Opinions from 4300 Doctors
Today, smoking alternatives such as vaporized tobacco products, snus, chewing tobacco, snuff, gums, and nicotine pouches are coming to take the place of cigarettes. These options have gained popularity since the last survey of R4I, conducted by asking more than 4300 doctors across the world on whether they consider smoking alternatives safe enough to recommend for their patients.

Read here for smoking alternatives and how doctors feel about their safety:
- Do Doctors Recommend Smoking Alternatives? R4I Survey Results
- A Swedish Case Study on Snus as a Smoking Alternative
Success has been made in the grip against cancer and reduction of smoking among adults. Ever since the 1960s, when over 40% of adults in that country smoked cigarettes, gradual declines in the percentage of smokers were likewise documented in other world regions during that period.
Up until 2024, current US estimates since 1965 range from 41.9% to about 11%, indicating that the US smoking population was cut by a whopping 73.7% over the span of 60 years.
This decline is partly attributed to the fact that smoking alternatives such as vaping, snus, chewing tobacco, snuff, gums, and nicotine pouches have gained significant popularity over the years. Vaping, though, is one of the newer alternatives in smoking, emerging into the arena in the mid2090s. From this period on, the global e-cigarette and vape market has witnessed tremendous growth. In 2023, the vape market was valued approximately at USD 28.17 billion, and from years 2023-2030 it is expected to grow with an annually compound growth rate (CAGR) of around 30.6%. In comparison, the cigarette market is expected to increase, though only at the estimated CAGR of around 2.3% from the years 2024 to 2030 – nowhere near the astounding growth rates of the e-cigarette and vape market.

However, still, ways to reduce the number of tobacco smokers and ensuing deaths remain a long way ahead. The number of deaths from smoking tobacco-related diseases continues to surpass 6 million each year, according to the WHO.
What Are The Alternatives To Smoking? Are They Safer?
Smoking alternatives refer to a product that aids a smoking individual in lessening or quitting cigarette smoking while providing nicotine without traditional cigarettes. Whereas a lot of these alternatives are said to be less harmful than smoking, none of them is safe. Below is an overview of the popular alternatives to smoking:
Vaping
Vaping basically refers to inhaling a vapour containing Nicotine or flavourings through electronic devices. Some studies suggest that vaping is indeed less harmful than smoking since it’s delivered as vapour and not smoke. However, vaping should not assume euphoria, as pulmonary illness and cases of addiction, especially in youth, continue to emerge even as evaluation of long-term effects is still ongoing.
Snus
Snus denotes moist powder tobacco put between the lip and gums. Predominantly, commonly located in Sweden and some Nordic regions this particular tobacco contrivance is linked to a substantial reduction in smoking rates. Studies have regarded snus as safer than smoking as it doses, especially helps avoid inhalation. However, its risks include oral cancer and other cardiovascular effects.
Nicotine Pouches
Nicotine pouches are the same concept as snus but do not contain tobacco. Instead, these are placed under the lip to deliver nicotine into gums; therefore, they are believed to be safer as compared with the traditional tobacco products, though they too may lead to nicotine dependence.
Chewing Tobacco
Chewing tobacco is shredded leaf tobacco, placed between the inside of the cheek and gum slowly releasing nicotine. While it avoids the lungs, oral cancers, and nicotine dependence, in itself due to chewing tobacco.
Snuff
Tobacco in a powdered form that enters the nose, and/or that is used extensively under the lip. Like other smokeless products and while avoiding the hazards from the smoke and lung, the risks of this include oral and nasal cancer.
Nicotine Gums
Nicotine gums help ease withdrawal symptoms by absorbing nicotine from the oral lining. Approved as a cessation assistance, nicotine gum is much less harmful than smoking and contains no carcinogens associated with tobacco.
Do Doctors Recommend Smoking Alternatives? R4I Survey Results
Yes, there may be a lower health risk with smoking alternatives than with smoking cigarettes, but there are risk factors attached to it, and it is a conduit for nicotine addiction. There are many questions raised about potential long-term health effects from inhaling or ingesting nicotine and the other chemicals found in these products.
To know what are doctors’ opinions regarding smoking alternatives and which may include vaping, snus, chewing tobacco, nicotine gums, and nicotine pouches, we conducted our latest R4I survey. We asked a total of 4,332 doctors from around the world whether or not they consider these smoking alternatives safe enough to recommend to patients at high risk for cancer, cardiovascular disease, respiratory disorders, diabetes, and other serious health conditions.
Almost 70% of doctors will recommend smoking alternatives under particular circumstances, and about 30% remain hesitant.