Objective: To investigate community tobacco control leaders' attitudes toward harm reduction approaches to tobacco use, in order to assess benefits and risks associated with these strategies. Design: Cross sectional design involving qualitative outcomes from nine structured focus groups. Subjects: 47 community tobacco control leaders in Minnesota working in the areas of public policy, clinical treatment of nicotine dependence and youth development participated. Outcome measures: Participants discussed definitions of harm reduction; benefits and risks of harm reduction methods; and how funds for tobacco control research and programmes should be allocated. Results: Results indicated inconsistency about the definition of harm reduction: most groups included a broad range of strategies that extended beyond those typically referenced in the scientific literature. Many participants stated that harm reduction might be beneficial, particularly for smokers who could not or would not quit. However, most also expressed concern about a number of risks, including delivering a mixed message about tobacco, inadvertently benefiting the tobacco industry, and causing unanticipated negative health effects. Participants were inclined to suggest public policy measures (for example, smoking bans, increased taxes) as means for reducing harm. Conclusions: Results indicate that even among tobacco control leaders there is a need for common terminology to describe harm reduction approaches and that public policy approaches to harm reduction are considered more dependable than strategies that involve pharmaceutical treatment or rely on the tobacco industry, such as product modification.