Bates C. Taking the nicotine out of cigarettes - why it is a bad idea. Bulletin of the World Health Organization 2000; 78: 944.

“If removing nicotine will not work, what is the alternative? . . . . Regulators should be concentrating on cleaning up the delivery system, and tending to increase the amount of nicotine in the smoke relative to toxic smoke constituents such as tar and carbon monoxide. Regulatory pressure may be used to force selective reduction of tobacco toxins relative to nicotine by the use of chemically active filters, a switch from burning to heating tobacco, and greater use of oral tobacco, tobacco distillates and perhaps, ultimately, to nicotine delivery devices that do not use tobacco at all but, unlike current nicotine replacement therapies (patches and gum, etc.), deliver a psychoactive and satisfying dose of nicotine to the addict. None of these approaches avoids all harm – far from it – but the evolution (rather than prohibition) of addictive nicotine delivery products represents an important strategy in reducing tobacco-related deaths in the 21st century.”


Ramström L. Snuff – an alternative nicotine delivery system. In: Ferrence R, Slade J, Room R, Pope M (eds.). Nicotine and public health. The American Public Health Foundation, Washington D.C., 2000; Chapter 9: 159-178.

“If snuff dipping had been a major contributor to oral cancer, Sweden’s high levels of snuff dipping in the late 1960s and later should have been reflected in high death rates for oral cancer about 1990 compared with other countries. Instead, Sweden has lower rates for male oral cancer than [Canada, Denmark, France, Ireland, and the U.S.A.].” (p. 169).

“While snuff use may entail some health risks, there is good evidence that these are substantially lower than those associated with smoking. Switching from smoking to snuff use would therefore represent a reduction in health risks.” (p. 172).


Sweanor DT. Is it the nicotine or the tobacco? Bulletin of the World Health Organization 2000; 78: 943.

“[L]ess deadly tobacco products should have regulatory advantages over the most deadly products. Tobacco products that do not require combustion (such as the ‘snus’ sold in Sweden) offer clear advantages.”

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