public. As derived from the elements of an ideal surveillance system noted in the introduction to this chapter, and existing surveillance activities noted above, the following are suggestions for new or enhanced components to these existing activities.

Consumption of Tobacco Products and PREPs

State and regional information on the consumption of various products would provide useful information, especially if reported on a monthly or quarterly basis. In addition, future reporting systems that include PREPs may also need to be based on milligrams of nicotine consumed per product, as pounds of tobacco may become a less complete marker of consumption.

Specific Tobacco Constituents of Both the Products and the Smoke They Generate

At the time of PREP and other new product release, there should be detailed, manufacturer-derived information on important and major physical and chemical constituents of all tobacco products, including additives and the structural components of the products, such as filters, fibers, and fragments of fibers. Some independent postmarketing monitoring of product constituents may be necessary to ensure that changes are known to the public and the scientific community. For example, a recent letter from the Commissioner of the Massachusetts Department of Public Health to the Chairman of the Federal Trade Commission (Koh, 2000) highlighted the need for such monitoring. Koh points out that R.J. Reynolds’ Eclipse product produced higher concentrations of toxic chemicals in 2000 than in 1996, suggesting that consumers would need to be informed of the added dangers from the 2000 version of the product. More details and specific recommendations can be found in Chapter 7, Implementation of a Science-Based Policy of Harm Reduction.

Product constituents can be influenced by agricultural and manufacturing practices. There is currently no systematic surveillance of agricultural practices or curing processes that can influence levels of undesirable constituents (e.g., tobacco-specific nitrosamines), as well as new breeds or hybrids (including genetically-altered) of tobacco that may have implications for human health. Hence, there should be enhanced monitoring of tobacco agricultural practices. General data on the types and amounts of tobacco harvested, as well as curing and processing practices would assist in identifying new and existing potentially undesirable constituents (e.g., tobacco-specific nitrosamines), as well as new breeds or hybrids (including those genetically altered) of tobacco that may have implications for



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