This memo urges USPSTF to expand their consideration of options for smoking cessation to include tobacco harm reduction, alternative health education interventions not involving use of pharmaceuticals, and to address issues raised by e-cigarettes. Available evidence suggests that, for many hard-core smokers, THR may be far more effective than currently endorsed smoking cessation protocols. Since the main argument against THR is the assumption that THR cannot be implemented without recruiting large numbers of teen non-smokers to tobacco use, USPSTF is also urged to review the degree to which e-cigarettes, as a THR modality, is attractive to teen non-smokers.

Rather than continuing to rely on pharmaceutical products as the major intervention for smoking cessation, the USPSTF should play a leadership role in encouraging research and implementation of cessation options that promise to be far more effective.