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Int. J. Environ. Res. Public Health 2009, 6(1), 10-24; doi:10.3390/ijerph6010010
Review

Is Smokeless Tobacco Use an Appropriate Public Health Strategy for Reducing Societal Harm from Cigarette Smoking?

1,* , 2
 and 3
1 University of Florida College of Dentistry, Gainesville, 1329 SW 16th Street, Suite 5180 P.O. Box 103628, Gainesville, FL 32610-3628 USA FL, USA 2 University of Wisconsin Comprehensive Cancer Center, #385 Warf Office Building, 610 Walnut Street, Madison, WI 53726 USA 3 Oregon Research Institute, 1715 Franklin Blvd., Eugene, OR 97403 USA
* Author to whom correspondence should be addressed.
Received: 22 November 2008 / Accepted: 20 December 2008 / Published: 23 December 2008
(This article belongs to the Special Issue Smoking and Tobacco Control)
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Abstract

Four arguments have been used to support smokeless tobacco (ST) for harm reduction: (1) Switching from cigarettes to ST would reduce health risks; (2) ST is effective for smoking cessation; (3) ST is an effective nicotine maintenance product; and (4) ST is not a “gateway” for cigarette smoking. There is little evidence to support the first three arguments and most evidence suggests that ST is a gateway for cigarette smoking. There are ethical challenges to promoting ST use. Based on the precautionary principle, the burden of proof is on proponents to provide evidence to support their position; such evidence is lacking.
Keywords: Smokeless tobacco; harm reduction; smoking cessation; smoking initiation Smokeless tobacco; harm reduction; smoking cessation; smoking initiation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Tomar, S.L.; Fox, B.J.; Severson, H.H. Is Smokeless Tobacco Use an Appropriate Public Health Strategy for Reducing Societal Harm from Cigarette Smoking? Int. J. Environ. Res. Public Health 2009, 6, 10-24.

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Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert