Should Africa Emulate Sweden’s Strategy to End Smoking?
Sweden is expected to become the first country in Europe to become smoke-free in 2023, two years ahead of its own government's target and 17 years ahead of the EU's smoke-free 2040 goal. The introduction of new smoke-free alternative products in Sweden in the past 15 years has accelerated progress towards achieving a smoke-free society, with a 60% decrease in smoking rates between 2006 and 2020.
In Sweden, the use of snus (a smokeless tobacco product) has contributed to a significant reduction in smoking rates among men, from approximately 1.9 million smokers in 1963 to under 1 million in 2012. A range of smoke-free alternatives, including e-cigarettes, heated tobacco, and nicotine pouches, are available in Sweden and have contributed to the country's progress toward becoming smoke-free.
Sweden's experience of deploying safer alternatives to cigarettes has resulted in significantly reducing smoking-related mortality and morbidity and can be replicated in other countries. If Africa adopted the "Swedish model" of embracing tobacco harm reduction and encouraging smokers to switch to a range of alternative products, over 7 million deaths every year could be prevented.
Tobacco control measures alone are not sufficient, and access to smoke-free alternatives is critically important. A recent survey conducted in the United Kingdom found that two-thirds of smokers believed e-cigarettes to be just as harmful as cigarettes, despite evidence showing they are at least 95% less harmful.
Smoke-free alternatives must be genuinely acceptable to smokers as a better alternative to cigarettes, which means ensuring a range of flavors and nicotine concentrations for consumers to buy. Educating the public on smoke-free alternatives to cigarettes is necessary, as there is a spate of misinformation about their safety.
Harm reduction strategies, such as allowing adult smokers who cannot or will not quit to switch to smoke-free alternatives, should be embraced by countries seeking to beat smoking like Sweden did.
Sweden's approach of displacing smoking with smoke-free alternatives has delivered sensational public health gains, with record low levels of tobacco-related mortality and morbidity that cannot be matched by any country in Europe.
Today, if African countries adopted the 'Swedish model' of embracing tobacco harm reduction and encouraging smokers to switch to a range of alternative products, over 70 million early deaths could be prevented in the next decade alone. Harm reduction strategies should be supported by policy settings that make smoke-free alternatives more affordable than the most harmful combustible cigarettes, eliminating financial barriers to switching.
Policy settings that make smoke-free alternatives more affordable than the most harmful combustible cigarettes, and eliminate financial barriers to switching should be encouraged. Policymakers in Africa need to mitigate the dangers of a public health revolution and fully embrace the opportunities, by applying the learnings from Sweden's tobacco control success to reorder priorities and application of modern tobacco control.
Making smoke-free alternatives accessible, acceptable, and affordable can help smokers switch to less harmful products and reduce smoking prevalence. Smoke-free alternatives to cigarettes must be accessible, acceptable, and affordable to smokers in order to drive considerable reductions in smoking prevalence.
For more information on the report; visit https://smokefreesweden.org/