It is such a long report I left bit out..here is the conclusion
The tobacco industry is continuing to evolve and adaptto new regulations on tobacco products, a decliningdomestic cigarette market, and growing internationalcigarette business (25). Perhaps the most interestingrecent development has been the rapid growth of elec-tronic cigarettes. What started out as a novelty sold pri-marily on the Internet has quickly grown into a billiondollar a year enterprise pushing cigarette makers toenlarge their offerings (47). In 2008, RJ Reynolds (nowReynolds American, Inc.) acquired the Conwood Smoke-less Tobacco Company and gave that entity a new name:the American Snuff Company. In 2009, Reynoldslaunched Camel Snus, a pouch-like device for sucking inthe mouth, and the following year introduced Cameldissolvable tobacco orbs and sticks. Reynolds has alsoacquired the rights to market Zonnic nicotine replacementproducts and purchased Niconovum AB, a Swedish com-pany making oral nicotine replacement therapies. And in2013, Reynolds began test marketing a new electroniccigarette ("Vuse") complete with the company’s first tele-vision ads since the 1970s.Meanwhile Lorillard, makers of Newport cigarettes, in2012 acquired Blu Electronic Cigarettes, a leading manu-facturer of cigarettes designed to be "vaped" rather than"smoked." And Philip Morris has entered this territory.The company in 2003 changed its name to Altria, and inCummings and ProctorCancer Epidemiol Biomarkers Prev; 23(1) January 2014Cancer Epidemiology, Biomarkers & Prevention34on March 6, 2016. © 2014 American Association for Cancer Research. cebp.aacrjournals.org Downloaded from
2009 acquired the US Smokeless Tobacco Company.Shortly thereafter, Altria began marketing Marlboro Snusalong with other smokeless products such as Skoal andCopenhagen in the United States, while devoting anincreasing share of resources to its business overseas. Andin 2013, Phillip Morris announced that it, too, wouldintroduce its own electronic cigarette, the "Mark Ten."Although some predictions have cigarette consumptiondropping to near trivial levels in the United States over thenext half century, the trend in other parts of the world islessencouraging (25). Cigarette consumption isincreasingin many low- and middle-income countries as cigarettemanufacturers have shifted much of their marketing,promotion, and production into these emerging econo-mies. Smoking remains the leading cause of preventableillness and premature death in most parts of the world,killing approximately 6 million people every year (48).Especially in developing nations, cigarette use is stillperceived as a rite of passage into adulthood and anordinary and noncontroversial behavior for adults, espe-cially males (49).The global effort to reduce the burden of tobacco usehas been aided by the Framework Convention on Tobac-co Control (FCTC), the first global health treaty, nego-tiated under the auspices of the World Health Organi-zation (50). The FCTC has been ratified by more than 170countries, though the United States has yet to join in.Ratification of the treaty obligates countries to imple-ment a comprehensive set of policies, including highertaxes, effective health warning labels, and smoke-freepolicies (50). The tobacco industry continues to workagainst efforts by governments to adopt policies thatwill effectively limit cigarette marketing and protectpublic health (51).It is more critical than ever that the medical and publichealth community adopt evidence-based guidelines toensure that governments implement the kinds of policiesand programs that will be effective in reducing tobaccouse. Interventions to reduce tobacco use will need toevolve in the future to reflect shifting public attitudes andinnovations by the industry to adjust to a changing reg-ulatory environment. Increasing attention should also begiven to more imaginative "endgame" strategies thatenvision a world entirely free of tobacco (4, 46, 52). Cig-arette smoking as we have known it had a historicalbeginning, and at some point will hopefully come to anend.Disclosure of Potential Conflicts of InterestK.M. Cummings and R.N. Proctor have served in the past and continueto serve as paid expert witnesses for plaintiffs in litigation against the
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