Sweden: Soon Europe's First 'Smoke-Free' Country

Scenic view of Stockholm's old town Gamla Stan at sunset, with colorful buildings and church spires against a vibrant sky.
17 September 2024
CHAPTER 6 . THR: A global transformation

Sweden: Soon Europe's First 'Smoke-Free' Country
A Case Study: Sweden

A case study: U.S.A

Swedish flag waving in the foreground with a lake and forested shoreline in the background.

AT A GLANCE

 

Sweden is reaping the benefits of Tobacco Harm Reduction

 

39.6%

lower rate of death from tobacco-related diseases compared to the EU average[1]

 

41%

lower incidence of cancer than EU average[1]

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Based on current trends, Sweden will soon become a smoke-free society. Smoking in Sweden has fallen to just 5.6% of people over the age of 16, compared to 15% in 2008. The World Health Organization (WHO) considers countries to be smoke-free when smoking prevalence is less than 5% of the population.[2] As a result, Sweden is reaping the benefits.[3]

 

A key to Sweden’s success has been its openness to allow the sale of smokeless alternatives to cigarettes that satisfy adult smokers’ desire for nicotine, and to avoid excessively restricting these products.

 

Since the 1970s, snus, a moist, pasteurised Oral Tobacco Product, has been contributing to Sweden’s lower smoking rate and the reduced incidence of smoking-related disease and death, when compared to the rest of Europe. The introduction of newer, smokeless alternative products has continued to propel it towards a smoke-free society. Vaping was first introduced in 2015 and Oral Nicotine Pouches became available in 2018.

"Sweden has shown that THR can be accelerated through providing smokers access to Smokeless Products."

 

Asli Ertonguc

Area Director, British American Tobacco UK Limited

Asli Ertonguc
Source: Statistics Sweden, ages 16 - 84 years

Source: Statistics Sweden, ages 16 - 84 years[4]

 

 

3.5m

 

 

Lundgrens

In Europe, 3.5 million early deaths could be prevented across the EU if other countries adopted the ‘Swedish model’.[1]

Swedish adult smokers have access to a wide range of Smokeless Products – snus, Oral Nicotine Pouches, Vapour Products, and Heated Products – which are legal and available both online and in stores.

 

There are a wide range of flavours and nicotine concentrations.

 

Smokeless Products are more affordable than cigarettes because products are taxed based upon estimated risk profile. Products that are judged to be higher risk, are taxed higher.[5]

 

Learning from Sweden’s success story and replicating its approach on a global scale are considered both critical to driving down smoking rates, and reducing tobacco-related health risks, diseases and premature deaths.

 

In Europe, 3.5 million early deaths could be prevented if other countries adopted the ‘Swedish model.’[1] Smoking is a significant public health challenge, and it is essential that governments use proven approaches to reduce smoking.

2022 Lung, Trachea and Bronchus Cancer Deaths

 

Age-Standardised Rate (world) per 100,000

Mortality, Both Sexes, Age 15-85+, in 2022[7]

Mortality, Both Sexes, Age 15-85+, in 2022[7]

EU Flag

Snus illegal in the EU 

Despite its reduced-risk status relative to cigarettes, snus is illegal in the EU with the exception of Sweden.

Tobacco Harm Reduction in action

Lowest smoking rate in Europe, 5.6% vs. 23% EU average[1]

Similar usage of tobacco per capita vs. EU

Lowest lung, trachea and bronchus mortality rates in the EU[6]

References

[1] Human, D., et al., The Swedish experience: a roadmap to a smoke free society. Smoke Free Sweden 2023, 2023. Available at: https://smokefreesweden.org/wp-content/themes/smokefreesweden/assets/pdf/reports/Report%20The%20Swedish%20Experience%20EN.pdf

[2] World Health Organization, Tobacco-free generations: Protecting children from tobacco in the WHO European Region. 2017. Available at: https://cdn.who.int/media/docs/librariesprovider2/euro-health-topics/tobacco/20170428_who-tobaccofreegeneration-draft09.pdf

[3] Farsalinos, K., et al., No Smoke Less Harm. Smoke Free Sweden, 2024. Available at: https://smokefreesweden.org/No%20Smoke%20Less%20Harm.pdf

[4] Folkh.lsomyndigheten, Tobacco and nicotine use (self-reported) by age, sex and year. Percentage. Available at: http://fohm-app.folkhalsomyndigheten.se/Folkhalsodata/pxweb/en/A_Folkhalsodata/A_Folkhalsodata__B_HLV__aLevvanor__aagLevvanortobak/hlv1tobaald.px/ (Accessed: 29 July 2024)

[5] World Health Organization and International Agency for Research on Cancer, Cancer Today: Data visualization tools for exploring the global cancer burden in 2022. (Selection criteria: Age-Standardized Rate (World) per 100 000, Incidence, Both sexes, Cancer Type [Lip, oral cavity], European Union (27), age [15-85+], Available at: https://gco.iarc.who.int/today/en (Accessed: 8 August 2024)

[6] The Swedish Parliament, Excise taxes on nicotine-containing consumer products after the year 2023, 2022. Available at: https://www.riksdagen.se/sv/dokument-och-lagar/dokument/svar-pa-skriftlig-fraga/punktskatter-pa-nikotininnehallande_H9121477/(Accessed: 24 July 2024)

[7] World Health Organization and International Agency for Research on Cancer, Cancer Today: Data visualization tools for exploring the global cancer burden in 2022. (Selection criteria: Age-Standardized Rate (World) per 100 000, Mortality, Both sexes, Cancer Type [Trachea, bronchus and lung], European Union (27), age [15-85+], Available at: https://gco.iarc.who.int/today/en (Accessed: 8 August 2024)

Check out our other Omni™ chapters

  • Smokeless Products: An Introduction
    Read more
  • 01. Our Vision: A Need for Reappraisal
    Read more
  • 02. The Big Questions
    Read more
  • 03. Impact of Smoking
    Read more
  • 04. Our Smokeless Science
    Read more
  • 05. Our Smokeless Products
    Read more
  • 07. THR: Global Regulation
    Read more
  • 08. THR: Scientific Engagement
    Read more
  • 09. Our Future Outlook
    Read more
  • 10. References
    Read more
  • 11. Our Published THR Science
    Read more
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