Empowerment in a Pouch
A Game-Changer for Women in the World’s Pursuit of a Smoke-Free Future
Authors: Dr Delon Human & Prof. Marewa Glover
HOW POUCHES ARE SECURING WOMEN’S HEALTH
Smoke-free success starts with women
Throughout the course of their lives, women’s health is shaped by multiple factors, from cardiovascular disease and cancer to mental wellbeing, caregiving pressures and access to effective prevention tools.
Tobacco use remains one of the most powerful drivers of avoidable illness and early death among women globally, making smoking cessation central to wider goals of health equity among genders.
Sweden is on the brink of becoming the world’s first smokefree country, defined as adult smoking prevalence below 5%. That achievement has only been possible because progress has increasingly reached women, a group historically underserved by traditional quit-smoking approaches.
Today, Swedish women are quitting smoking at a pace that’s six times faster than their counterparts across the European region, transforming national health outcomes and providing a roadmap for gender-responsive public health throughout the world.
Ensuring no one is left behind
For decades, Swedish women found it harder than men to quit smoking. Ground-breaking evidence from Smoke Free Sweden shows oral nicotine pouches are helping change this trajectory. Its Power in a Pouch report documents how these smoke-free, tobacco-free alternatives accelerate quit rates by fitting more naturally into women’s daily lives.
Sweden’s earlier gains were driven largely by snus, adopted mainly by men. Nicotine pouches have broadened access, appealing to women who did not take up previous alternatives.
Placed under the lip, they deliver pharmaceutical-grade nicotine without combustion and carry risk profiles comparable to established nicotine replacement therapies listed by the World Health Organization.
Since their introduction in 2016, women’s smoking rates in Sweden almost halved, narrowing the gender gap in quitting. This progress is already reflected in some of Europe’s lowest smoking-related cancer rates, underscoring the profound health dividends of replacing cigarettes with safer alternatives.
Sweden’s experience shows what is possible when innovation meets inclusion, empowering women with practical tools to quit smoking and delivering healthier futures for families and communities worldwide.
Sweden’s transformation
With the EU’s lowest smoking rate (5.3%), Sweden is set to become the first country in the world to achieve official ‘smoke-free’ status, thanks to its embrace of safer alternatives like snus, vapes and nicotine pouches. Since the introduction of pouches in 2016:
EVIDENCE OF A HEALTH REVOLUTION
The No.1 quitting aid for women
Survey data analysed in Power in a Pouch shows that women rate nicotine pouches as the most effective method for quitting smoking. Among female respondents, pouches dramatically outperformed other cessation aids, including nicotine gum and vapes.
These preferences are reflected in population-level outcomes. Since nicotine pouches became widely available, women’s quit-smoking rates have increased by 200%, contributing to one of the steepest declines in female smoking prevalence observed across the globe.
Features that support sustained quitting
Women who switched from cigarettes consistently identified characteristics of nicotine pouches that supported long-term quitting:
- Socially considerate, without smoke, vapour or smell
- Ease of use in work and social settings
- Choice of flavours and strengths
- Flexibility that fits daily routines
IMPLICATIONS FOR POLICY & WOMEN’S HEALTH
What female ex-smokers say about nicotine pouches
Focus group discussions with female ex-smokers revealed a compelling, consistent theme: nicotine pouches offered the most realistic, respectful and sustainable way to quit smoking.
Unlike some other aids for quitting, nicotine pouches were not only seen as effective, but also as compatible with everyday life. Participants repeatedly described nicotine pouches as socially considerate, clean and stigma-free qualities that made it easier to quit smoking without drawing attention or feeling marginalised.
Nicotine pouches are seen as a cleaner, socially acceptable substitute for smoking. Many began using pouches after trying to quit cigarettes or vaping. They described pouches as less harmful, fresher and more tactful – especially in social or professional contexts:
“My friend used to smoke a lot, then she switched to nicotine pouches. No smell, way fresher. I’ve tried different flavours – now I’ve quit smoking completely.”
“It feels less harmful. I train a lot – smoking ruined my stamina. With nicotine pouches I can keep working out.”
“I smoked before I had kids, but when I started working again it didn’t feel right smelling like smoke around my child.”
“It doesn’t smell, it doesn’t show and you don’t have to go outside.”
“I started using nicotine pouches when I quit smoking. It was easy to switch.”
“I can use them anywhere. At brunch, in the office, on a train – no one sees, no one smells, no one minds.”
“They don’t bulk up my bag. No vape to charge, no bottle of liquid, no lighters – just a tiny tin.”
What Sweden’s success shows
Sweden’s progress illustrates the impact of risk-proportionate regulation that recognises differences between combustible cigarettes and safer nicotine alternatives.
Female daily smoking prevalence in Sweden has dropped to just 5.7%, one-third of the EU average and a 49% decline since 2015. According to the WHO, European women are quitting six times slower than Swedes – emphasising the urgent need for an innovative approach.
Maintaining momentum
Proposals to restrict or ban nicotine pouches in other countries should be considered in light of Sweden’s success. Limiting access to products that women already use to quit smoking risks slowing progress in reducing smoking-related harm among women.
This International Women’s Day
Smoke Free Sweden urges policymakers to recognise nicotine pouches as an effective cessation tool for women and to ensure that regulation reflects real-world evidence. Supporting women with practical, effective alternatives to cigarettes remains one of the most reliable ways to advance smoke-free public health goals.