Smoking has very serious negative health consequences and shortens life by up to a decade. A smoker who quits before their 30th birthday reduces their risk of premature death by 97%. Every person who quits smoking, or does not take up smoking, therefore has a major positive public health impact.
This is a debating article. The opinions are those of the named writer. Comment or contact editorial staff if you want to answer!
DEBATE. There is a strong consensus in the EU that smoking should be tackled with higher cigarette taxes and tougher regulations. As a result, the price of cigarettes in the EU has increased by 45% on average since 2010. And regulations such as marketing and health warnings have been harmonised and are now mandatory across the EU.
The trend has been so rapid that Sweden has fallen behind several 'best-in-class' countries. But even though many countries have long had both stricter rules and higher cigarette prices than Sweden, only six per cent of Swedish men smoke, compared to 19 per cent in Ireland, 29 per cent in France and 14 per cent in Finland. The effects of the low smoking rate on Swedish public health are obvious. In the EU, the mortality rate is more than twice as high.
How can you explain that both stricter rules and higher prices lead to more smokers and poorer public health?
Swedes opt out of cigarettes
In new report from Lakeville shows that oral nicotine, such as snus and nicotine pouches, is important in helping smokers quit. The major difference between Sweden and the EU is that the sale of snus is only authorised in Sweden. This means that Swedish men have long been able to opt out of smoking in favour of a less harmful alternative nicotine product. Something that has been denied to European men for a long time.
Over the past decade, however, a large number of alternative nicotine products have been launched. E-cigarettes and nicotine pouches - popularly known as 'white snuff' - are two examples of nicotine products that have rapidly gained market share in Europe. Neither product is harmless to health. Both are addictive due to their nicotine content, but compared to smoking, the negative health effects are very limited. A frequently cited figure is that the health damage from the alternative nicotine products is less than five per cent of the damage from smoking.
Market shares are changing - not the mill
However, there has been criticism that marketing and flavouring attract entirely new consumer groups to the product category. This risks jeopardising the effect that the products can have on public health.
Critics often assume that more marketing leads to more sales. It is not quite that simple. What happens is that the market shares between different nicotine alternatives are redistributed, mainly from smoking to safer nicotine alternatives. The effect of increased marketing has been a redistribution of market share, not an increase in total alcohol consumption.
Want to replace the tobacco flavour
The sum of the loads thus appears to be fairly constant. The increased use of snus in Norway over the last two decades has been accompanied by a significant decrease in smoking, and this in all age groups. Since 2005, the proportion of smokers has decreased by 17 percentage points, while the proportion of snus users has increased by 10 percentage points. The proportion of men who use snus in Sweden is about 20 per cent, and about 6 per cent of men smoke. The EU average is 28 per cent.
We know that smokers prefer to break with the taste of tobacco through flavoured nicotine pouches. Although there is some new recruitment to nicotine pouches, the absolute majority of users come from the group of former smokers or nicotine users. New recruitment is therefore not mainly driven by flavouring.
Risks exist - but are low
Overall, this is about how we should continue to deal with people using nicotine products that do not take their lives or the lives of others. Nicotine products are not harmless, but the likelihood - the risk - of harm resulting from the hazard must be considered. Compared to many other things in society, the risk of harm is extremely low. Therefore, we cannot justify strict regulation based on the addictive properties of the substance when it is proven to save lives.
Today we can say that about one in four Swedes use nicotine daily. This has been the case for a very long time. What is changing is that fewer people are dying and users are becoming more and more satisfied with their use.
