Tobacco. WHO (2024) Tobacco. Available at: https://www.who.int/news-room/fact-sheets/detail/tobacco

Dai X, Gakidou E, Lopez AD (2022) Evolution of the global smoking epidemic over the past half century: strengthening the evidence base for policy action. Tob Control 31(2):129–137. https://doi.org/10.1136/tobaccocontrol-2021-056535

Article  PubMed  Google Scholar 

Prevalence, The Tobacco Atlas. Available at: https://tobaccoatlas.org/challenges/prevalence/. 26 Oct 2023

O’Leary R, Polosa R (2020) Tobacco harm reduction in the 21st century. Drugs Alcohol Today 20(3):219–234. https://doi.org/10.1108/DAT-02-2020-0007

Article  Google Scholar 

Beaglehole R, Bonita R (2024) Harnessing tobacco harm reduction. Lancet 403(10426):512–514. https://doi.org/10.1016/S0140-6736(24)00140-5. (Epub 2024 Feb 1)

Article  PubMed  Google Scholar 

Harm Reduction International (n.d.) What is Harm Reduction? Harm Reduction International. https://hri.global/what-is-harm-reduction/. Accessed 3 Oct 2025.

Polosa R, Rodu B, Farsalinos K (2025) Health effects of e-cigarettes, heated tobacco, and oral nicotine products. Intern Emerg Med. https://doi.org/10.1007/s11739-025-04057-4

Article  PubMed  PubMed Central  Google Scholar 

Statistical Office of the European Union (Eurostat). Daily smokers of cigarettes among persons aged 15 and over. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Tobacco_consumption_statistics#Daily_smokers_of_cigarettes

Ramstrom LM (2024) If there had been no snus in Sweden: the impact of snus on mortality attributable to smoking. Harm Reduct J 21(1):176. https://doi.org/10.1186/s12954-024-01095-7

Article  PubMed  PubMed Central  Google Scholar 

https://gsthr.org/countries/profile/swe/#:~:text=Vaping%20devices%20can%20be%20purchased,can%20also%20be%20bought%20online

Rodu B, Cole P (2004) The burden of mortality from smoking: comparing Sweden with other countries in the European Union. Eur J Epidemiol 19:129–131

Article  PubMed  Google Scholar 

Hajat C, Stein E, Ramstrom L, Shantikumar S, Polosa R (2021) The health impact of smokeless tobacco products: a systematic review. Harm Reduct J 18(1):123. https://doi.org/10.1186/s12954-021-00557-6

Article  CAS  PubMed  PubMed Central  Google Scholar 

La Rosa GRM, Del Giovane C, Minozzi S, Kowalski J, Chapple I, Amaliya A, Farsalinos K, Polosa R (2025) Oral health effects of non-combustible nicotine products: a systematic review and network meta-analysis of randomized controlled trials. J Dent 160:105910. https://doi.org/10.1016/j.jdent.2025.105910

Article  CAS  PubMed  Google Scholar 

Lee PN (2007) Circulatory disease and smokeless tobacco in Western populations: a review of the evidence. Int J Epidemiol 36(4):789–804

Article  PubMed  Google Scholar 

https://web.archive.org/web/20201220044442/https:/www.fda.gov/news-events/press-announcements/fda-grants-first-ever-modified-risk-orders-eight-smokeless-tobacco-products

https://www.fda.gov/tobacco-products/advertising-and-promotion/swedish-match-usa-inc-modified-risk-tobacco-product-mrtp-applications-general-snus-products

Clarke E, Thompson K, Weaver S, Thompson J, O’Connell G (2019) Snus: a compelling harm reduction alternative to cigarettes. Harm Reduct J 16(1):62. https://doi.org/10.1186/s12954-019-0335-1

Article  PubMed  PubMed Central  Google Scholar 

Travis N, Warner KE, Goniewicz ML, Oh H, Ranganathan R, Meza R, Hartmann-Boyce J, Levy DT (2025) The potential impact of oral nicotine pouches on public health: a scoping review. Nicotine Tob Res 27(4):598–610. https://doi.org/10.1093/ntr/ntae131

Article  CAS  PubMed  Google Scholar 

Benowitz NL, Burbank AD (2016) Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends Cardiovasc Med 26(6):515–523. https://doi.org/10.1016/j.tcm.2016.03.001. (Epub 2016 Mar 10)

Article  CAS  PubMed  PubMed Central  Google Scholar 

Pack QR, Priya A, Lagu TC, Pekow PS, Atreya A, Rigotti NA, Lindenauer PK (2018) Short-term safety of nicotine replacement in smokers hospitalized with coronary heart disease. J Am Heart Assoc 7(18):e009424. https://doi.org/10.1161/JAHA.118.009424

Article  PubMed  PubMed Central  Google Scholar 

Hajat C, Stein E, Shantikumar S, Niaura R, Ferrara P, Polosa R (2022) A scoping review of studies on the health impact of electronic nicotine delivery systems. Intern Emerg Med 17(1):241–268. https://doi.org/10.1007/s11739-021-02835-4. (Epub 2021 Oct 12)

