RT Journal Article SR Electronic T1 Paying more attention to the ‘elephant in the room’ JF Tobacco Control JO Tob Control FD BMJ Publishing Group Ltd SP e35 OP e36 DO 10.1136/tobaccocontrol-2016-053150 VO 26 IS e1 A1 Ron Borland YR 2017 UL http://tobaccocontrol.bmj.com/content/26/e1/e35.abstract AB This commentary argues that a nicotine reduction strategy for tobacco control is a secondary strategy to the wider availability of low toxin forms of nicotine to give smokers a viable alternative to cigarettes. Failure to confront the likely reality of continued nicotine use and to make it as low in harm as possible may prolong the tobacco epidemic.