title: [Safety of long-term nicotine use: An ongoing debate].
abstract: BACKGROUND
  Long-term nicotine use has been proposed as a risk-reduction strategy in smokers unwilling or unable to quit. However, its safety remains debated.
  
  
  METHODS
  Analysis of publications identified in PubMed, Toxibase, Google Scholar and in the Food and Drug Administration, and French National Authority for Health websites.
  
  
  RESULTS
  Nicotine seems to be implicated in the genesis of atherosclerosis. It could be a cancer precursor, could be implicated in cancer proliferation and angiogenesis, in apoptosis reduction, and may be genotoxic. New studies are warranted for more complete assessment of the risk-benefit balance.
  
  
  CONCLUSIONS
  It is difficult to affirm the safety of long term nicotine use. The risk-benefit balance should be assessed in terms of a risk-reduction strategy, as in other domains, notably illicit drug use.
authors.affiliation: Inserm U669, centre d'addictologie, hôpital Paul-Brousse, Assistance publique-Hôpitaux de Paris, université Paris-Sud, 14, avenue P.V.-Couturier, 94804 Villejuif, France. Electronic address: patrick.dupont@pbr.aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Dupont
authors.affiliation: Inserm U669, centre d'addictologie, hôpital Paul-Brousse, Assistance publique-Hôpitaux de Paris, université Paris-Sud, 14, avenue P.V.-Couturier, 94804 Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Benyamina
authors.affiliation: Inserm U669, centre d'addictologie, hôpital Paul-Brousse, Assistance publique-Hôpitaux de Paris, université Paris-Sud, 14, avenue P.V.-Couturier, 94804 Villejuif, France.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Aubin
mesh_terms: D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D000069451:Long Term Adverse Effects / Q000453:epidemiology; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D009538:Nicotine / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D015538:Nitrosation / Q000187:drug effects; D018570:Risk Assessment; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000628:therapy*
chemical_list: D009538:Nicotine
keywords: Cancérogenèse; Carcinogenesis; Cardiovascular effects; Effets cardiovasculaires; Long-term safety; Nicotine; Substitution treatment; Sécurité d’emploi au long cours; Traitement substitutif