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Smokeless products drive dramatic decline in Sweden’s smoking rate

May 30, 2024 People's Journal 181 views

SWEDEN has achieved a remarkable public health feat and is poised to become the 1st smoke-free country, with the lowest smoking prevalence, thanks to its transition to smokeless products, according to a new report.

Sweden’s public health agency reported that only 5.6 percent of Swedish adults smoked cigarettes in 2022, down from 49 percent of men in 1960. It will likely become the first country to achieve smoke-free status, with a smoking rate below 5 percent.

The report titled “No Smoke Less Harm” attributes this achievement to Sweden’s openness to alternative nicotine products and details the significant health benefits associated with the transition.

Sweden has a considerably lower rate of tobacco-related deaths (44% lower) and cancers (41% lower) compared to the rest of the European Union. Cancer deaths specifically have declined by 38%.

The report, released by the Stockholm-based advocacy group Smoke Free Sweden, argues for a reevaluation of tobacco harm reduction (THR) strategies. It contends that combustible cigarettes, not nicotine itself, are the primary culprit behind smoking-related illnesses.

“The Swedish experience demonstrates the importance of understanding public misperceptions about nicotine to develop health policies that better protect and inform consumers,” said Dr. Karl Fagerström, a public health expert who contributed to the report.

While nearly one in four Swedish adults still use nicotine daily, in line with European averages, Sweden boasts far lower rates of tobacco-related deaths (44% lower), cancer rates (41% lower), and cancer deaths (38% lower) compared to the rest of the European Union.

The report, released by global health advocacy group Smoke Free Sweden, finds that combustible cigarettes, not nicotine itself, are the primary culprit behind smoking-related health problems. It emphasizes the existence of significantly less risky forms of nicotine consumption.

Smoke Free Sweden is a movement that encourages other countries to follow Sweden’s lead in tobacco harm reduction. Its report appeals for the World Health Organization (WHO) and global public health communities to acknowledge that combustible products, not nicotine itself, cause harm to smokers.

It urges policymakers to acknowledge the potential of THR in cutting harm, regulate nicotine products based on their relative risk profile, encourage healthcare professionals to embrace THR, and empower THR users to advocate for supportive policies.

The report credits the low rate of smoking-related diseases to Swedes’ preference for alternative smokeless tobacco products like snus, oral nicotine pouches, heated tobacco products, and vapes. This shift, the report says, has led to a “smoke-free generation.” ZYN, the most popular oral nicotine pouch in the US, originated from Sweden.

“While nicotine is addictive, it does not cause the serious diseases associated with smoking,” Dr. Fagerström said. “Our findings support a shift in focus from cessation to substitution with less harmful alternatives for those unable to quit completely.”

Sweden has 52 percent fewer tobacco-related male deaths than Poland and 57 percent fewer than Romania. For male lung cancer, Sweden has significantly fewer deaths than France, Germany, Italy, and Poland.

Dr. Scott Gottlieb, a former commissioner of the US FDA, had recognized the benefits of smoke-free products. He said in a recent interview over CNBC that, “If we can convert more currently addicted adult smokers onto these modified risk products (ZYN nicotine pouches) that don’t have all the harms associated with combustion, we can achieve a substantial net public health benefit.”

The report concludes that high nicotine use does not lead to high rates of health problems, presenting compelling evidence that despite similar levels of nicotine consumption. It says that while smoking is linked to high rates of death and disease, smokeless alternatives, like snus and oral nicotine pouches, don’t pose a similar health risk.

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