{"id":7227,"date":"2023-03-17T14:15:35","date_gmt":"2023-03-17T13:15:35","guid":{"rendered":"https:\/\/snusforumet.se\/?p=7227"},"modified":"2023-03-17T14:15:36","modified_gmt":"2023-03-17T13:15:36","slug":"sweden-nears-smoke-free-status-a-public-health-miracle","status":"publish","type":"post","link":"https:\/\/snusforumet.se\/en\/sweden-nears-smoke-free-status-a-public-health-miracle\/","title":{"rendered":"Sweden nears smoke-free status: a ‘public health miracle’"},"content":{"rendered":"\n

Sweden will soon be the first country in the world to reach smoke-free status<\/strong>. And lessons from Sweden’s “public health miracle” can help inspire other countries, according to a new report on the \u201cSwedish Experience\u201d with tobacco harm reduction.<\/strong><\/p>\n\n\n\n

The report, \u201cThe Swedish Experience: A Roadmap to a Smoke-free Society<\/a>\u201d, describes many of the circumstances that have contributed to Sweden\u2019s current daily smoking rate of 5.6 percent. It also details many of the positive public health effects, including a 38 percent lower incidence of cancer compared to the rest of the EU and a 39.6 percent lower tobacco mortality rate.<\/p>\n\n\n\n

\u201cIn many ways, Sweden is the best-kept secret in public health,\u201d said lead author Dr. Delon Human during the report\u2019s launch event in Stockholm.<\/p>\n\n\n\n

\u201cWe want to make sure that the rest of the world understands what Sweden has achieved.\u201d<\/p>\n\n\n\n

Human, head of the pro-harm reduction healthcare consulting group Health Diplomats<\/a>, explained that in 2023 Sweden\u2019s daily smoking rate will likely drop below 5 percent, the World Health Organization (WHO) definition of \u201csmoke-free\u201d.<\/p>\n\n\n\n

Meanwhile, he continued, the smoking prevalence in much of the rest of the EU is closer to 25 percent. He believed it was unlikely that any other EU member state would likely reach smoke-free status by the EU target of 2040.<\/p>\n\n\n\n

Democratisation of tobacco control<\/h2>\n\n\n\n

Sweden, said Human, had already democratised affordable design furniture thanks to Ikea and car safety thanks to the 3-point seatbelt pioneered by Volvo.<\/p>\n\n\n\n

\u201cWhat we see here is now a democratisation of tobacco control,\u201d he explained.<\/p>\n\n\n\n

\u201cWhy is this not being shouted from the hilltops that this is a fantastic public health achievement?\u201d<\/p>\n\n\n\n

The reason, according to physician Dr. Anders Milton, head of the Snus Commission<\/a>, is that Sweden\u2019s public health bodies follow an absolutist and moralistic view of tobacco propagated by the WHO.<\/p>\n\n\n\n

In their eyes, \u201canything related to tobacco consumption or consumption of nicotine is bad regardless if it kills you or doesn’t kill you\u201d, Milton told the audience.<\/p>\n\n\n\n

He emphasised that it\u2019s Swedish consumers and citizens, rather than the country\u2019s public authorities and politicians, that deserve the most credit for putting Sweden on the doorstep of becoming the first country in the world to achieve smoke-free status<\/a>.<\/p>\n\n\n\n

\u201cIn Sweden, we are in a position where people have chosen, not the authorities. But the authorities have accepted it,\u201d he explained.<\/p>\n\n\n\n

Consumers pivotal in Sweden’s smoke-free journey<\/h2>\n\n\n\n

The availability and cultural acceptance of snus in Sweden as a safer, smoke-free alternative, allowed consumers to make that choice as the dangers of cigarettes became more widely known.\u00a0<\/p>\n\n\n\n

Sweden\u2019s exemption from the EU snus ban was likely critical to Swedes\u2019 narrow acceptance of EU membership in 1995, said Milton. And comparing Sweden\u2019s public health statistics with the rest of the EU since then makes it clear that the availability of snus in Sweden has resulted in tangible public health benefits.<\/p>\n\n\n\n

\u201cIt\u2019s important for Swedish public health, the Swedish image, and Swedish consumers, to have snus. We have snus. The rest of Europe doesn\u2019t,\u201d he explained.<\/p>\n\n\n\n

Cardiologist Konstantinos Farsalinos also highlighted consumers\u2019 role in the \u201cSwedish Experience<\/a>\u201d of tobacco harm reduction as it draws ever closer to reaching smoke-free status.<\/p>\n\n\n\n

\u201cThis has been a consumer-initiated and consumer-driven revolution,\u201d he said.<\/p>\n\n\n\n

New Zealand-based harm reduction advocate Marewa Glover<\/a> drew parallels to the role consumers played in the growth of vaping. The vaping \u201cindustry\u201d really began with smokers embracing vaping as a safer alternative.<\/p>\n\n\n\n

