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Every six seconds someone dies from a smoking-related disease and the problem is likely to worsen; the steep smoking declines in richer countries are slowing while in poorer countries smoking is set to rise. Existing forms of tobacco control are proving insufficient. While many people give up smoking, on their own or with medicinal products, many fail. ‘Quit or die’ is no longer the only option for those who cannot give up. Safer nicotine products offer another way. There is substantial international, independent evidence that these products are demonstrably safer than cigarettes. These potential lifesaving products could lead to a global revolution in public health.