Tobacco-related death and disease place significant health and economic burdens on society. In an attempt to reduce these, support is growing for the use of alternative nicotine delivery systems in smokers who are unable to break their addiction to nicotine. However, as increasing numbers of alternative nicotine delivery systems are developed, by pharmaceutical companies, the tobacco industry and other manufacturers, the need for a comprehensive regulatory policy governing all such products becomes even more important. This article reviews the existing legislation surrounding tobacco and nicotine, the politics of nicotine delivery, and current scientific knowledge surrounding nicotine, and assesses the various policy options to minimize tobacco-related harm. Segmentation of the nicotine market, according to different smokers' needs, and research and philosophical issues are also considered.