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In Norway, snus (low nitrosamine smokeless tobacco) is allowed to compete with cigarettes for market share, and over the past decades the prevalence of snus users has increased as the prevalence of smokers has decreased. The author has aimed to sum up the findings from research that has tried to identify the role of snus in smoking cessation and how availability to snus in Norway has affected the magnitude of concomitant use of snus and cigarettes.

Relevant results from Norwegian studies are presented, and, if possible, compared to findings from studies conducted in other countries.

Snus is reported by ever‐smokers to be the most preferred method for quitting, and former smokers make up the largest segment of Norwegian snus users. The quit rate for smoking is consistently observed to be higher for snus users than for smokers who have no experience of use of snus. Moreover, those using snus are more likely to have quit smoking completely or considerably reduced their cigarette smoking than users of medicinal smoking cessation products. The increase in snus use among men in Norway has not been paralleled by an increase in dual use of snus and cigarettes.

The results observed in Norway might not be extrapolated to other countries that do not have the same history of use of snus.

The replacement of cigarettes by snus has been the most typical pattern of use in Norway, and the availability of snus may have been beneficial to public health.

Besides neighbouring Sweden, Norway is the only country in the eurozone with a tradition of snus use. Knowledge about the pattern of snus use in these countries is relevant for policymakers when deciding the legal status of snus in the EU.

This paper aims to analyse Swedish tobacco policy, especially in relation to EU tobacco regulation. The paper also seeks to review the arguments and the scientific support presented in the debate around Swedish snus, setting it in the context of future EU regulation on tobacco.

The article draws on previous research, official documents and newspaper articles to examine tobacco policy development on a national and EU level.

The paper shows that the so‐called Swedish experience has led to a somewhat ambivalent political attitude towards tobacco policy. The Swedish case of snus also demonstrates the EU as a political and regulatory force in national policymaking and how different economic and political interests are using scientifically based arguments to advance goals of their own. The paper argues that political measures are dictated by ideology and political considerations, which are themselves supported by ambiguous scientific results. Harm reduction is used as a political tool in a debate which extends well beyond public health concerns.

This paper contributes to research on tobacco policy in general and on Swedish snus in particular. The paper also puts the snus question in a broader context of national public health policy and EU regulation.

Health promotion strategies often attempt to change people’s behavior through targeting their risk perceptions. These perceptions may, however, be moderated by other factors. This study therefore aimed at investigating the trustworthiness and consistency of risk information, as well as respondent perceptions of the adequacy of amount received among a representative sample of former smokers, and how this information is related to gender, age, education level and whether using nicotine or not.

The respondents are part of a seven-year follow-up of former smokers in Sweden. Initially, 1400 respondents were contacted, whereof 705 (response rate 50%) answered a Web-survey. The majority (85 %) was still nicotine-free but some made use of nicotine in different forms. The data analysis includes descriptive statistics and logistic regressions.

Most respondents trusted risk information whether offered by the public authorities or came from other sources such as media, and generally perceived that there was an adequate amount. However, there were some differences between the products, where quite a few distrusted information on Nicotine Replacement Therapies (NRTs) and some perceived the information on snus and NRTs as contradictory and too little.

Knowledge about how former smokers perceive information regarding negative aspects of cigarette use may facilitate more effective risk communication with current smokers, and it may also be important for communicating information about other nicotine products to those who are trying to or who already have quit smoking.

The paper aims to describe the public health potential and legal status of electronic cigarettes (e‐cigarettes) and Swedish snus. The author evaluates claims made for and against tobacco harm reduction.

The author presents the scientific evidence for tobacco harm reduction and evaluates competing claims.

The legal status of cigarettes, e‐cigarettes and snus in many jurisdictions is not commensurate with their respective risk profiles. The prohibition of the least hazardous forms of nicotine delivery is not based on any coherent regulatory pyramid and can only be explained by the hostility of some anti‐smoking campaigners towards tobacco harm reduction.

The paper uses the most recent data available at the time of publication in its analysis of a rapidly growing market and a volatile regulatory environment.

This paper aims to overview the need for tobacco harm reduction, the consumer products that facilitate tobacco harm reduction and the barriers to its implementation. The worldwide endemic of tobacco smoking results in the death of over seven million smokers a year. Cigarette quit rates are very low, from 3%–12%, and relapse rates are high, from 75%–80% in the first six months and 30%–40% even after one year of abstinence. In addition, some smokers do not desire to quit. Cigarette substitution in tobacco harm reduction is one strategy that may reduce the burden of morbidity and mortality.

This review examines the displacement of smoking through substitution of non-combustible low-risk products such as snus, heated tobacco products and e-cigarettes.

Toxicological testing, population studies, clinical trials and randomized controlled trials demonstrate the potential reductions in exposures for smokers. Many barriers impede the implementation of product substitution in tobacco harm reduction. These products have been subjected to regulatory bans and heavy taxation and are rejected by smokers and society based on misperceptions about nicotine, sensational media headlines and unsubstantiated fears of youth addiction. These barriers will need to be addressed if tobacco harm reduction is to make the maximum impact on the tobacco endemic.

This review provides the rationale for tobacco harm reduction, evaluates the current products available and identifies the barriers to implementation.

Despite substantial declines in cigarette smoking in England since the 1970s, around 20 per cent of the adult population still smokes. In Sweden, 10 per cent of adult males and 12 per cent of adult females smoke cigarettes, while snus use is prevalent among 19 per cent of adult males and 4 per cent of adult females. Traditional cessation‐only approaches may need to be supplemented with broader tobacco harm reduction measures to reduce smoking prevalence further. General practitioners (GPs) are well placed to give patients advice on tobacco harm reduction. This paper seeks to address these issues.

