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David Sweanor has played a global role in steering the World Health Organization, governments and nongovernmental organizations to use the most powerful interventions they have to end smoking. His focus on policy measures to reduce the carnage from cigarette smoking, including a leading role on excise taxes, marketing restrictions and smoke-free policies, has long included tobacco harm reduction (THR). And in the process, Sweanor has highlighted the need to move from blunt approaches to all tobacco products to a system that regulates products proportionate to their risk. In a recent conversation, Sweanor discussed the origins of innovation in THR.