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September 11, 1981

The Health Consequences of Smoking: The Changing Cigarette

JAMA. 1981;246(11):1257. doi:10.1001/jama.1981.03320110061035

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The major point of this well-written 14th report of the Public Health Service on the health consequences of smoking is that there is no such thing as a safe—or even safer— cigarette, notwithstanding advertising claims to the contrary. In essence, it is not so much what is in a cigarette that causes the multifarious health problems—and there are more than 2,200 known compounds in the smoke—but the fact that cigarette smoking in any form can cause great harm. Switching from a "high-tar" to a "low-tar" brand is, in the words of a recent advertisement of Great Britain's Health Education Council, "like jumping from the 36th floor instead of the 39th."

A key term is what the report calls "compensatory smoking," ie, if a smoker compensates for reduced tar yield by increasing the number of cigarettes, the depth of inhalation, or the volume or frequency of puffs, a reduction in tar