The authors administered an online survey to assess knowledge, perceptions and attitudes to tobacco and nicotine products to 220 GPs (100 in England and 120 in Sweden).

Most GPs (96 [96 per cent] England, 115 [98 per cent] Sweden) addressed smoking cessation with patients as part of their regular practice. Most GPs (87 [87 per cent] England, 102 [85 per cent] Sweden) felt extremely or fairly knowledgeable about the risks associated with cigarettes, but less so about nicotine in tobacco products and pharmaceutical nicotine. When asked to rank various products on a risk continuum, GPs rated cigarettes as riskiest and tobacco cessation and nicotine‐containing products as least risky. However, when asked to rank components of cigarettes based on their health risks, GPs ranked nicotine as the third riskiest (74 [74 per cent] England, 104 [87 per cent] Sweden), after tar and carbon monoxide, but before smoke or tobacco. When asked questions about a hypothetical nicotine replacement therapy (NRT) product that looks like a cigarette and is licensed for harm reduction, GPs perceived that sensory experience and tobacco harm reduction could be benefits to patients, but perceived appeal to children and risk for abuse could be drawbacks.

Most respondent GPs are well informed about the relative risks of nicotine and tobacco, but more research needs to be done to investigate their concerns over the long‐term substitution of cigarettes with alternative nicotine products.

Discusses the findings of a study investigating the attitudes, perceptions and experiences of Scottish non‐profit environmental organisations and the costs and benefits of the Internet as a marketing and communications tool. Aims to ascertain whether the size of the organisation and the level of Internet use determines the perceptions and beliefs of non‐profit organisations within the environmental sector in Scotland and whether these factors also determines the costs and benefits experienced by Internet users. Finds that regardless of size or the level of use, organisations believe the Internet is a cost‐effective way to market their organisations and promote awareness. However, attitudinal factors affect the level of use by small organisations. Overall the organisations within the sample have indicated that the Internet is a low cost, high benefit marketing solution.

This paper aims to examine preferences for different smoking cessation tools, investigates smokers’ perceptions of these tools by examining their brand personalities and determines whether these perceptions predict intentions to use particular cessation tools.

Two surveys of smokers evaluated cessation tools from electronic cigarettes to hypnosis.

Smokers showed a strong preference for electronic cigarettes over other cessation tools. Different aspects of brand personality predicted intention to use different cessation tools.

The research used online surveys rather than real purchasing behavior. The results indicate that advertisements emphasizing the personality attributes of different cessation tools could be effective in encouraging the use of appropriate cessation tools.

If research validates e-cigarettes as a valuable cigarette smoking cessation tool, then public service advertisements encouraging their use should emphasize their sincerity and excitement. If e-cigarettes have a net negative effect on public health, public service advertising should stress that the marketing of e-cigarettes is not sincere.

This research extends the idea of brand personality, showing how it can encourage behavior that promotes public health goals.

To a great extent research about smoking cessation has focussed on effects from different support programs and means, in spite of that several studies have shown that over 90 percent quit smoking without such help. Factors that are important for the individual in the process from being a smoker to becoming smoke-free is less examined and also how these factors interact. The purpose of this paper is to describe typical careers or pathways that end up with a successful smoking cessation.

Respondents were recruited during Oct 2009-May 2010 via screening-questions in the so-called Monitor – project. By the turn of each month 1,500 individuals, aged 16-84, from a representative sample in the Swedish population, were interviewed via telephone. Respondents who stated being previous daily smokers, but smoke-free for at least 12 months, and agreed to participate were asked to answer a postal survey (n=1,683) concerning their process to a smoke-free life. The analyses of data included the linking of individuals between different states in the stages toward becoming smoke-free.

Several typical pathways were described and respondents with more severe smoking habits followed different pathways than individuals with milder problems. Nicotine replacement therapys or Swedish smoke-free tobacco was not found to be a component in any of the typical pathways.

Smoking cessation is a heterogeneous phenomenon and individuals can follow several pathways to become smoke-free, therefore this study adds to a more nuanced picture of smoking cessation and also expands the knowledge concerning smoking cessation in individual long-term processes.

This paper aims to provide a brief summary of the effectiveness and efficacy of tobacco harm reduction (THR). THR is the substitution for cigarettes of low‐risk alternatives, including Swedish or American‐style smokeless tobacco, pharmaceutical nicotine products, and electronic cigarettes. The paper then very briefly summarizes the current social and political situation regarding THR.

This paper is a review of the evidence.

The risk from smoke‐free tobacco/nicotine products is so low as to be unmeasurable. For most smokers, adopting THR is a lower risk option than to trying to become nicotine abstinent. THR products have been widely adopted in some populations, providing great public health benefits. There is currently an explosion of interest in electronic cigarettes. However, THR is a threat to the business model of the tobacco control industry, and so they are fighting hard to discourage it. Because they cannot admit their real motives for discouraging THR, anti‐THR activism is an entirely dishonest enterprise.

Tobacco harm reduction is the greatest untapped public health initiative in the developed world. It is more promising than further attempts to promote tobacco/nicotine abstinence. The future inevitably includes a large portion of the population using low‐risk tobacco/nicotine, but anti‐THR efforts might keep people smoking in the short run.

While most of the content of this paper is well known to experts on THR, many ostensible experts on health, as well as other opinion leaders and policy makers, are unaware of the truth.