Sweden's smoking rate has fallen to 5.6%, bringing it close to smoke-free status
The Swedish government has officially confirmed that the country's smoking rate has dropped to 5.6%, making the country the first in Europe to reach smoke-free status.
In the European Union and the United Kingdom, smoke-free means less than 5% of a given population smokes.
Much of Sweden's success is due to Tobacco Harm Reduction (THR). But aside from e-cigarettes, which have replaced smoking in the UK, or heated tobacco products, whose sales of cigarettes have plummeted in Japan, a third major THR option is key to the Swedish story: snus, a moist oral tobacco product placed on the inside of the upper lip for use.
Smoking rates in Sweden have declined rapidly over the past few decades: from 40% in 1976 to 15% in 2002 for men and from 34% to 20% for women.
Of course, these rates continue to decline, as the prevalence of oral smoking - especially among men - increases correspondingly, suggesting a substitution effect.
Studies have also shown that rates of lung cancer and heart disease have declined, especially among men, and remain low compared to other developed countries that have long smoked.
The use of snus is a tradition in Sweden: a century ago, snus was far more important in the country than smoking. Then it fell, then bounced back from the 1970s, overtaking smoking again in the 1990s. Until recently, governments have been incentivizing people to switch from cigarettes to smoking by mouth through taxes.
THR proponents often note the WHO's seeming disdain for safer nicotine products, and they often point to Sweden as a model that can be replicated or at least studied carefully.
"Swedish men consume just as much tobacco as men elsewhere in Europe, but more with mouthfuls than cigarettes - and they have been doing so for a long time." Karl Erik Lund, PhD, a graduate senior researcher in public health in Norway. "But having worked in the tobacco control community for 36 years, my impression is that it is hard to accept that the availability of oral cigarettes may have a greater impact on reducing smoking than the tobacco control regulations we have fought for our entire lives."
At a recent event organized by the Stockholm Oral Nicotine Committee, Dr. Karl Fagerstrom, a Swedish psychologist and founding member of the Society for Nicotine and Tobacco Research (SRNT), shared, He hopes the upcoming Swedish presidency of the EU will be a great opportunity to share their 5% success story with other EU countries.
"Sweden will host the next Council of Ministers, rotating between EU member states every six months from January 2023, and promote EU legislation. We hope that Sweden will be generous enough to share this expertise internationally." "He added.
The European Union has banned the sale of oral cigarettes since the early 1990s, but Sweden, which joined the EU shortly after the ban, was granted an exemption. Overall, the EU aims to be smoke-free by 2040.
England, which has largely embraced e-cigarettes, hopes to reach that threshold by 2030.
The fact that oral cigarettes are barely available for sale across the EU apparently prompted Swedish Match - the world's leading producer of oral cigarettes, which also makes the increasingly popular Zyn nicotine packs - to turn to the US market.
According to the Centers for Disease Control and Prevention, as of 2020, 2.3 percent of American adults reported using smokeless tobacco products, such as oral cigarettes, every day or some days.
In November, Philip Morris International (PMI), which is also targeting the U.S. market, acquired more than 90 percent ownership of Swedish Match.
The move was controversial.
INNCO, a nonprofit that advocates for the rights of people who use safer nicotine products, asked PMI's leadership in a press release to direct their vast marketing and distribution capabilities to ensure Swedish Match's snus and nicotine bagged products - which do not cause cancer, Heart disease or lung disease - available, affordable and acceptable for all smokers in low - and middle-income countries (LMIC).
But David Sweanor, an independent tobacco industry expert and adjunct professor at the University of Ottawa, has long stressed that Swedish Match and Volvo, lauded for their leadership in reducing risk in cars, were once controlled by the same holding company. He used the comparison to highlight that a technological transition in the nicotine industry - unlike, say, the shift from gasoline-powered cars to electric vehicles - remains questionable and, for the most part, unwelcome.