Joseph Hart 3 November 2025

 

October 25th will forever be remembered as a glorious day in harm reduction history as Sweden became the first country to become “smoke-free”. Let’s take a look at how and why the Nordic country achieved this incredible milestone.

What is “smoke free”?

A country is considered “smoke-free” if less than 5% of the adult population smokes every day. There are a few African countries (Ghana, Ethiopia, and Nigeria) with sub-5% smoking rates, but they never had high prevalence, even during smoking’s heyday.

In the West, some European countries had rates as high as 60%, while Sweden’s “peak” was around 38% in the early 60s. As such, “smoke-free” is as much about effective change as it is about hitting an arbitrary number.

Sweden has been hovering over the 5% mark for a number of years. It was only a matter of time before it got there, and now it has.

What does it mean that Sweden is “smoke-free”?

There is a lot of sophistry in the world of public health. But perhaps the most naked of these conjurer’s tricks is the attempt to claim Sweden’s low smoking rates are the result of public health policies.

Get hold of the right rent-a-mouth academic and they’ll try to tell you that the Swedish model involves long-term, coordinated efforts at all levels of government, including bans on tobacco advertising, age limits, and the introduction of smoke-free environments both indoors and in specified outdoor areas. Then they’ll tell you that licensing and strict requirements for tobacco vendors help further limit youth access to cigarettes.

However, we’ve seen similar programs implemented in other countries without the same results. Instead, there is, as I think Clive Bates once said, an almost-perfect experiment being run in Europe for several decades that tests what happens when one country has free access to snus, while the control countries ban the harm-reduction product.

Did Sweden encourage harm reduction?

Another point that is worth noting is that the Swedish government never outright encouraged its citizens to use snus. Instead, we can kind of think of snus as a citizen-driven solution to the problem of smoking. Sure, you can argue that regulatory measures meant snus was taxed more lightly than cigarettes, but to me it’s just as much about the government getting out of the way. That’s a lesson that several administrations could learn.

Sadly, the EU banned snus due to misleading research linking it to oral cancer. In doing so, it keeps many European citizens smoking, leading them down a path of death and illness. However, in recent years, Sweden innovated again, leading to the birth of nicotine pouches.

How nicotine pouches helped Sweden get below 5%

While snus was really popular with Swedish men, women were a little less convinced. Yet, the introduction of nicotine pouches changed all that. Smaller, tobacco-free, and less prone to staining teeth, many women suggested they were a far more appealing product.

Interestingly, data suggests 21% of Swedish men use snus daily compared to just 9% of women. When it comes to nicotine pouches, 18% of women are users, with men lagging behind at 12%.

To me, that’s a clear sign that having a diversity of products is how you bring down smoking rates. If snus were permitted in Europe, smoking prevalence might not be down to 5%, but it would be far, far lower.

Final thoughts

Sweden’s smoke-free success is a fine achievement. But it’s about much more than healthy citizens. It’s a huge, unignorable sign to other countries that access to smokeless pouches like snus is a big part of reducing smoking. The mistakes the EU made with snus cannot be repeated with nicotine pouches.