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An editorial in The Lancet medical journal labelled the 2014 paper an extraordinarily flimsy foundation on which to base the major conclusion of Public Health Englands review

These efforts can all serve to shift public perceptions of the tobacco industry, subtly directing the general public into believing the tobacco industrys pretense that it can be part of the public health solution to end smoking, the authors write

Using culturally-tailored messages and images, tobacco companies began targeting urban, poor, African-American communities through the media from the 1960s, and they cynically used philanthropy to gain favor within communities of color

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Other components that may alter the pyrolysis of amino acids can also change HCA levels in smoke