The promotion of smoke-free products in Sweden is driven by the tobacco and nicotine industry

For several years, Sweden has set itself the goal of becoming a "smoke-free" society, meaning a daily smoking prevalence of less than 5% among adults. To achieve this ambition, the country has widely adopted strong anti-smoking measures that have been rigorously enforced, as well as encouraged the use of smoke-free nicotine products, such as snus or nicotine pouches, presented as less harmful alternatives. harmful effects of cigarettes. Researcher Louise Adermark, professor of pharmacology at the University of Gothenburg, believes that this policy direction has been too heavily influenced by industrial interests. She points out that although snus use is common in Sweden, the real long-term effects of these products remain insufficiently understood.[1].

Sweden's unique strategy against smoking

By 2024, Sweden would have achieved an adult daily or occasional smoking prevalence of 10.9% and an adult daily smoking prevalence of 5.4%. This figure drops to 4.5% if people with a migrant background are excluded, which some harm reduction advocates use to claim that Sweden has already reached its target. But this way of presenting the data is criticized by several public health experts, who consider it misleading.

Niclas Malmberg, a member of the Tobaksfakta think tank, points out that smoking is now much more widespread among immigrants. Targeted actions are being carried out in affected neighborhoods and in certain places of worship to strengthen prevention efforts. Sweden Democrats MP Tobias Andersson says that risky behaviors are difficult to change in these groups, often due to a lack of trust in the authorities.

Rising global consumption and misperception of risk

While smoking is declining, overall nicotine and tobacco use is increasing in Sweden. Products like e-cigarettes and nicotine pouches, while combustion-free, contain nicotine and are not without risks.

According to Lisa L. Ermann, a prevention specialist at the Swedish Cancer Society, the proportion of the population using tobacco or nicotine products has increased from 25 to 28 percent in two years. She points out that surveys can underestimate actual consumption, particularly depending on the wording of the questions ("sometimes" vs. "occasionally," "currently" vs. "daily").

Among those over 45, the rate of daily smokers is highest. However, among those aged 16-29, occasional smokers predominate, at 9.6%. Snus remains very popular among men, which contributes to a relatively low smoking rate compared to the rest of Europe. Conversely, women, especially younger women, are more likely to use nicotine pouches.

Ermann emphasizes that snus is not a cessation product. Some studies even suggest that using snus or e-cigarettes could increase the risk of starting to smoke in the long term. The arrival of nicotine pouches on the market has changed usage trends, with marketing more heavily targeting young women.

In 2024, 21.5 % of men aged 16 to 84 will use snus daily, compared to 5.9 % of women of the same age who use nicotine pouches.

Challenges of public health communication and access to treatment

Public health communication remains a complex issue, often hampered by a lack of resources. Several Swedish experts acknowledge that, despite their commitment, their own children use nicotine pouches, proof that information is not always enough.

Campaigns perceived as too moralistic or repressive can have the opposite effect, sparking a form of rebellion, particularly among young people.

In Sweden, general practitioners generally recommend quitting smoking, but much less often address the issue of snus or nicotine pouch use, as noted by cardiologist Magnus Lundback, also a researcher at the Karolinska Institutet. He notes that prolonged snus use can lead to stiffening of blood vessels and impair the response to certain treatments, such as nitroglycerin.

Lundback criticizes the widely held notion that snus is "good for your health." He believes that the industry's narrative heavily influences political decisions in Sweden.

He distinguishes between medical withdrawal treatments, used for a few weeks, and commercial nicotine products, designed to replace cigarettes without aiming for total cessation. The goal is not to get rid of nicotine, but simply to use it differently. ", he sums up.

He acknowledges that current treatments are imperfect, but that the alternatives proposed by the industry are not a better solution. If they were, he says, the question would no longer arise.

In its rhetoric, the industry promotes a so-called "harm reduction" approach: it is no longer a question of eliminating nicotine use, but of offering forms deemed "less harmful" than cigarettes. In Sweden, this strategy has received political support, notably through the official inclusion of the principle of harm reduction in the national public health policy in 2024.

This positioning is exploited by the tobacco industry to strengthen its lobbying efforts in other Member StatesBy highlighting the Swedish experience, it seeks to convince policymakers that these products can contribute to the European objectives of reducing smoking by 2040. This strategy is based on a simplistic and biased narrative, which obscures a significant part of the reality.

Recently, Sweden was even recognized by the industry-backed World Vapers' Alliance for its " remarkable performances " in reducing smoking. The association insisted on a positive correlation, according to it, between the drop in the country's smoking rate and the overall use of nicotine (pouches, snus, e-cigarettes) which is very high, particularly among young people.[2].

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[1]Raman Sandhya, Sweden's push for smokeless products leads some to wonder about risks, Roll Call, published August 6, 2025, accessed August 7, 2025

[2]Tobacco-free generation, Tobacco Reduction: Industry-Backed World Vapers' Alliance Highlights Select Member States, published July 11, 2025, accessed August 7, 2025

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