Follow Us on Google
By Bianca Iboma-Emefu
Sweden’s emergence as one of the world’s closest nations to becoming officially smoke-free has intensified global discussions on tobacco harm reduction, with public health experts pointing to the country’s sharp decline in smoking-related diseases as evidence that evidence-based alternatives can complement traditional tobacco control strategies.
With adult smoking prevalence now estimated at about 5.6 per cent, Sweden has recorded one of the lowest smoking rates in the world and the lowest in Europe. The development has coincided with significant reductions in lung cancer and other smoking-related illnesses, prompting renewed calls for countries to examine harm reduction approaches alongside existing smoking prevention and cessation programmes.
Public Health Advocate and Consultant with the Lagos State Ministry of Health, Iboma Godswill Iboma, said Sweden’s experience demonstrates how science-driven innovation, when supported by strong regulation, can improve public health outcomes.
According to him, the country’s achievement reflects a combination of comprehensive tobacco control measures and the availability of regulated, non-combustible nicotine products for adult smokers who might otherwise continue smoking.
“Public health progress should ultimately be measured by health outcomes. Sweden demonstrates that when adult smokers are provided with access to scientifically substantiated lower-risk alternatives alongside strong tobacco control policies, significant reductions in smoking prevalence and smoking-related diseases can be achieved,” he said.
Iboma explained that the greatest health risks associated with smoking stem primarily from the combustion of tobacco rather than nicotine itself, noting that while no tobacco or nicotine product is completely risk-free, eliminating combustion substantially reduces exposure to many of the toxic chemicals produced by cigarette smoke.
Sweden’s progress has been linked largely to the long-term transition of many adult smokers from combustible cigarettes to smoke-free alternatives, particularly suns, a regulated smokeless tobacco product widely used in the country.
Researchers say that although nicotine use has not disappeared, the migration away from combustible cigarettes has contributed to measurable improvements in population health, including lower rates of smoking-related illnesses.
The public health expert described Tobacco Harm Reduction (THR) as a complementary strategy designed for adult smokers who are unable or unwilling to quit nicotine entirely; stressing that complete cessation remains the most desirable outcome.
“The ultimate objective remains reducing disease and premature deaths. While complete cessation remains the ideal outcome, public health also recognises the importance of reducing harm among smokers who may otherwise continue smoking.” He added that providing practical options for smokers could strengthen broader tobacco control efforts rather than replace them.
Health experts also noted that declining smoking rates offer wider public health benefits, including reduced healthcare costs, improved workforce productivity, lower pressure on health systems and increased life expectancy.
Despite growing scientific interest in Tobacco Harm Reduction, Iboma emphasised that robust regulatory safeguards remain essential.
He called for strict age restrictions, quality standards, and strong enforcement against illicit trade, continuous surveillance and sustained investment in youth smoking prevention programmes.
“Protecting young people must remain non-negotiable,” he said.
The discussion comes as countries continue to review tobacco control policies amid rising cases of non-communicable diseases linked to smoking.
“Sweden’s experience should not necessarily be viewed as a blueprint for every country. Rather, it provides an opportunity to examine how science, regulation and innovation can work together in pursuit of a shared public health goal fewer smokers, fewer smoking-related diseases and healthier populations,” Iboma said.
