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Cigarettes kill, but it's not the nicotine or the tobacco. It's the smoke!

Nearly everyone knows that smoking is unhealthy, but a lot of people continue to smoke to get nicotine from tobacco. Few people realize that it is the smoke, not the nicotine or the tobacco that is actually unhealthy. The dominant message to smokers is that they must quit or die; that there are no other options. But this is simply not true. There are other options for people who cannot or will not stop using nicotine.

Reduce the harm: Go smoke free.

Using modern smokeless tobacco products can reduce the risks of tobacco use by around 99% compared to smoking. These products include moist snuff (which is sometimes called by its Swedish name, snus), chewing tobacco, and lozenges. And you do not have to chew or spit - many modern products require no spitting and are as easy to use as a breath mint. Or try switching to electronic cigarettes which deliver a vaporized nicotine which looks and feels like smoke but does not actually involve any smoke, and thus avoids the terrible health effects of breathing smoke. Of course, you can also try pharmaceutical nicotine products, but unfortunately the available nicotine patches and gums are not designed to be good long-term alternatives to tobacco.

Switching from cigarettes to smokeless tobacco is a proven way to lower your risk -- it is almost as good for you as quitting entirely. Switching to electronic cigarettes or pharmaceutical nicotine products is almost certainly as good.

Public health is all about harm reduction

Suggesting that smokers have options other than quitting entirely is controversial, but it should not be. Almost all of public health is devoted to reducing risks and harms, not eliminating them entirely. The term "harm reduction" is most often used in the context of clean needles for injection drug users, or using condoms to make sex safer. But we think the best analogy is seatbelts. Instead of telling people that they should just quit driving, we try to make cars and roads as safe as possible. Similarly, we do not tell people to quit playing hockey or bicycling, but we try to get them to wear helmets.

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Unfortunately, smoking and tobacco policy is controlled by people who are not trying to improve people's health, but just want to eliminate tobacco and nicotine use. They take the extreme position that regardless of the benefits people get from nicotine, and regardless of the actual health risks, that all tobacco use should be eliminated. These anti-tobacco extremists would rather have tens of millions of people make themselves miserable trying, and usually failing, to quit smoking, rather than to admit that switching to other sources of nicotine might be a good solution for some of those smokers.

Of course, this does not mean that someone who does not use nicotine should start. It is easier, cheaper, and a bit healthier to avoid nicotine altogether. But if you like nicotine, smoking tobacco is the worst way of getting it. Switching from cigarettes to smokeless tobacco or pharmaceutical nicotine is almost certainly as good as quitting entirely, switching to electronic cigarettes might be just as good, and any of these are certainly much better than trying to quit and failing.

Even if you plan to quit nicotine entirely someday, switching now is a good idea. Each cigarette you smoke could be the one that kills you. If you switch to a low-risk alternative now, you dramatically lower your health risks and can still quit entirely later. Indeed, for many people it appears that quitting after switching to the alternative products is easier than just quitting smoking.

Ok, I'm convinced. What do I do next?

If you decide to try switching to a low-risk alternative to smoking (or quitting entirely), the sooner your do it, the better. However, do not hold yourself to unrealistic goals and give up if you cannot reach them. Some people who switch, do it overnight. Others find themselves gradually shifting from one product to another, still having the occasional cigarette. So, if it takes a while to become used to the new product be patient. Switching slowly is still a lot healthier than not switching at all, and big lifestyle changes can take time.

Do not assume that the new experience will be exactly the same as smoking. Some former smokers find smokeless tobacco or e-cigarettes to be better than smoking because they are satisfying, more convenient, and often cheaper. However, many former smokers never like the alternatives as much, so do not assume that you will find a perfect substitute. Just keep this in mind: You have a pretty good substitute that is very unlikely to kill you. Isn't giving up a bit of satisfaction worth it for the health benefits?

Be sure to try different products if you do not like the first one you try. Smokeless tobacco is the most proven substitute, and maintains some of the taste and smell of smoked tobacco. But the new e-cigarettes are much more similar to the smoking experience. If you want to minimize other experiences and just get the nicotine, a patch or an oral dissolvable product might be right for you.

Finding the low-risk alternative products might be easy or difficult depending on where you live. In North America, almost every store that sells cigarettes also sells smokeless tobacco. Electronic cigarettes are more difficult to find, and may have to be ordered over the internet. For more about e-cigarettes and how to get them see our electronic cigarettes FAQ.

This website is operated by university professors and other public health experts who are concerned about improving people's health and well being. We are not so naive to think that everyone is just going to quit using nicotine and with that in mind we are working at finding and promoting actions that reduce the associated health risks. We also do not think it is acceptable to lie to manipulate people's behavior, or fair to just punish smokers with new taxes and regulations. By telling the truth about nicotine and tobacco we can help smokers rather than punishing them.

The anti-tobacco extremist position kills many smokers for whom "just say no" is not an option, but switching is. They do this by lying to people to prevent them from learning about the huge benefits of switching. Now that you know the truth, you might be able to save yourself or others from dying from smoking.

Smokers have more choices than just quitting or dying.