Get South Africa quitting like Sweden to save smokers’ lives, experts urge Ramaphosa

LEADING international public health experts are urging President Cyril Ramaphosa to adopt the ‘Swedish way’ today (Friday) to secure a smoke-free South Africa and save the lives of millions of cigarette smokers.

As Mr Ramaphosa prepares to give his keynote speech at the Presidential Health Summit, the experts have pointed to the historic achievement of Sweden, which is about to become the first country in the world to achieve smoke-free status.

“Sweden’s success story should be celebrated as a public health revolution,” said Dr Delon Human, secretary-general of the Africa Harm Reduction Alliance (AHRA). “We should all be on the mountaintop shouting ‘Victory!’, and looking at Sweden as the best-case practice.

“The Swedes’ model of tobacco harm reduction is the one that South Africa should be following, and Mr Ramaphosa’s speech at the Presidential Health Summit today is the ideal place to start.”

Sweden is set to drop below a 5% tobacco smoking prevalence rate in the next few months. This is the level at which a country is considered officially smoke-free.

No other member of the European Union is close to matching Sweden’s achievement and none is even on track to do so by the EU’s target of 2040, in 17 years’ time.

South Africa lags even further behind with a smoking rate approximately five times higher than Sweden’s, a seminar held by the AHRA in Johannesburg heard.

Sweden’s innovative strategy to minimise the harmful effects of tobacco smoking and save lives is detailed in a new report entitled The Swedish Experience: A roadmap for a smoke-free society, which was co-authored by Dr Human and presented at last Friday’s seminar.

Sweden’s approach combines tobacco control methods with harm minimization strategies such as the use of vapes and nicotine pouches. According to the report, 3.5 million lives could be saved in the next decade if other EU countries adopt similar measures.

“The Swedish way is all about saving lives and about the quality of life for smokers who’ve been unable to quit,” said Dr Human. “Harm reduction is their way out, it’s their fire escape.”

Sweden’s smoking rates just 15 years ago were more than 150% higher than they are today. It now has the lowest percentage of tobacco-related diseases in the EU and a 41% lower incidence of cancer than other European countries.

The seminar heard that the tobacco control bill currently before Parliament in South Africa could jeopardise hopes of Mzansi becoming smoke-free any time soon.

Dr Derek Yach, a global health consultant who was president and founder of the Foundation for a Smoke-Free World, warned against proposals in the bill that would regulate harm-reduction products, such as vapes and nicotine pouches, the same as combustible cigarettes.

“Standing back and going along with equalisation of the harm reduction category versus the combustible category will set us back,” he said. “A review in a few years’ time will show that we’ve actually forgone the opportunity to save many, many lives.”

AHRA president Dr Kgosi Letlape said: “For adult smokers, switching to non-combustible alternatives is highly recommended. Where governments have allowed these alternatives into their environment, the use of combustible cigarettes has come down and health benefits have been derived.”


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Notes to editors:

About the report

The report was commissioned by Health Diplomats, an international organization working to improve access to healthcare and encourage innovation and the use of harm reduction to minimize the negative impact of alcohol, food, nicotine and drugs.

The full report is available here: The Swedish Experience ENG.pdf

Some of the report’s conclusions and suggestions for implementation in other countries.

1: Recognize smoke-free products as significantly less harmful than smoking. Encourage smokers to switch from cigarettes to less harmful alternatives.

2: Provide fact-based information. It is clear that there are no risk-free tobacco products. But, for example, e-cigarettes are 95% less harmful than cigarettes. Of course, it is better for a smoker to switch from regular cigarettes to e-cigarettes, although it is not without risk.

3: Develop policies that make smoke-free alternatives more accessible than cigarettes. For example, differentiated taxes that give smokers financial incentives to switch from cigarettes to less harmful alternatives.

About the report’s authors:

Dr Anders Milton, formerly chairman of the Swedish Medical Association, the Swedish Red Cross and the World Medical Association.

Dr Delon Human, physician specializing in global public health issues. Former advisor on public health issues to, among others, three WHO directors-general and the UN secretary-general.

Prof Karl Fagerström, docent and internationally recognized expert in addiction research and smoking cessation.