Article  PubMed  Google Scholar 

Rezk-Hanna M, Warda US, Stokes AC, Fetterman J, Li J, Macey PM, Darawad M, Song Y, Ben Taleb Z, Brecht ML, Benowitz NL (2022) Associations of smokeless tobacco use with cardiovascular disease risk: insights from the population assessment of tobacco and health study. Nicotine Tob Res 24(7):1063–1070. https://doi.org/10.1093/ntr/ntab258

Article  CAS  PubMed  PubMed Central  Google Scholar 

Haussmann HJ, Fariss MW (2016) Comprehensive review of epidemiological and animal studies on the potential carcinogenic effects of nicotine per se. Crit Rev Toxicol 46(8):701–734. https://doi.org/10.1080/10408444.2016.1182116. (Epub 2016 Jun 9)

Article  CAS  PubMed  PubMed Central  Google Scholar 

National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health (2014) Nicotine (Chapter 5). In The Health Consequences of Smoking—50 Years of Progress: a Report of the Surgeon General. Centers for Disease Control and Prevention (US). https://www.ncbi.nlm.nih.gov/books/NBK294308/

Lee PN, Fariss MW (2017) A systematic review of possible serious adverse health effects of nicotine replacement therapy. Arch Toxicol 91(4):1565–1594. https://doi.org/10.1007/s00204-016-1856-y. (Epub 2016 Oct 3)

Article  CAS  PubMed  Google Scholar 

Murray RP, Connett JE, Zapawa LM (2009) Does nicotine replacement therapy cause cancer? Evidence from the Lung Health Study. Nicotine Tob Res 11(9):1076–1082. https://doi.org/10.1093/ntr/ntp104. (Epub 2009 Jul 1)

Article  PubMed  PubMed Central  Google Scholar 

Goicoechea JZ, Boughner A, Lee JJC, Mahajan A, Yeo K, Sproga M, Russell C, Coughlan M, Selya A, Caci G, Caponnetto P, Tomaselli V, Polosa R (2024) Respiratory symptoms among e-cigarette users without an established smoking history in the VERITAS cohort. Sci Rep 14(1):28549. https://doi.org/10.1038/s41598-024-80221-8

Article  CAS  PubMed  PubMed Central  Google Scholar 

Caci G, Selya A, La Rosa GRM, Spicuzza L, Morjaria JB, Geraci G, Polosa R (2025) Respiratory effects of electronic cigarette use in individuals who never smoked: a systematic review. Clin Med 25(2):100295. https://doi.org/10.1016/j.clinme.2025.100295. (Epub 2025 Feb 23)

Article  Google Scholar 

Mughis M, Ahmad M, Rashid H, Nasir A, Mukarram H, Chaudhary S, Tariq S, Zaman T (2024) Assessment of respiratory health implications of vaping: a systematic review of toxicity mechanisms and adverse effects of electronic nicotine delivery systems. Cureus 16(9):e69236. https://doi.org/10.7759/cureus.69236

Article  PubMed  PubMed Central  Google Scholar 

Parris BA, O’Farrell HE, Fong KM, Yang IA (2019) Chronic obstructive pulmonary disease (COPD) and lung cancer: common pathways for pathogenesis. J Thorac Dis 11(Suppl 17):S2155–S2172. https://doi.org/10.21037/jtd.2019.10.54

Article  PubMed  PubMed Central  Google Scholar 

Pesola F, Smith KM, Phillips-Waller A, Przulj D, Griffiths C, Walton R, McRobbie H, Coleman T, Lewis S, Whitemore R, Clark M, Ussher M, Sinclair L, Seager E, Cooper S, Bauld L, Naughton F, Sasieni P, Manyonda I, Hajek P (2024) Safety of e-cigarettes and nicotine patches as stop-smoking aids in pregnancy: secondary analysis of the Pregnancy Trial of E-cigarettes and Patches (PREP) randomized controlled trial. Addiction 119(5):875–884. https://doi.org/10.1111/add.16422. (Epub 2024 Jan 17)

Article  PubMed  Google Scholar 

Hajek P, Przulj D, Pesola F, Griffiths C, Walton R, McRobbie H, Coleman T, Lewis S, Whitemore R, Clark M, Ussher M, Sinclair L, Seager E, Cooper S, Bauld L, Naughton F, Sasieni P, Manyonda I, Myers Smith K (2022) Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial. Nat Med 28(5):958–964. https://doi.org/10.1038/s41591-022-01808-0. (Erratum in: Nat Med. 2023 Nov;29(11):2957. doi: 10.1038/s41591-022-02099-1)

Article  CAS  PubMed  PubMed Central  Google Scholar 

Brinchmann B, Gunn E, Becher R, Grimsrud T, Ørjasaeter I (2023) Use of Swedish smokeless tobacco during pregnancy: a systematic review of pregnancy and early life health risk. Addiction 118(5):789–803. https://doi.org/10.1111/add.16114. (Epub 2023 Jan 16)

Article  PubMed  Google Scholar 

Back S, Masser AE, Rutqvist LE, Lindholm J (2023) Harmful and potentially harmful constituents (HPHCs) in two novel nicotine pouch products in comparison with regu