Sweden enshrines tobacco harm reduction in public health policy

Sweden has enshrined tobacco harm reduction in public health policy after official data showed just 4.5 per cent of Swedish-born adults now smoke – below the 5 per cent smoke-free threshold.

Smoke Free Sweden, a campaign group, said this success has led the parliament to formally adopt harm reduction, reinforcing Sweden’s role as a global leader in public health innovation.

“Swedes have participated in a long-running harm reduction experiment, providing undeniable proof that replacing smoking with smokeless nicotine dramatically reduces smoking-related disease, disability and premature deaths – a net gain for public health, while reducing expenditure,” Dr. Delon Human, leader of Smoke Free Sweden, said.

“With harm reduction now policy in Sweden, every public health decision will reflect this approach. Other countries should adopt Sweden’s model without further delay.”

Sweden now prioritises reducing harm by encouraging smokers to switch to safer alternatives like snus, nicotine pouches and vapes.

Adopted by Parliament in December 2024, the policy states: “Tobacco policy must consider the varying harmful effects of different products. Cigarettes pose a greater health hazard than smokeless nicotine… This must be reflected in taxation and policy goals.”

Sweden has already applied risk-based taxation by lowering excise tax on snus while increasing it on cigarettes.

“Sweden’s formal adoption of harm reduction is a global milestone,” says Dr. Human. “With smoking rates at 5.3 per cent, Sweden is set to become the first smoke-free nation. Policymakers serious about reducing smoking-related deaths must follow suit.”

Among Swedish citizens born elsewhere in Europe, the smoking rate is 7.8 per cent – less than a third of the EU average. The public health benefits mean Sweden has 41 per cent fewer cancer cases than the European average and 44 per cent lower tobacco-related mortality.

Other nations applying Sweden’s model are seeing similar results. New Zealand has nearly halved smoking rates (12.2% in 2018 to 6.9% in 2024) by promoting vaping, while Japan saw a 43 per cent drop in cigarette sales from 2015 to 2020 as smokers switched to heated tobacco products.

In the UK, nearly three million quit smoking using vapes in five years.

“In every tobacco control discussion, regulators should ask, ‘How have Swedes made smoking history, while saving lives?’,” Dr. Human concluded.