Why Sweden should be the focus at COP10

By Dr. Anders Milton

Over the coming days, delegates from 183 countries will be making their final preparations for the Conference of the Parties (COP10) to the WHO Framework Convention on Tobacco Control (FCTC). As governments around the world struggle to reduce the burden of smoking, COP10 represents one of the most important platforms through which to share expertise on how to save lives. If I were a delegate, I certainly know which approach I would be championing.

Without a doubt I would be sharing everything I know about the unique success of Sweden in becoming smoke free. Achieving a ‘smoke-free’ status, defined as less than 5% of the population smoking, is a feat only Sweden has nearly reached in Europe. As of the latest 2022 data, the smoking rate was just 5.6%, and it’s probable that Sweden has since dipped below this threshold.

As a COP 10 delegate, I would highlight  how Sweden’s success is not just a national achievement but also a testament to the effectiveness of recognising harm reduction as a key strategy in tobacco control. Sweden’s positive attitude towards less harmful alternatives, including snus, echoes the FCTC’s emphasis on reducing the harm caused by tobacco. Its openness to other products, such as nicotine pouches and vapes, has played a key role in setting an important international precedent. As many other countries have focused on traditional tobacco control mechanisms only, if at all, they have found it difficult to replicate Sweden’s success.

Sweden’s strides toward a smoke-free status align seamlessly with the objectives outlined in the WHO’s FCTC. Its unique mix of tobacco control and harm reduction has likely already saved thousands of lives, with a substantially lower rate of smoking-related illnesses and a cancer incidence 41% lower than the European average. Imagine this success replicated around the world, and the lives saved as a result. The world is now looking to Sweden as the example to follow, and asking the question: How did Sweden do it? Answering this question is central to the FCTC’s principles.

As a delegate, I would acknowledge Sweden’s firm commitment to rigorous tobacco control measures. This includes advertising limitations, packaging guidelines, and sales regulations. But I would make it very clear that it does not stop there. Equally significant is our balanced regulation of alternative products, particularly in taxation and advertising. This strategy is fully aligned with the FCTC’s call for comprehensive strategies. What this really underscores is the importance of a multifaceted approach in tackling the tobacco epidemic. It should serve as a model for other countries striving to meet FCTC standards.

The FCTC emphasises the importance of global cooperation in combating tobacco-related challenges. Sweden, by actively sharing its effective tactics in harm reduction and smoking cessation, is a perfect example of this kind of global partnership. As a delegate I would stress the importance of wider recognition of such cooperative efforts. By fostering dialogue and knowledge exchange, we can collectively strengthen the global fight against smoking related deaths.

I would be a very optimistic COP10 delegate, one that has seen the fantastic results of a strategy that works and saves lives. Delegates should advocate for more flexibility in the FCTC guidelines to allow countries to explore and implement innovative approaches tailored to their unique circumstances and encourage harm reduction more strongly.

That’s what I would do and share with the others as a delegate at COP10.

But here, I would like to send a plea to those who will actually be there in Panama next week: As delegates at COP 10, your role extends beyond mere discussion; you must act as catalysts for global health transformation. It’s time to look to Sweden not just as a model but as a call to action. You need to actively encourage the WHO and member countries to embrace flexible, innovative approaches in tobacco control, particularly those that have shown success in Sweden. This conference should be a launchpad for tangible, worldwide initiatives aimed at reducing the impact of tobacco.