Sweden is about to reach a public health milestone: This 2023 will become the first “smoke-free” country in the world, when it reaches a smoking rate of less than 5% of the population. The Nordic country already had the lowest rate in Europe in 2022 (5.6%) and if, as expected, this percentage continues to decline, it will be the The only European country that will reach the EU objective of eradicating cigarettes before 2040, specifically 18 years before, an achievement that makes it the beacon to follow to save millions of lives.
The key to Swedish success lies in the implementation of harm reduction strategies and the popularization of snus, an indigenous smokeless tobacco product in a pasteurized, moist form, consumed orally, which is placed under the lip to deliver nicotine through the gums. Smokers have turned to less harmful alternatives, such as snus, nicotine pods, electronic cigarettes or tobacco heating devices, because they are less harmful (by reducing exposure to toxic substances by 95%), but also because be more affordable, since the Swedish government decided to support them with more lax taxation linked to their lower risk.
23% is the average smoking rate in the EU, almost five times higher than that of Sweden
According to the report, “The Swedish experience, roadmap for a smoke-free society”, in the last 15 years, Sweden has reduced its smoking rates from 15% in 2008 to 5.6% in 2022, while the average smoking rate in the EU currently stands at 23%, almost five times higher than that of Sweden. Only 3% of Swedes aged 16-29 smoke, the lowest European rate of youth smoking, compared to 29% of other Europeans aged 15-24. In addition, the next generation, between 30 and 44 years old, also has a smoking rate of less than 5%.
As a result, Sweden’s achievements in health are unparalleled. The incidence of cancer in Sweden is 41% lower than in the rest of its European counterparts, which is equivalent to 38% less in the total number of deaths from cancer. In 24 of the other 27 EU Member States there is a smoking death rate twice as high or more than Sweden’s, relative to the size of the population. In all tobacco-related diseases, Sweden has a mortality rate that is 39.6% lower than the EU average and is one of the three countries with the lowest number of deaths from lung cancer. The report therefore concludes that if the tobacco-related death rates shown by Sweden were replicated in other countries, more than 3.5 million lives could be saved in the next decade in the EU alone.
3.5 million lives could be saved in the EU in the next decade
Smoking cigarettes or other combustible tobacco products is the leading cause of death from noncommunicable diseases worldwide. According to the World Health Organization (WHO), in 2017, eight million deaths were attributed to tobacco. Yet today, there are still more than 1 billion smokers in the world., despite being fully aware of the risks of smoking. Public health professionals and harm reduction experts advocate that Tobacco control policies that regulate and demonize smokeless alternatives in the same way are the main mistake that differentiates the rest of the European countries, with persistently high smoking rates, from Sweden.
In the Nordic country, sales of snus and nicotine sachets surpassed those of cigarettes in 2016. Patrik Hildingsson, vice president of communication and public affairs at Swedish Match, a company that has produced snus since 1917, explains that in the early 1900s snus was more popular than tobacco, but cigarettes took the lead, reaching their peaks in Sweden in the 1970s. In that decade, the publication of an EU report on the harm caused by cigarettes and its broadcast on television changed the chip of the Swedish population, who returned to consume snus and other less harmful and more affordable alternatives. Although the success achieved with snus is not replicable because the EU only allows it to be marketed in Sweden, Norway and Denmark (now the US also accepts it), Hildingsson hopes that the available science and data that support the lower health impact of the alternatives low-risk is taken into account and the same does not happen as with snus.
In this sense, during a press conference in Stockholm, Anders Milton, doctor, co-author of the report and president of the Snus Commission was very clear: “None of the products linked to tobacco are harmless, but with cigarettes you die, not with their alternatives”. For this reason, Professor Karl Fagerström, a founding member of the Society for Research on Nicotine and Tobacco, explained that “if snus had been regulated against in Sweden, it would have been a national health disaster.” “You can’t force people to quit smoking without giving them alternatives. In addition, they have to be accessible and that happens because they have a lower tax burden than cigarettes»said Stefan Mathisson, editor-in-chief of the Swedish vaping news portal Vejpkollen. Therefore, experts argue that the success achieved with snus in Sweden can be achieved in other countries through the various smokeless alternatives on the market, as long as governments regulate them differently from cigarettes taking into account their lower risk profile.