[Reduction of nicotinic risk--is it possible?]

To decrease the health consequences of tabagism pandemic, quitting is still the only goal. The size of the problem leads to question if harm reduction is possible. Today, this concept, which was successful with illegal drugs, cannot be applied to tobacco because of a lack of proof. There is no safe cigarette and all brands have the same toxicity. Arguments in favor of smokeless tobacco are still insufficient for a public health decision. A voluntary decrease of tobacco consumption does not decrease morbidity and mortality of heavy smokers. A long-term use of nicotine replacement therapy is acceptable to reduce the daily smoking under medical supervision in smokers with chronic tobacco related disease who have previously failed in attempts to quit smoking.