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Sweden is almost smoke-free, but—with a 1992 snus ban still in place—the EU lags behind
Sweden is almost smoke-free, but—with a 1992 snus ban still in place—the EU lags behind
Public health data show that smoking rates are significantly lower in Sweden than across the rest of the European Union and Swedish men also have the lowest incidence of smoking-related diseases. It also has the fewest number of deaths from lung and oral cancer among men in the EU.
A critical reason for this difference is the large number of Swedish men who have switched from smoking to snus—an oral smokeless tobacco product placed between the lip and gums. More recently, nicotine pouches have also contributed to the decline in smoking.
When Sweden joined the EU in 1995, it was exempted from the EU’s 1992 ban on snus, a far less harmful means of consuming nicotine than cigarette smoking. This nicotine-containing better alternative had already seen significant use among Swedish men since the 1970s.
Public health data reveal that this forward-thinking approach helped Sweden drive down the number of daily smokers to 5.3 percent in 2024—and as low as 4.3 percent among Swedish-born citizens.1
Sweden’s sustained progress puts it on the cusp of achieving “smoke-free” status—which, like the targets set by many governments across the world, requires the country to have a smoking prevalence rate below of five percent or below.
In fact, smoking prevalence in Sweden declined by 27 percent from 2014 to 2023, compared to an 11 percent decline in the EU, where 24 percent continue to smoke daily or occasionally.2
The impact of this low smoking prevalence in Sweden is now being seen in independent research on the number of deaths from smoking-related diseases—particularly among men, who began switching from smoking to snus much earlier than women. Swedish men have by far the lowest lung and oral cancer death rate among males in the EU.3
So, could Sweden’s success only be due to stricter smoking control measures? It appears not, as its cigarette regulations—which include minimum age limits, marketing restrictions, prominent health warnings, a ban on characterizing flavors, and indoor smoking bans—are broadly similar to those adopted by the rest of the EU.
The only notable difference between Sweden and other EU nations on tobacco control is its long-term acceptance of snus and, more recently, nicotine pouches. This underscores the importance of complementing traditional tobacco control measures with tobacco harm reduction to help adults who don’t quit tobacco and nicotine entirely to switch to a better alternative to continued smoking.
Of course, the best choice any smoker can make is to quit all forms of nicotine and tobacco consumption. But the global reality is, every year, millions of adults continue to smoke.
The case of Sweden provides clear evidence that smoke-free alternatives can help to reduce smoking rates—and potentially smoking-attributable diseases—faster than traditional measures alone.
The sooner other countries act, the better the outlook for global population health.