Just 40 years ago, the 1964 Surgeon General's Report on Smoking and Health alerted the American public to the health risks of cigarette smoking. It launched a remarkably successful public health campaign that dramatically cut adult smoking prevalence, from 42.4% in 1965 to 22.8% in 2001, and recast the cultural acceptability of tobacco use.1 Less well known is the fact that the cigarette itself has undergone major change in the past 40 years. Today's 46.2 million American smokers buy a product very different from the cigarette sold in 1964.

In the late 1960s, tobacco manufacturers introduced “light” or “low tar” brands that yielded 7-14 mg tar per cigarette, compared to the 22 mg tar of the average cigarette sold at that time.2 Later, “ultralight” brands appeared, with tar yields below 7 mg per cigarette. Today, almost 90% of cigarettes sold in the United States are in these categories.3 Better taste is not the reason why smokers buy light cigarettes. They buy them because they have the misconception that smoking lower tar products reduces their risk of lung cancer and other tobacco-related diseases.4 Advertisements for these …