In the last decade, harm reduction has been increasingly suggested as a method to reduce the harm caused by smoking in smokers who are unable or unwilling to quit all nicotine products. One of these methods includes long-term substitution of tobacco with nicotine replacement therapies (NRTs). The aim of this study is therefore to gain insight into the perceived pros and cons of the long-term use of NRTs. We conducted 19 semi-structured interviews with long-term users of NRTs, 16 ex-smokers and 3 dual users of tobacco and NRTs. Participants were asked about their reason for using NRTs, including perceived pros and cons of using NRTs, the risk of relapse to smoking and their motivation to quit using NRTs. The results identified five major themes that entailed pros and cons of the long-term use of NRTs. These were the non-nicotinic factors of NRTs, health risks of NRTs vs. smoking, intrapersonal processes, the social environment of smoking vs. NRTs and finances. None of the ex-smokers feared to relapse to smoking, and few were motivated to quit NRTs. Non-nicotinic factors were found to have an important role in developing an addiction to NRTs. The use of NRTs yields some of the expected benefits and helps avoid some of the expected drawbacks of smoking. However, the drawbacks of using NRTs were still a concern regarding long-term health effects and continued addiction.