emerging products. We cannot assume that innovation for innovation’s sake will ultimately lead to significant public health gains, there must be continued vigilance and dialogue to ensure that harm reduction products deliver on their promise.