Smokeless tobacco as a nicotine delivery device: harm or harm reduction?

Smokeless tobacco (ST) delivers nicotine in doses similar to those received in cigarette smoking but does not expose the user to the toxic combustion gases and particles that are responsible for most tobacco-induced disease. This Opinion piece discusses the controversies pertaining to ST and health, the pros and cons of ST in harm reduction, and progress in treatment for those who would like to quit ST use.