In recent years, the tobacco control community has experienced impassioned and at times acrimonious debate about harm reduction. For years, tobacco control has stood fast on a doctrinaire devotion to an absolutist precept: that tobacco use of any sort was unacceptable. With the advent of nicotine replacement therapy, there was early consternation from some who, like Gertrude Stein, felt nicotine is nicotine is nicotine. Nicotine weaning was one thing, but nicotine maintenance bordered on profanity.

In this issue, we take the debate on harm reduction further by considering a tobacco product, the widespread use of which appears to be associated with significant reductions in lung cancer and myocardial infarction in Sweden. We commissioned a major review of the public health significance of snus,¹ an oral tobacco product that has been widely used since the early 20th century and which has seen a prolonged growth in use since the 1970s, a period in which cigarette use mostly declined. This review is the most comprehensive yet published, but it and a related paper advocating the liberalisation of policy on snus availability in Europe² have immediately generated controversy, as readers of the responses by Tomar et al³ and Kozlowski et al⁴ will discover.

The editors hope that many readers will participate in this important debate by utilising the journal’s rapid response function. It is our policy to publish all responses, except those which are defamatory. We look forward to the debate this topic deserves.