Leading the way to a smoke-free future: The experience of Sweden
[Position Paper]
Introduction
In recent years, smoking has been the subject of stringent public policies worldwide, particularly in Europe. The European Union (EU) seeks to lead in the fight against the leading preventable health risk and the most important cause of premature death of its citizens, accounting for approximately 700,000 deaths per year. However, despite the progress and strategies implemented, the EU still faces a high number of smokers and a smoking prevalence rate of 23%.
In their commitment to reducing this rate, the Member States have rigorously adopted the measures proposed by the World Health Organization (WHO) in the context of its Framework Convention on Tobacco Control (FCTC) and have transposed into their legal systems the directives and recommendations of the European institutions in this field. Many of these countries have also implemented awareness and information programs aimed at smoking cessation and prevention. But only Sweden has maintained a truly comprehensive approach. The Scandinavian country has adopted, transposed and implemented all of the above, but, in addition, has allowed its smokers to switch from cigarettes to alternative nicotine products; this combination of measures has managed to lower the smoking prevalence rate to the current 5.6%. This is the lowest figure in the EU, even among Member States that focused on reinforcing more restrictive public policies.
Indeed, the public policies promoted due to the FCTC and the MPOWER initiatives constitute the most significant contribution to the fight against smoking, but many of the countries that have adopted them still face a high number of smokers. This is likely because they focus only on strictly coercive elements. Sweden’s comprehensive approach, equally rigorous in the regulation, cessation and prevention of cigarette consumption, also offers other factors that promote gradual behavioral change and invite governments and institutions to consider broadening the approach to the global ambition of a smoke-free future while respecting the idiosyncrasies of each country.
Our analysis focuses on the path taken by Sweden in its fight against smoking and the main elements of its comprehensive approach. It will explore the measures proposed by the WHO, the European directives and recommendations that regulate nicotine products’ content, labeling and packaging, restrictions on advertising, promotion and sponsorship, the implementation of traceability systems and measures to discourage consumption and fiscal measures. Cooperation between Member States and collaboration with international organizations, such as the WHO, will also be examined.
