Finns prefer nicotine replacement therapy to harm reduction

When it comes to smoking cessation, the effectiveness and availability of nicotine replacement therapies make them more attractive than e-cigarettes to Finns.

Finland is one of the leading countries in the fight against tobacco use. Most of the measures recommended by the FCTC have already been implemented. implemented : ban on smoking and vaping in enclosed public places and in a large number of outdoor public spaces, ban on all flavours other than tobacco flavour, ban on all forms of online advertising or sales and, more recently, introduction of plain packaging for all tobacco and nicotine products.

The combination of these measures and their maintenance over time, thanks to the protection of the anti-smoking policy in order to escape the vagaries of political changes, allowed Finland to display, in 2018, a daily smoking prevalence of 13.3 % (10.9 % for women, 15.7 % for men)[1]. As a result, the goal of a tobacco-free generation – that is, fewer than 5,100 smokers in the population – by 2040 has been set. advanced to 2030. Finland no longer only wants to be a tobacco-free country, but also a nicotine-free country.

Craze for nicotine replacement treatments

One of the strengths of the Finnish approach is the clear preference given to nicotine replacement therapy (NRT) to support smoking cessation, rather than e-cigarettes or other products.[2]. Available without a prescription, TNS are not only available in pharmacies, but can also, since 2006, be purchased in grocery stores or other stores.

This availability of TSNs and the medical nature of these products have contributed to their establishment in consumer habits. A preference which is made to the detriment of electronic cigarettes, to the great regret of Jari Ollika, president of Vapers Finland RY, an association promoting vaping. "Nobody believes in harm reduction", he says, “Vaping is seen as an extension of Big Tobacco. E-cigarettes are not seen as smoking cessation aids.”[3]The success of TNS and their wide availability, however, attracts some covetousness from pharmacists, who would like to re-establish exclusive sales in their network in order to recover this market.

A position also shared in Europe

Although it upsets manufacturers and sellers of electronic cigarettes, Finland's position is not exceptional: it is also the one developed in the report of the European SCHEER committee.[4] and, in France, by the High Council of Public Health (HCSP)[5]. These two organizations consider not only that the level of proof of the effectiveness of electronic cigarettes is not sufficiently established in stopping smoking, but also that the long-term toxicity of these products remains very uncertain. As in Finland, the HCSP recommends as a priority the use of different NRTs (patches, gums, lozenges, oral spray), the effectiveness of which is medically recognized.

Keywords: Finland, TNS, vaping, smoking cessation.

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[1] Finland, FCTC report 2020, WHO.

[2] Finland Backs NRT Over Harm Reduction, TobaccoReporter, published March 27, 2023, accessed March 28, 2023.

[3] Sidhu K, “NRT or Cold Turkey”: Why Finland Won’t Back Tobacco Harm Reduction, Filter Mag, published March 27, 2023, accessed March 28, 2023.

[4] Scientific Committee on Health, Environmental and Emerging Risks (SCHEER), Opinion on electronic cigarettes. Published on April 16, 2021, accessed on June 21, 2022.