TABLE OF CONTENTS
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Foreword by Sally Satel, MD ------ 01Executive Summary ------ 02Introduction ------ 02Cigarette Smoking:It's Even Deadlier Than You Think ------ 03Nicotine: Addictive But Not Deadly ------ 03Smoking Cessation vs. Harm Reduction ------ 04Smokeless Tobacco Products ------ 04Health Effects of Smokeless Tobacco ------ 05Does Switching to Smokeless Tobacco Work? ------ 06Health Policy Questions ------ 06Conclusions and Recommendations ------ 08Appendix:Examples of Smokeless Tobacco Products ------ 09
This manuscript is a position statement of the American Council onScience and Health. The author gratefully acknowledges the assis-tance of the following ACSH staff who provided critical reviews ofcontent and perspective, especially with regard to the policy sec-tions of the report.Scott D. Ballin, JDTobacco and Health PolicyConsultantWashington, DCClive BatesFormer Director (1997-2003),Action on Smoking and Health,UKLondon, United KingdomRonald W. Brecher, PhD, DABT,CChemPrincipal, Globaltox: ToxicologyFocused SolutionsGuelph, ON, CanadaEmil William Chynn, MD, FACS,MBAMedical Director,IWANT2020.com, Inc.New York, NYMichael Dubick, PhDSenior ResearchPharmacologist, US ArmyInstitute of Surgical ResearchSan Antonio, TXDwight B. Heath, PhDDepartment of Anthropology,Brown UniversityProvidence, RIRudolph J. Jaeger,PhD, DABT,REA(California)Consulting Toxicologist,Environmental Medicine Inc.Westwood, NJMichael Kunze, DrMedProfessor, Institute of SocialMedicine, Medical UniversityViennaVienna, AustriaCarl V. Phillips, PhDAssociate Professor, Universityof Alberta School of PublicHealthEdmonton, AB, CanadaLars M. Ramstrom, PhDDirector, Institute for TobaccoStudiesStockholm, SwedenWilliam O. Robertson, MDMedical Director,WashingtonPoison CenterSeattle, WADavid Schottenfeld, MDProfessor Emeritus, School ofPublic Health, University ofMichiganAnn Arbor, MIPeter G. Shields, MDProf. Medicine/Oncology, Dir.Cancer Genetics/Epidemiology,Georgetown Washington, DCRobert B. Sklaroff, MDElkins Park, PAJacob SullumSenior Editor, ReasonDallas, TXDavid T.Sweanor,BA(Hon),LLBAdjunct Professor of Law andMedicine, University of OttawaOttawa, ON, CanadaJohn W. Waterbor, MD, DrPHAssociate Professor ofEpidemiology,University ofAlabama at BirminghamBirmingham, ALElizabeth M. Whelan, ScD, MPHPresident and FounderGilbert Ross, MDMedical/Executive DirectorThe author also gratefully acknowledges the following individuals,who provided peer reviews, critical analysis, commentary, and sug-gestions during the development of this review,and whose nameshave been listed with their permission: