In Norway (Lund, 2009), as in the United States (Biener, McCausla

In Norway (Lund, 2009), as in the United States (Biener, McCausland, Curry, & Cullen, 2011), use of smokeless tobacco has been a typical male phenomenon, and for this reason, women were not included in our clearly study. However, as the prevalence of snus use among women is increasing, future studies should probably include women, and this could possibly have impact on the overall results. As the sample and the study population were generally very similar on key variables such as age, region, urbanity, and smoking status, our results could possibly be representative for Norwegian males aged 20�C50 years, but probably not for the whole population. Conclusion Lacking any compelling evidence of net harm to society from correcting misperceptions of the relative risk between cigarettes and snus, the human right for the individual to receive accurate information about options to reduce risk should prevail.

Going beyond the no-safe-tobacco message to provide better information on the nature of relative risk from snus as compared with smoking is necessary to respect the individual right to health relevant information and smokers�� autonomy and may also��as our study indicates��result in increased quit rates for cigarette smoking. Some have argued that failure to disseminate information about reduced risks for fear that population nicotine use may increase could be regarded as paternalism and create public mistrust of health messages about tobacco use (Gartner, Hall, Chapman, et al., 2007; Kozlowski, 2002).

To prevent uptake of snus among youth, public health and tobacco control professionals could use other methods than withholding information about relative risks, including taxation, restrictions, and information campaigns aiming to change the cultural symbolism of snus use. Likewise, to prevent snus use among smokers who otherwise are able to quit cigarettes, health professionals should not suppress accurate risk information but encourage uptake of behavioral therapy supported by nicotine replacement therapy or varenicline in accordance with established clinical guidelines (Britton, 2008). Devising a way to inform smokers about the risk continuum of tobacco products (without anyone decoding this information as snus being risk free) should be an important research priority in countries where snus is allowed to compete with cigarettes for market share.

History shows that the tobacco industry cannot be trusted to market their products in a manner that prioritizes health Dacomitinib over profits. Therefore, any promotion of switching from cigarettes to snus should be restricted to health departments. Funding This work was supported by the Norwegian Institute for Alcohol and Drug Research, the Norwegian Directorate of Health, and the Norwegian Research Council project no.

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