Sweden Becomes Europe’s First “Smoke-Free” Country: Lowest Cancer Incidence in Europe, with E-cigare

News today, May 25: Recently, several public health experts in Sweden jointly released a report stating that Sweden is expected to reduce its smoking rate to below 5% within the next few months, becoming Europe’s first “smoke-free” country. The experts pointed out that the effective implementation of tobacco control policies has benefited from emerging nicotine alternatives such as e-cigarettes.

A “smoke-free” society refers to a population in which the smoking rate is below 5%. In 2017, the EU formally proposed the public health goal of achieving a smoke-free society by 2040. At a recent international seminar in Stockholm, Swedish experts presented the report The Swedish Experience: A roadmap for a smoke-free society, announcing that Sweden has achieved the goal of becoming a smoke-free nation.

The report details Sweden’s groundbreaking strategy for reducing the harmful effects of smoking and saving lives. One of the report’s authors, Dr. Anders Milton, former president of the medical association, said that if other EU countries adopted Sweden’s tobacco control strategy, more than 30,000 lives could be saved over the next decade. Another author, former Secretary-General of the World Medical Association Dr. Delon Human, said that for smokers, switching from traditional combustible cigarettes to e-cigarettes or nicotine pouches is far better than continuing to smoke.

In fact, no nicotine product is completely harmless. However, compared with combustible cigarettes, e-cigarettes reduce harm by 95% and are, to a certain extent, safer than combustible cigarettes. At the same time, compared with NRT (nicotine replacement therapy), e-cigarettes deliver nicotine more efficiently and in a purer form. Therefore, as an alternative that reduces carcinogens from combustible cigarettes while helping relieve nicotine dependence, using e-cigarettes is a very effective way to quit smoking.

Data from a Lancet survey show that in 2019, the number of global deaths caused by smoking reached 7.7 million. In addition, medical research has found a positive correlation between smoking and the onset of cardiovascular disease and lung disease. Therefore, quitting smoking is a necessary step in protecting public health. The emergence of e-cigarettes not only allows smokers to obtain nicotine in a healthier way, but also reduces overall smoking rates and even the harms of secondhand smoke.

Using e-cigarettes for smoking cessation and harm reduction has become a consensus in some countries’ tobacco control efforts, and growing evidence continues to show that e-cigarettes offer greater advantages for safe smoking cessation. The well-known U.S. publisher Wiley-BlackWell once published a paper titled Prospective association between e‐cigarette use frequency patterns and cigarette smoking abstinence AMOng adult cigarette smokers in the United States.

The paper was jointly released by the University of Southern California and Boston University. It reported that after a five-year follow-up study of 5,699 adult smokers, 560 smokers in the sustained e-cigarette use group successfully quit smoking. Researchers also found a positive correlation between continued e-cigarette use and smoking cessation success. After excluding the effects of timing and selection bias, the final results showed that daily e-cigarette users were four times more likely to maintain smoking abstinence for 12 months than those who did not use e-cigarettes consistently.

Sweden’s success in promoting its tobacco control strategy is precisely due to its acceptance of smoke-free products as lower-harm alternatives. In fact, Sweden’s tobacco control strategy has brought substantial benefits. Relevant data show that Sweden’s overall cancer mortality is 38% lower than that of other European countries, and its cancer incidence is 41% lower, making it the EU country with the lowest proportion of tobacco-related diseases.

As one of the new tobacco products, e-cigarettes’ distinctive flavors have indeed attracted more users. In the long run, if the public and the media treat e-cigarettes appropriately rather than viewing them as something terrifying, it will certainly have a more positive impact on public health across society. Dr. Fagerström, one of the authors of the Swedish report, also believes that if other countries, like Sweden, reduce the supply and demand of combustible cigarettes while setting different tax rates, providing financial incentives for smokers, and encouraging a shift from cigarettes to lower-harm alternatives such as e-cigarettes, it would bring enormous benefits to the world.

References

Anders Milton, Delon Human, Fagerström, et al. The Swedish Experience: A roadmap for a smoke-free society. SMOKE FREE SWEDEN 2023#p#Page Title#e#

Alyssa F. Harlow, Andrew C. Stokes, Daniel R. Brooks, et al. Prospective association between e‐cigarette use frequency patterns and cigarette smoking abstinence among adult cigarette smokers in the United States. Wiley-Blackwell online Open, 2022