How Sweden Became a Smoke-Free Success Story

Finally, Sweden has enforced additional measures to further reduce smoking rates, such as smoking bans in public spaces and increased tobacco taxes. Since 2005, smoking has been prohibited inside all bars and restaurants[vii]. Since 2019 Sweden has been the only European country with a smoking ban in all outdoor dining areas[viii]. Furthermore, it has raised tobacco taxes, including both specific and ad valorem taxes[ix], making tobacco products less affordable, particularly for youth and low-income individuals.

These measures have proven highly effective in reducing consumption and have played a pivotal role in reshaping public perceptions. Along with strong tax and control policies as well as public health initiatives, Sweden has become one of the countries with the lowest smoking rates in Europe.

Smoking Cessation Services and Resources in Sweden

In addition to the aforementioned strategies, Sweden has implemented a comprehensive approach to support individuals aiming to quit smoking, encompassing increased access to smoking cessation programs, free counselling services, and the provision of nicotine replacement therapies (NRT)[x]. These programs are often integrated into primary healthcare services, ensuring accessibility for the general population[xi]. They typically include counselling sessions, personalized support, behavioural therapy, and guidance on the use of pharmacological aids [xii],[xiii].

An essential aspect of Sweden's tobacco cessation strategy is the provision of free counselling services, such as the Swedish National Tobacco Quitline (Sluta-Röka-Linjen[xiv]). The Quitline provides free, anonymous support via telephone, and advice on NRT such as patches and nicotine gum. Together, these initiatives aim to reduce smoking prevalence and enhance public health.

Key milestones in Sweden’s Decline in Smoking

• 1977 Act on warning labels and content declarations on tobacco products is introduced.
• 1979 Act on the marketing of tobacco and alcohol is introduced.
• 1995 Act on tobacco taxation comes into effect.
• 2002 Health warnings and marketing regulations are introduced in the Tobacco Act.
• 2005 Indoor smoking bans in service establishments are introduced in the Tobacco Act.
• 2005 The WHO Framework Convention on Tobacco Control is ratified.
• 2005 Marketing bans, sponsorship, and outdoor advertising are introduced in the Tobacco Act.
• 2015 The goal of a smoke-free Sweden by 2025 is adopted.
• 2019 The Act on tobacco and similar products is adopted, which includes additional smoke-free outdoor environments and a licensing requirement for selling tobacco.
• 2022 – Enactment of the Act on Tobacco-Free Nicotine Products, regulating products such as nicotine pouches. This law introduced age limits (18 years for sales, 25 years for marketing), delegated oversight to the Swedish Food Agency, and implemented restrictions on marketing and sales.

This remarkable smoking decline that Sweden achieved is the result of decades of gradual implementation of public health policies starting already in the mid ‘60s. Sweden has consistently strengthened its tobacco control laws since 1977 with a legislation mandating warning labels on tobacco products. From increasing taxes in the 1990s to implementing indoor smoking bans and embracing WHO's Framework Convention on Tobacco Control in 2005, each step has built upon the last. The country's adoption of a smoke-free goal by 2025, along with stricter regulations in 2017/18 on licensing requirements to sell tobacco and additional smoke free outdoor environments, reflects a persistent effort to reduce smoking rates and protect public health[xv]. These milestones show how consistent, long-term policy can shift attitudes towards smoking and set an international example.

For a visual timeline that highlights Sweden’s key anti-smoking milestones see the graph from Cancerfonden[xvi], showing how each policy helped pave the way to Sweden’s low smoking rates.

Switzerland: a very different situation

In Switzerland, the smoking prevalence is 24% among the population aged 15 and over, making it one of the highest rates in Europe[xvii]. Despite some recent efforts, Switzerland remains on the road toward adopting stricter tobacco control policies. Although Switzerland's Federal Act on Tobacco Products and Electronic Cigarettes (Tobacco Products Act, TobPA) came into force in 2024, it contains significant gaps — such as insufficient restrictions on tobacco advertising and limited protections against secondhand smoke exposure[xviii] — and fails to fully safeguard the population, particularly minors, from the harmful effects of tobacco use. As a result, tobacco consumption remains high, and youth initiation rates show little sign of decline. Switzerland signed the WHO Framework Convention on Tobacco Control (FCTC) in 2004 but has yet to ratify it, leaving international commitments unmet. Furthermore, the ‘Yes to Protecting Children and Young People from Tobacco Advertising’ initiative, launched by major Swiss health organizations, has been waiting to come into force for two years, reflecting persistent delays in implementing stronger measures. To truly address the tobacco epidemic, Switzerland must prioritize the ratification of the FCTC and close the existing legal loopholes to protect public health effectively.

The Tobacco Industry’s Misleading Propaganda

The tobacco industry (TI) continues to promote misleading claims by attributing Sweden’s low smoking rates to the legal status of snus, presenting it as a key tool for smoking cessation[xix],[xx].

The tobacco industry is concealed behind several communication initiatives that attempt to promote the false idea that Sweden’s public health results were achieved thanks to the use of snus. One example, among many, of such manipulation is Smoke Free Sweden[xxi]. On its slick website—decorated with the blue and yellow colors of the Swedish flag—this organization spreads half-truths and propaganda to persuade the public that snus was the key to Sweden’s success in tobacco control.

Behind this initiative, once again, is a familiar figure in the tobacco industry's propaganda efforts: Delon Human, associated with the deceptive organization Health Diplomats[xxii]. Human was also involved in the manipulation pretending that electronic cigarettes are 95% less dangerous than traditional cigarettes[xxiii]. Another recent communication initiative promoting industry narratives is “Quit Like Sweden”[xxiv], which has likely been financed by the tobacco industry, although this is not transparently disclosed.

The Swedish Cancer Society (Cancerfonden) is very clear in its message: there is no evidence linking the decline in smoking rates to snus use.

While smoking prevalence in Sweden has steadily decreased, the rate of snus use has remained relatively stable over time, suggesting no causal relationship[xxv].

At the European level, the sale of oral tobacco (such as snus) has been widely banned since 1992[xxvi]. In the years that followed, the tobacco industry intensified its efforts to oppose the ban, using "The Swedish Experience" as a strategic argument to advocate for lifting restrictions[xxvii]. This narrative, however, overlooks the broader tobacco control policies that have contributed to Sweden’s success in reducing smoking rates. The fact that snus is legal in Sweden while it has long been banned in other countries is by no means a valid argument to claim that snus is behind Sweden’s tobacco control success. Such a claim is a deliberate distortion — it brushes aside decades of robust public health policies, strong societal support for anti-smoking measures, and strict tobacco regulation. To credit snus alone is not just misleading; it’s propaganda serving industry interests.

Conclusion

Sweden’s journey toward becoming a smoke-free success story serves as a powerful example of how comprehensive public health policies can significantly reduce smoking rates. Through a combination of strict regulations on tobacco sales, advertising, and smoking in public spaces, alongside robust smoking cessation programs, Sweden has managed to reduce its smoking prevalence to one of the lowest in Europe. However, challenges remain, particularly in relation to the rising use of snus, which may present new health risks that need addressing. Despite these challenges, Sweden’s approach offers valuable lessons for other countries striving to tackle tobacco use and improve public health. By implementing a multi-faceted strategy that includes education, regulation, and support for cessation, other nations can follow Sweden's lead in reducing smoking-related diseases and enhancing the well-being of their populations.