\u201cConsumers innovated and improved the product. They began to set up vape shops. They began to set themselves up as manufacturers. It really was a groundswell of consumer-driven innovation,\u201d she explained.<\/p>\n\n\n\n

\u201cThen people who smoked all around the world got into the vaping industry. It wasn’t the tobacco companies.\u201d<\/p>\n\n\n\n

Neutrality and Sweden’s smoke-free status<\/h2>\n\n\n\n

Researcher Karl Olof Fagerstr\u00f6m<\/a>, also a member of the Snus Commisison, theorised that Sweden\u2019s neutrality during World War II helped create conditions that allowed Swedes to choose snus over cigarettes.<\/p>\n\n\n\n

\u201cSmoking among men never went up as high in Sweden as in the countries that went to war and where cigarettes were freely and widely distributed,\u201d he explained.<\/p>\n\n\n\n

\u201cThat also meant that the old habit of using snus prevailed in some small pockets of the society.\u201d<\/p>\n\n\n\n

Thus as the health hazards of smoking became more widely known in the 1960s and 1970s, Swedes could easily substitute cigarettes with snus, a much less harmful alternative.<\/p>\n\n\n\n

Farsalinos pointed out that, while very few Swedes smoke<\/a>, the country\u2019s overall nicotine intake is \u201calmost identical\u201d to the rest of Europe.<\/p>\n\n\n\n

\u201cBut they’re not taking nicotine through smoking. And this is the big difference between Sweden and the rest of the European Union,\u201d he explained.<\/p>\n\n\n\n

Public health battle has become a moral battle<\/h2>\n\n\n\n

Because Swedish nicotine consumers choose snus, and more recently nicotine pouches, the country\u2019s nicotine use hasn\u2019t resulted in the same amount of death and disease as seen in other EU countries.<\/p>\n\n\n\n

\u201cThey manage to be smoke-free by substituting for cigarettes, using other products,\u201d he continued, pointing out that \u201cthe enemy is smoking\u201d.<\/p>\n\n\n\n

\u201cSweden as a country has not eliminated nicotine use, it has eliminated smoking, and that’s a public health benefit for the population.\u201d<\/p>\n\n\n\n

Farsalinos lamented that the anti-tobacco movement has shifted the discussion about tobacco and nicotine to one about the morality of personal choice rather than public health.<\/p>\n\n\n\n

\u201cThe fight against tobacco and against nicotine, appears to be more of a moral battle about ethics and judging behaviours rather than a public health battle,\u201d he said.<\/p>\n\n\n\n

Milton agreed, arguing that \u201cit\u2019s important for public health authorities to tell people the truth\u201d about products’ relative risks and associated harms.<\/p>\n\n\n\n

The opportunity cost of battling safer nicotine options<\/h2>\n\n\n\n

Glover pointed to the opportunity cost for wider public health goals of devoting resources toward making it harder for consumers to have access to reduced-risk products.<\/p>\n\n\n\n

\u201cYou have billions of dollars pouring into trying to get people to stop using nicotine via risk-reduced products,\u201d she said<\/p>\n\n\n\n

\u201cThat money could be diverted to the next, you know, leading cause of preventable disease.\u201d <\/p>\n\n\n\n

The report concludes by identifying six factors behind Sweden’s smoke-free status that are \u201ckey to driving considerable reductions in smoking prevalence\u201d.<\/p>\n\n\n\n

The factors include differentiating between combustible and non-combustible forms of tobacco; risk differentiation between different tobacco and nicotine products; and providing access to smoke-free alternatives such as snus. Also important is public education about reduced-risk alternatives, consumer acceptance of those alternatives, as well as making those alternatives affordable.<\/p>\n\n\n\n

\u201cTaken together, these learnings will help countries struggling to beat smoking,\u201d the authors write.<\/p>\n\n\n\n

\u201cIt is our belief that if the policies and approach of Sweden are replicated, countries around the world will be able to become smoke-free, just as Sweden has done.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Sweden will soon be the first country in the world to reach smoke-free status. And lessons from Sweden’s “public health miracle” can help inspire other…<\/p>\n","protected":false},"author":3,"featured_media":7229,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[313,254],"tags":[543,298,530,352,252,260,331],"class_list":["post-7227","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-opinions","tag-anders-milton-2","tag-karl-olof-fagerstrom","tag-marewa-glover","tag-smoke-free","tag-snus-commission","tag-swedish-experience","tag-who-2"],"acf":[],"yoast_head":"\nSweden nears smoke-free status: a 'public health miracle' - Snusforumet<\/title>\n<meta name=\"description\" content=\"Sweden will soon be the first country in the world to reach smoke-free status and people need to learn about this \u201cpublic health miracle\u201d.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/snusforumet.se\/en\/sweden-nears-smoke-free-status-a-public-health-miracle\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sweden nears smoke-free status: a 'public health miracle' - 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