Federal policy mandating safer cigarettes: a hypothetical simulation of the anticipated population health gains or losses.

If manufacturing a safer cigarette is technically possible--an open question--then mandating that tobacco manufacturers improve the safety of cigarettes would likely have both positive and negative implications for the nation's health. On the one hand, removing toxins may reduce the incidence of smoking-related diseases and premature mortality in smokers. On the other hand, smokers might be less inclined to quit, those who have quit might resume the habit, and youth who have never smoked will have one less reason to avoid tobacco use. To assess the expected population health impacts of a legislative or regulatory mandate, we created the Tobacco Policy Model, a system dynamics computer simulation model. The model relies on secondary data and simulates the U.S. population over time spans as long as 50 years. Our simulation results reveal that even if requiring cigarettes to be safer makes smoking more attractive and increases tobacco use, a net gain in population health is still possible.