Tobacco is a uniquely dangerous consumer product and there is no safe level of use. Most of the harm comes from the poisons in tobacco smoke. Smokeless tobacco products are less hazardous but are associated with an increased risk of mouth and throat cancers. Although nicotine is the addictive component of tobacco, it is relatively benign compared to the other toxins in tobacco. Therefore it is possible to use ‘clean’ nicotine that is found in medicinal nicotine replacement products without causing lasting harm. One way of reducing the harm caused by tobacco may be to facilitate the switch from smoked tobacco products to the use of ‘clean’, non-tobacco, nicotine products.