BACKGROUND AND IMPLEMENTATION CHALLENGES: The tobacco industry is successfully communicating through international press, claiming that Sweden is now smoke-free thanks to snus, used as a strategic harm reduction approach. This narrative concludes that countries should follow Sweden’s example, through refraining from regulations of nicotine products.
What do we know of the facts behind this narrative? Let us look at statistics, research and Swedish tobacco control history to find out.
INTERVENTION OR RESPONSE: Best avaliable knowledge from Swedish authorities and organisations on tobacco and nicotine use and purchase, company compliance to regulations and the connection between usage of tobacco and nicotine products, and the history of tobacco control measures in Sweden, is presented.
RESULTS AND IMPACT: During the 1990s, Sweden implemented decisive measures that had discouraging and normative effects, stemming from the first regulations in the 1960s. Public places have been made smoke-free, a ban on tobacco advertising was implemented early as well as an age limit, a sales permit requirement for selling tobacco was introduced and tobacco tax increased. These laws have been monitored and enforced by authorities, and tobacco use has been monitored continuously. Smokers have been offered cost-free smoking cessation
continuously since 1998. Resources supporting tobacco prevention organisations have been available during this whole period.
Regulations of different tobacco and nicotine products currently differ greatly in Sweden. The taxation of nicotine is much lower compared to tobacco taxation, making nicotine snus more affordable to cost sensitive groups. Nicotine snus was introduced to market in 2016, unregulated until 2022.
During recent years, total tobacco and nicotine use is increasing in Sweden. Use is being picked up by young people and young women in particular, resulting in usage increasing rapidly among those groups.
CONCLUSIONS: Decisive tobacco control measures have led to decreased smoking prevalence in Sweden.
To reduce tobacco use, all tobacco and nicotine products must be regulated equally.