Sweden is a proof that a pragmatic tobacco control policy allowing consumers to transition to far less dangerous tobacco alternatives could save many lives in India
Two decades ago, the WHO’s scientific advisers recommended against the use of smokefree tobacco as a strategy to reduce harm for smokers who won’t stop. They argued that the benefits have not been demonstrated, while the potential for harm remains, stating that a “lower risk of adverse health outcomes is achieved by reducing smoking and not by substituting with an alternative.
As we know today – and many knew then – when it comes to snus, a low-toxicant smokeless tobacco product, this advice was wrong. In fact, if Sweden, the birthplace of snus, followed this advice, the rates of premature death caused by tobacco would be 50% higher. But, despite this advice, the Swedes transitioned in large numbers away from smoking to using snus instead. As a result, Swedish men, who were the first to embrace snus as an alternative to smoking, have the lowest smoking prevalence in the European Union and the lowest rates of tobacco-attributable deaths. If, on the other hand, the rest of the European Union followed the Swedish example, millions of lives could be saved.
India has 267 million tobacco users, with roughly a third of these tobacco users being smokers. The remaining two thirds consume smokeless tobacco products that are far more dangerous than snus.
When it comes to new, far less toxic tobacco and nicotine products that don’t burn tobacco, the WHO has been providing the same advice as they’ve given on snus 20 years ago. In the documents released by the WHO for the 10th Conference of the Parties (COP10) to the Framework Convention on Tobacco Control (FCTC) taking place in Panama in November, it recommends that countries ban or restrict and tax all tobacco products the same as if they were the same from the perspective of health risks. This is despite scientific consensus that burning of tobacco, not tobacco or nicotine itself, is responsible for most of the harm from smoking. Effectively, the message they’re giving to smokers who won’t quit is that they may as well carry on smoking. This is hugely disappointing from an organization that is still well respected, despite the blunders and scandals that have plagued it over recent years.
By contrast, the Swedish government recently announced that it will reduce taxes on snus by 20 percent while increasing taxes on cigarettes due to their more significant health effects.
And it is no longer just Sweden that has seen record-breaking declines in smoking thanks to smokers being able to choose a product that can replace cigarettes. Norway, UK, New Zealand or Japan have seen unparalleled declines in smoking rates as safer alternatives, including vaping, snus, nicotine pouches and heated tobacco, displaced deadly cigarettes.
When it comes to smoking, the WHO doesn’t need to reinvent the wheel: just follow science this time. For the sake of one billion smokers who aren’t lucky enough to live in Sweden. The same applies to India where, against any logic, the only legal form of nicotine consumption is the most dangerous one. Tobacco users have the right to improve their health by having access to options that can give them nicotine with far lower health risks associated.
- Professor Bijon Misra
