EU Snus Ban Costs More Lives

A new report from the Swedish Snus Commission underscores the accelerating human toll of the European Union’s unconscionable ban on smokeless tobacco: “…among men over the age of 30, 355,000 lives per year could have been saved if the other EU countries had matched Sweden’s tobacco-related mortality rate.”  Sweden is the only EU nation in which sales of snus are legal.

In 2009, epidemiologist Phil Cole and I, analyzing data from the World Health Organization and the International Agency for Research on Cancer, reported in the Scandinavian Journal of Public Health that 274,000 smoking-attributable deaths would be avoided if men throughout the EU had the smoking prevalence of men in Sweden (here).  Four years later, I updated that figure to 291,000 (here).       

The Snus Commission report, available here, was produced by a distinguished group of Swedes.  The commission’s chairman is Anders Milton, a physician and former President and Chairman of the Swedish Medical Association, President of the Swedish Confederation of Professional Associations from 1993 to 2001, and President of the Swedish Red Cross from 2002 to 2005.  His collaborators are Christina Bellander, a journalist who previously headed business development at Swedish TV4 and was a Board Member of New Wave Group AB, Mittmedia AB and the Swedish Educational Broadcasting Company; Göran Johnsson, a former member of the Social Democratic Party’s Executive Committee, Board Member of Volvo AB and Chairman of Swedish national television broadcaster SVT from 2011 to 2014; and Karl Olov Fagerström, a WHO-recognized nicotine and tobacco researcher who has authored 150 articles in peer reviewed journals.

The casualty list from the indefensible and immoral EU snus ban continues to grow. 

The Swedish Miracle Continues

 A special report on tobacco and e-cigarettes published by Eurobarometer, the official polling organization of the 28-nation European Union (here), underscores the remarkable success of what researchers call “The Swedish Experience”.

According to the report, the prevalence of smoking in Sweden is just 7%, with no other EU country even remotely close.  UK prevalence is 17%, while only Denmark, the Netherlands, Belgium and Ireland are below 20%.  The prevalence of daily smoking in Sweden is a bare 5%, as shown in the chart at left (credit to Lars Ramstrom from Sweden), and the prevalence of former smoking is 41%, the EU’s highest by far. 

Eurobarometer provides an array of impressive statistics: “In all but one country, at least eight in ten (80%) of smokers consume tobacco products daily. The exception is Sweden, where only just over half (52%) give this response. In turn, over a fifth (21%) of smokers in Sweden are irregular smokers, consuming listed tobacco products less than monthly.  In all other countries, very few respondents give this answer.”

There is only one explanation for Sweden’s remarkable number: the popularity of snus, the sales of which are prohibited in all other EU nations.  The new report reveals that 20% of Swedes use snus daily.  The only other countries with daily smokeless use are Denmark (1%), home of Oliver Twist chewing tobacco pellets, and Finland (2%).

The Eurobarometer report should pressure the EU to end its snus ban.  Swedish Match has filed a complaint with the European Court of Justice to compel EU action.  For more on “the worst regulation in the EU,” see Clive Bates’ excellent commentaries, such as this (here).

New Eurobarometer Report Supports The Swedish Miracle

How can the European Union continue to deny Sweden’s success in tobacco harm reduction?  I have documented how Swedish snus has contributed to that country’s world record low rates of smoking (here and here) and smoking-related deaths – rates that would translate into hundreds of thousands of lives saved if snus were not banned in the rest of Europe (here and here).  The EU’s  European Commission persists in ignoring this American researcher and a growing number of international tobacco research and policy experts (here).  Perhaps a new report by Eurobarometer, the EU’s official survey organization, will force a policy change.

The 200+ page report (available here) analyzes tobacco prevalence and consumption, including cigarettes, snus and e-cigarettes, across all EU countries.  Its findings substantiate the dire consequences of the EU’s misguided ban on snus. 

The following table of reported key smoking indicators clearly demonstrates the effect of the Swedish snus experience.  Sweden has the lowest smoking prevalence, at 11% -- less than half the 26% prevalence throughout the EU and eight points lower than second-place Finland.  Sweden also leads the EU in prevalence of former smoking, at 35%.  It is the only country in the EU with cigarette consumption among smokers of less than 10 per day.  The reason is obvious: half of Swedes have “ever tried…oral tobacco (snus), chewing or nasal tobacco.”

Intriguing numbers are also supplied from Finland.  That nation has the second lowest smoking rate (19%) and the second highest ever use of smokeless tobacco (14%).  It is widely known that snus use remains popular in Finland.  In fact, snus importation increased last year (here), even though the product has been officially prohibited in Finland since it joined the EU in 1995.  Research shows that Finnish smoking rates would have declined even more if snus sales had not been banned (here).

Some suggest that snus would have no appeal outside of Sweden, but the product is clearly popular in Finland and in Denmark. Last year, the EU sued Denmark for permitting snus sales (here).  Also popular among Danes is a chewing tobacco product, Oliver Twist, another effective cigarette substitute and one that is legal in the EU.  The Eurobarometer numbers show that snus could work in Austria, Estonia and several other countries that have populations with smokeless tobacco experience.   

Keep in mind that the differences in snus and smoking rates noted here would have been much even more impressive if Eurobarometer had separately reported men and women’s numbers.  The snus experience has primarily affected smoking rates among Swedish men, although snus use has also been linked to smoking cessation in Swedish women (here).

The EU should take its head out of the sand and dissolve its unhealthy snus ban.

Tobacco Use in Sweden Versus the Rest of the European Union, 2014
EU Country	Current Smoking (%)	Former Smoking (%)	Cigarettes Per Day	Ever Tried Oral, Nasal Tobacco (%)
Sweden	11	35	9.9	50
Finland	19	24	13.5	14
Malta	20	19	14.8	1
Luxembourg	21	22	12.8	7
Italy	21	16	13.2	3
Ireland	21	19	13.9	5
Slovakia	21	16	12.5	4
United Kingdom	22	19	14.3	4
Estonia	22	21	11.5	10
Denmark	23	30	13.3	13
Netherlands	23	31	11.4	4
Belgium	25	19	14.1	5
Portugal	25	12	14.9	2
Czech Republic	25	18	14.3	9
Lithuania	26	18	12.1	5
Austria	26	17	19.8	10
Germany	27	22	15.3	9
Romania	27	13	14.2	1
Poland	28	15	15.6	5
Spain	29	19	13.7	2
Slovenia	30	18	16.5	6
Latvia	30	21	12.7	8
Hungary	30	11	16.1	3
Cyprus	31	15	19.5	2
France	32	22	13.0	4
Croatia	33	16	16.7	3
Bulgaria	35	16	15.6	2
Greece	38	21	19.5	1
EU	26	20	14.4	5