Sweden’s smoke-free success is ‘inconvenient truth’ for prohibitionists

BRUSSELS – Sweden’s rapid progress towards ‘smoke-free’ status is an “inconvenient” reality that contradicts those who seek to crack down on safer nicotine alternatives, say advocates of harm reduction.

MEP Charlie Weimers (ECR, Sweden) spoke out yesterday (Wednesday 3 February) as international health experts unveiled evidence in the Brussels Parliament showing that oral nicotine pouches are helping to wipe out cigarettes in Sweden and allowing women to close a long-standing gender gap in quitting smoking.

“Sweden has become inconvenient precisely because it offers one of the clearest contemporary examples of harm reduction translated into population-level results,” Weimers said.

“In the next few years, my country is set to become the first to fall below the 5% smoking rate, the standard definition of smoke-free. Harm reduction is one of the most effective tools available to public health policy.

Leading public health advocates told MEPs, political aides and other stakeholders that nicotine pouches are a game-changer in the war against smoking, particularly for women.

Their ground-breaking report Power in a Pouch reveals that since their introduction in Sweden in 2016, smoke-free, tobacco-free nicotine pouches have:

• Supercharged the decline in smoking for both genders, with an almost 200% increase in quit rates among women
• Outperformed all other quit aids, with both men and women ranking nicotine pouches as the most effective method
• Been rated by women almost three times more effective than vapes and 56% more effective than nicotine gum
• Emerged as the preferred quit aid due to their clean, socially considerate and stigma-free format
• Driven a 49% drop in smoking among women, closing a gap that had persisted for decades

“The evidence shows that nicotine pouches are the most effective tool to help smokers – and especially women – to quit cigarettes,” said Prof Marewa Glover, behavioral scientist and co-author of the report. “Across health data, national surveys and women’s lived experience, the same story emerges. Nicotine pouches fit modern lives. They are clean, socially considerate and effective. And they work where other methods have failed.”

Sweden’s approach stands in sharp contrast to prohibitionist policies being pursued in many parts of Europe. Rather than restricting safer alternatives, Sweden has embraced harm reduction, recognising that smoke-free nicotine products are dramatically less harmful than cigarettes.

As a result, Sweden’s smoking rate has fallen to 5.3%, just above the international smoke-free benchmark. Male lung cancer deaths are 61% lower than the EU average, while overall cancer mortality is 34% lower.

“Sweden didn’t get here by accident,” said Prof Heino Stöver, Professor of Public Health at Frankfurt University. “It succeeded by following the evidence, not ideology. Harm reduction works when people are given realistic alternatives to smoking and nicotine pouches are now proving to be one of the most powerful tools we have.”

Consumer advocates warned MEPs that proposed bans and restrictions on nicotine pouches across Europe risk reversing these gains, particularly for women.

“Women are telling policymakers exactly what helps them quit, but they’re not being listened to,” said Carissa During, leader of the consumer group Considerate Pouchers. “Pouches are socially considerate and free from the stigma that still surrounds smoking and vaping. Taking them away doesn’t protect women – it pushes them back towards cigarettes.”

Dr Delon Human, leader of Smoke Free Sweden and former Secretary-General of the World Medical Association, said: “Sweden is winning the war against smoking by making safer nicotine alternatives accessible, acceptable and affordable.

“Misguided bans and barriers elsewhere are blocking access to products that save lives. That’s a public health failure. Denying women access to the quit aid that works best will cost lives.”

Dr Glover added: “When women have access to clean, stigma-free alternatives, quit rates soar. Without them, we condemn another generation to smoking-related disease. Policymakers face a simple choice: follow Sweden’s evidence-based success or allow preventable deaths to continue on a massive scale.”