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Kenneth E. Warner, PhD; John Slade, MD; David T. Sweanor, LLB

JAMA. 1997;278(13):1087-1092.

Abstract
In increasing numbers, Americans will seek to satisfy nicotine addictions through the use of novel nicotine-delivery products devoid of several of the poisons that make cigarettes so deadly. In the vanguard are tobacco industry devices that heat tobacco derivatives rather than burn tobacco, and pharmaceutical industry nicotine-replacement products, with nicotine gum and the patch now available over the counter. Ostensibly, these 2 industries have diametrically opposed objectives, the tobacco industry striving to sustain nicotine addictions, the pharmaceutical industry to end them. However, a series of technological, economic, political, regulatory, and social developments augurs a strange-bedfellows competition in which these industries will vie for shares of a new multibillion dollar long-term nicotine-maintenance market. Regulatory options range from encouraging competition to banning all nicotine-delivery devices. A more realistic approach discourages use of the most dangerous products, while making less hazardous products readily available to adults.

Author Affiliations
From the Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Dr Warner); Department of Medicine, University of Medicine and Dentistry of New Jersey, and St. Peter's Medical Center, New Brunswick, NJ (Dr Slade); and Non-Smokers' Rights Association, Ottawa, Ontario (Mr Sweanor).

Footnotes
Reprints: Kenneth E. Warner, PhD, Department of Health Management and Policy, School of Public Health, University of Michigan, 109 S Observatory, Ann Arbor, Ml 48109-2029 (e-mail: kwarner@umich.edu).

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