The Ministry of Health and Social Affairs' decision to change the mandate of FHM and the National Board of Health and Welfare to have a clear focus on harm reduction for smokers was welcomed by both user associations and political commentators.
"Finally some common sense in tobacco policy" exclaimed editorial writer and author Mattias Svensson in SvD
The debate on harm reduction for smokers has been intense in recent years. Uptake of both less harmful nicotine products such as traditional snus and nicotine pouches has increased significantly, as has the use of e-cigarettes. At the same time, the smoking has decreased to such low levels that Sweden is considered smoke-free according to the WHO standard. The EU has also drawn attention to Sweden's low proportion of smoking-related harm in relation to relatively high nicotine use.
"Silly strategy"
Mattias Svensson, editorial writer at SvD, notes that this has happened despite the fact that the previous Social Democratic government was a brake. For years, with the support of various state-funded lobby groups, the S government has instead worked to reduce all tobacco and nicotine use, including snus and e-cigarettes.
"This strategy has not only been foolish, but also harmful to health. Sweden is unique in the world with a lower proportion of men smoking than women, and a low proportion of smokers at all. It is difficult to escape the hypothesis that this has to do with snus as an alternative source of nicotine. As you know, snus is banned in the rest of the EU, where people smoke more, especially men. The possibility to choose less risky pleasurable substances saves lives." writes Mattias Svensson on The editorial page of SvD.
"It's hard to get out of this"
He is joined by Karl-Åke Johansson, spokesperson for the user association New Nicotine Alliance Sweden. He says the investigation will hopefully lead to a more open discussion.
"It will be difficult for the authorities, many of whom are actually active opponents of this type of harm reduction, to wriggle out of this. The new mandate means they have to put their cards on the table and ultimately let people decide on the evidence," says Karl-Åke Johansson to Vejpkollen.
"Modern research matters"
He also points out that similar reports already exist in other parts of the world. This enables comparisons and can broaden the discussion.
"It is important that the review also takes into account new research, not just that available five years ago. The UK Public Health Agency updates its report on e-cigarettes annually. Cochrane reviews have an ongoing report on e-cigarettes and known health risks in smoking cessation that is updated very frequently. The risk is that the Swedish review becomes more static and therefore counterproductive, if the reviewer tries to avoid certain research for various reasons" says Karl- Åke Johansson.
The inquiry shall report its findings to the government on June 30, 2023.
It would be interesting to see more of a philosophical debate on moralism and so-called public health policy. Much of it is not really about health but about a puritanical fear that people should not be allowed to have fun, enjoy themselves and have a good time. Recently, the government removed the old ban on dancing. The basis is about Luther and Protestantism as well as Nazism and eugenics. Why should nicotine be considered more "immoral" than caffeine, and why is cannabis so taboo according to some, even though it is probably less harmful as an intoxicant than alcohol and can also have medical benefits for pain patients, for example. Then, of course, there is another aspect of alcohol, which is about tastes and smells when it comes to wine, beer and certain spirits such as whiskey. It is good if Swedish authorities rethink about alternative nicotine products, but it is also important to remove unnecessary bans and restrictions, reduce taxes and not introduce new ones, and cut tax-funded contributions to organizations that oppose harm reduction and actually want a total ban.