Lowest Smoking Rates Across European Union Found in Sweden
In Sweden, a shift towards less harmful nicotine products is helping the country to outpace the European Union and move towards becoming the world's first smoke-free nation. The Swedish government frames these products as substitutes for traditional cigarettes, aiming to maintain control over the country's tobacco consumption and legislation.
One of the most popular nicotine products in Sweden is Snus, a smokeless tobacco product placed under the lip. While it does not cause lung cancer like cigarettes, Snus is associated with increased risks of esophageal, pancreatic, stomach, colorectal cancers, cardiovascular disease, and stroke.
Nicotine pouches, tobacco-free and containing nicotine with flavorings, share similarities with Snus in delivery but may cause side effects like gum irritation, nausea, and headaches. As newer products, their long-term health effects are still unclear. Regulatory standards in Sweden and some countries focus on controlling nicotine levels and ingredient safety to mitigate risks.
Vaping, or the use of e-cigarettes, involves inhaling nicotine aerosols without tobacco combustion. Vaping is linked to specific lung diseases such as bronchiolitis obliterans ("popcorn lung") and other respiratory issues if used heavily and long term. Its long-term effects are less well documented due to its relatively recent widespread use.
Compared to traditional cigarettes, which cause lung cancer, many other cancers, cardiovascular disease, respiratory disease, and harm from secondhand smoke, these alternative nicotine products pose a lower but not negligible health risk. Sweden’s public health data shows a significant decline in smoking-related diseases correlating with the rise of Snus and nicotine pouches, illustrating a "lesser of two evils" scenario despite ongoing concerns about chronic nicotine addiction and some cancer risks.
The decline in smoking in Sweden is particularly notable among older men and in larger cities with denser populations. Today, only about 5% of adults in Sweden smoke daily, making it the country with the lowest smoking prevalence in Europe. Moreover, Sweden has the lowest lung cancer mortality rate in the European Union.
Nicotine pouches and vaping are socially acceptable and more affordable than traditional cigarettes in Sweden, and their use is allowed in public spaces. These less harmful nicotine products greatly reduce the risk of secondhand smoke, contributing to a safer environment for non-smokers.
However, continued research and regulation aim to balance harm reduction with minimizing new nicotine addiction, especially among youths. While Sweden's approach using Snus, nicotine pouches, and vaping has contributed to dramatic declines in cigarette smoking and smoking deaths, it's important to remember that all these products maintain some risk, especially cardiovascular and certain cancer risks for Snus, uncertain but less severe risks for nicotine pouches, and potential respiratory risks for vaping.
[1] Public Health England. (2018). Evidence review of e-cigarettes and heated tobacco products 2018. London: Public Health England. [2] European Centre for Disease Prevention and Control. (2020). Nicotine pouches: A new tobacco product in the EU/EEA. Stockholm: ECDC. [3] World Health Organization. (2019). WHO Report on the Global Tobacco Epidemic, 2019. Geneva: World Health Organization. [4] International Agency for Research on Cancer. (2016). Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: IARC. [5] Swedish National Institute of Public Health. (2018). Snus and tobacco use among young people in Sweden. Stockholm: SNI.
These alternative nicotine products, such as snus, nicotine pouches, and vaping, are often marketed as less harmful alternatives to traditional cigarettes in the context of Sweden's smoking-reduction strategy. Despite their lower risks compared to cigarettes, these products still pose certain health risks, particularly for cardiovascular disease and certain cancers associated with snus use, uncertain but less severe risks for nicotine pouches, and potential respiratory risks for vaping. In the realm of health and wellness, continued research and regulation are crucial to balance harm reduction with minimizing new nicotine addiction, especially among youths. [1, 2, 3, 4, 5]
