Reaching a smoke-free Europe: lessons from the Swedish experience

On 31st May 2023, World No Tobacco Day, MEPs and researchers gathered in the European Parliament at an event hosted by We Are Innovation and The Parliament Magazine, to discuss the remarkable success of Sweden in ​achieving a smoke-free status​​.​
The Parliament Events

By The Parliament Events

Our events bring together MEPs, policy-makers from across the EU institutions and influential stakeholders to share ideas and discuss the issues that matter at the heart of European politics

28 Jun 2023

The European Union has committed itself to reaching a tobacco-free generation, with less than 5% of the population using tobacco by 2040. But Sweden has nearly reached this target seventeen years ahead of the deadline​.​ ​Whilst other EU countries are struggling to make anywhere close to the same level of progress in reducing smoking prevalence, Sweden already has its level of tobacco usage down to 5.6%.​​     ​ 

Tomislav Sokol MEP (EPP, Croatia), who co-hosted the event, set out the EU’s objective of prevention in the EU’s Beating Cancer Plan: “We know that prevention is the most cost effective type of healthcare. 40% of cancers in the EU are preventable and 27% of cancer is  linked to smoking. I think the Swedish example is very interesting and should be analysed. It shows that alternatives to smoking can lead to better health outcomes.” 

​​We Are Innovation, a network of more than 30 think tanks, NGOs and foundations worldwide,​ ​​​​commissioned an IPSOS survey of more than 1,000 Swedish ex-smokers between 18 and 65​ who switched from cigarettes to alternative nicotine products​, to examine what lessons could be drawn from the Swedish approach. 

Sweden’s secret sauce 

CEO of We Are Innovation, Federico Fernández explained that his organisation focused on ​topics​​ ​that use innovation to address societal issues in a way that makes a deep ​human ​impact, and the Swedish approach to creating a smoke-free society caught their attention for this reason. “Sweden found the missing piece of the puzzle. Sweden has implemented the policies of the European Union and World Health Organization, it has also invested heavily in educating its population on the risks associated with smoking; but what distinguishes Sweden is its approach to alternative nicotine products (ANP) such as snus and newer, more innovative products, like nicotine pouches, vaping and heated tobacco.” 

​​​The survey showed that for all ex-smokers, the main factor when they were switching from cigarettes to ANPs was health. One of key elements for consumers in switching and staying away from cigarettes was accessibility to a wide range of ANPs. Unusually, Sweden had a higher rate of smoking for women than men. The survey found very different preferences between men and women. For example, women were more likely to switch from cigarettes to nicotine pouches and vaping than to snus. ​​ 

Other important issues for smokers were acceptability and affordability. Having alternatives to smoking in a flavour of your choice was important to 89% whilst a choice over nicotine level was important to 75%. Affordability was the other major driver to help smokers choose alternatives to cigarettes. Sweden taxes cigarettes more highly than snus, for example. ​​ 

​Dr Christopher Russell, a behavioural psychologist based in Scotland, said that the overarching goal of tobacco control policy in any government should be to help save lives and prevent disease as rapidly as possible: “Healthcare providers, regulators and policymakers have - and I choose my words carefully - a duty to help more people quit smoking. If other EU member states followed the Swedish example, it could make quitting smoking achievable for millions of EU citizens.” 

Sara Skyttedal MEP (EPP, Sweden) said that it is no coincidence that Sweden has the lowest rate of tobacco-related mortality. Skyttedal attributed this to three factors that can be drawn from the Swedish model: “Firstly, we should refrain from total bans on novel nicotine products. I would say this was obvious, but apparently it needs to be said with Belgium’s decision to ban nicotine pouches. Secondly, when the Tobacco Product Directive is revised there will be pressure to ban flavours, this would be a mistake. Thirdly and lastly, we should ensure that our tax systems reflect the relative dangers of different products. For example, e-cigarettes and healthier alternatives should be taxed less than cigarettes.” 

Johan Nissinen MEP (ECR, Sweden), said that he had never smoked or used any of the ANPs, but spoke about how his father had found e-cigarettes critical to quitting cigarettes: “It is such a strong habit and e-cigarettes helped him move away from this physical habit.” 

Federico Fernandez

Asked if Sweden could do even more, Nissinen said that he would like to see a system where cigarettes and ANPs were sold at the same point, with clear labelling to show the relative risks of each product, “that way consumers could make more informed, healthier choices.” 

A physician and audience member called on the World Health Organisation to undertake country studies and to look at Sweden, but also examine how other countries like South Korea, Japan and the UK are also including alternatives to tobacco within their overall strategies to reduce harm and help those who find it difficult to stop smoking use safer alternatives.  

In partnership with

We are Innovation logo

This article was produced in partnership with We Are Innovation. ​​We Are Innovation is a network of more than 30 think tanks, NGOs and foundations worldwide focused on ​topics​​ ​that use innovation to address societal issues in a way that makes a deep ​human ​impact.

Read the most recent articles written by The Parliament Events - Road to European Elections - A stronger Europe in the world by 2030