Strict regulations on safer nicotine alternatives are hindering Kazakhstan’s fight against deadly cigarettes, according to a new report by international health experts.
Smoke Free Sweden’s latest Tale of Two Nations report compares Kazakhstan’s tobacco control policies with those of Sweden, where adoption of safer alternatives has powered progress towards official smoke-free status.
The report concludes that Kazakhstan’s restrictive approach to lower-risk nicotine products is slowing progress against smoking and contributing to a preventable death toll of more than 17,000 people every year.
While Sweden has reduced daily adult smoking to just 5.3%, Kazakhstan’s rate remains 15%, almost three times higher.
Report co-author Dr Gintautas-Yuozas Kentra, a Kazakh cardiologist and harm reduction specialist, said:
“Kazakhstan has shown it can reduce smoking, but progress has stalled because it continues to treat every nicotine product as though it carries the same risk as a cigarette. Science tells us that is simply not true.
“Sweden has shown there is a faster route to reducing the terrible toll of cigarettes by giving adult smokers access to regulated, lower-risk alternatives while maintaining strong protections for young people.”
The report notes that Kazakhstan reduced smoking during the early 2000s, but momentum has slowed markedly over the past decade. Daily smoking prevalence has fallen only from about 19% in 2014 to 15% today, despite increasingly restrictive regulation. Smoking remains especially prevalent among men, with 34% using tobacco compared with 5% of women.
By contrast, Sweden has cut smoking by 54% since 2012. It now has the lowest smoking-related disease burden in Europe, including a male lung cancer death rate 61% below the European Union average.
The report explains how Sweden achieved its success by combining traditional tobacco control measures with legal access to safer smoke-free alternatives including snus, nicotine pouches and vapes
Kazakhstan, by contrast, has banned vaping products and nicotine pouches while regulating heated tobacco products in much the same way as cigarettes.
The report estimates that tobacco kills 17,285 people in Kazakhstan every year. It also concludes that adopting evidence-based tobacco harm reduction policies could prevent up to 165,000 premature deaths over the next four decades.
Smoke Free Sweden leader Dr Delon Human, who also co-authored the report, says Kazakhstan has an opportunity to accelerate its progress if it embraces evidence rather than prohibition.
“No country has ever banned its way to the lowest smoking rate in the world,” said Dr Human, a former secretary-general of the World Medical Association.
“Sweden’s experience proves that when smokers are offered acceptable, affordable and regulated alternatives, millions choose to leave cigarettes behind. Kazakhstan can save lives by following that evidence.”
The report recommends that Kazakhstan policymakers integrate tobacco harm reduction into national policy, distinguish combustible cigarettes from lower-risk smoke-free alternatives, strengthen research and surveillance, protect young people while expanding access for adults who smoke, and improve public communication about the relative risks of nicotine products.
