Background: The WHO Framework Convention on Tobacco Control includes provisions for testing and regulating cigarette emissions. However, the current international standard for generating cigarette emissions--the ISO machine smoking regime--is widely acknowledged to be inappropriate for purposes of setting regulatory restrictions.
Objective: To review alternatives to the ISO machine smoking regime and the extent to which they: 1) Represent human smoking behaviour, 2) Reduce the potential for industry exploitation, particularly in the area of risk communication, and 3) Serve as suitable measures for product regulation.
Methods: Emissions data from 238 Canadian cigarette brands tested under the ISO and "Canadian Intense" machine smoking regimes.
Results: None of the alternative smoking regimes, including the Canadian Intense method, are more "representative" of human smoking behaviour and none provide better predictors of human exposure.
Conclusions: Given that alternatives such as the Canadian Intense regime are subject to the same fundamental limitations as the ISO regime, key questions need to be addressed before any smoking regime should be used to set regulatory limits on smoke emissions. In the meantime, regulators should remove quantitative emission values from cigarette packages and more work should be done on alternative machine smoking methods.