The Swedish Experience is an expression which has been used to describe how Sweden has managed to reduce smoking far faster and more efficiently than other countries. Through a combination of strategies, Sweden is the first country in the world to approach the EU goal of eliminating smoking among the population, defined as less than 5 percent smokers in the population. But how was it done and what role did the snus play in this?
This accomplishment would place Sweden 17 years ahead of the EU’s scheduled target year of 2040. In contrast, every other EU country is set to miss the 2040 objective (source)
Sweden’s model offers valuable lessons for nations worldwide, with the potential to save millions of lives each year by promoting a smoke-free future. Smoking cigarettes or other combustible tobacco products is the biggest cause of non-communicable deaths in the world. According to the World Health Organization (WHO), eight million deaths were attributable to tobacco in 2017. But what is the actual lesson Sweden can teach us?
In 1963, 49 percent of Sweden’s male population smoked. A couple of decades later, as science caught up and people started realizing what a devastating health threat this posed, Sweden started charting a path towards a smoke-free future, eventually achieving milestones far ahead of global targets. The main question that many people, and several research projects, have asked is – why? Why did Sweden do so much better? What is the secret of the Swedish Experience?
Sweden wasn’t the only country to implement measures against the tobacco epidemic as it has been called by some. Different countries took different paths and usually they consisted of campaigns directed at children and young adults, which in Sweden was called “A Non Smoking Generation”, and information and advertisements directed at adults. More powerful than that was of course the limitations on where you could smoke, introducing smoking bans in offices, restaurants and cafés.
Sweden was not the first country to ban smoking, Ireland was back in 2004. After the initial success of driving the number of smokers in the adult population down from 27 to 18 percent, that is still the current rate in Ireland indicating that neither the smoking ban, nor the intense campaigning has had any further impact on the Irish. And here we must also take into account that the Irish tobacco taxation is the highest in the EU, at over €9 per packet (all numbers from 2024)
In 2013, Spain, Bulgaria, Malta, Greece and Hungary introduced the strictest regulations of all. and some sources claim that it brought immediate health benefits, including substantially reduced problems with secondhand smoke at restaurants and public places. However, 10 years later, Bulgaria, Hungary and Greece still show the highest proportion of smokers in the EU, at 25-28 percent of the population. Bummer.
Implementing high taxes has been a tool since day one of this war on smoking. Sweden, which is has one of the highest taxation pressures in the world, is no stranger to putting extremely high taxes on products they would like to make less attractive. But in this case, Sweden is far from the top.
Looking outside of the EU, Australia is the country to beat in the race towards the highest taxes. A pack of cigarettes cost around €34 in 2023, and since the taxation is increased steeply every year, the price will be over €40 soon. And Australia has managed to push the smoking rate down to just over 8 percent, which is one of the lowest in the world right now.
But in countries like Spain, one of the main effects of high taxation has become intensified smuggling. In 2023, 600 million illegal cigarettes were seized in Europe, with Spain being a focal point. Considering that tobacco taxes is an important source of cash for most countries, the shift from the white to the black market also hurts countries and causes many more problems.
All countries do propaganda, usually in the form of information campaigns and with the purpose of enlightening its citizens about important issues. It is perhaps easy to think that everybody in at least the western world knows exactly how dangerous smoking without the alarming pictures and warning texts saying that smoking will kill you. However, sometimes people need a little reminder.
France is probably the country which has been campaigning the hardest against smoking. It has paid off and France is reducing the smoking rate, but it is difficult to single out one key factor since France also has introduced smoking bans on places like beaches, decided on plain packaging and introduced very high taxes. When talking about information and campaigns, there is also an effect which needs to be considered and which is difficult to define; the slow cultural shift, making a behavior undesirable and socially unacceptable.
In Sweden, some 20 years ago, a racial slur might pass as a harmless joke. Today, it would make most people cringe. 30 years ago, lighting a cigarette at a party would be the norm. 10 years ago, it would almost be odd to witness. Until vaping became a thing, but that is a different issue. Part of the reason for this shift in attitude might have been that smoking became tacky and disappeared out of Hollywood movies for years.
Like we say, it is a complex ecosystem of factors and research hasn’t always pointed in the same directions. Using the same or equivalent methods and reaching different results must indicate that there is another factor apart from campaigning, availability and taxation which clearly has a substantial impact on the results. And in this case, we believe that the X factor is snus.
With no higher taxes on tobacco than most, with no more campaigning than in most countries, there must be another factor. Nicotine chewing gum and plasters were of course acknowledged as alternatives to help quit smoking but they were available in other countries. What was not available is snus.
Easy access to alternatives, in combination with consistent, nationwide anti-smoking campaigns, laws against smoking in offices and other shared locations, and education in schools means that smokers have had a rough ride in Sweden the last couple of decades.
Alternatives like snus, nicotine pouches without tobacco, e-cigarettes, and heated tobacco are all allowed in Sweden and easy to find in stores and online. And while tobacco advertising was banned a long time ago, the nicotine pouches can still be marketed to adults, allowing more smokers to realize that they have options.
The end-result is that Sweden has the lowest smoking rates which directly translates to a one of the lowest rates of smoking-related illnesses like lung cancer. Unfortunately, the EU snus ban in 1992 means that snus isn’t available in other EU countries. Given that this is the main difference between Sweden and many of the other countries who have implemented the same type of regulations and same type of campaigns, what remains as one of the key explanations behind the Swedish experience must simply be snus.
In our pursuit of data-driven factual progress, we focus on taking action in the present rather than relying on an idealized future.
