Smoke Free Sweden: Brussels Warned Against Depriving Women of Best Tool to Quit Smoking

On International Women’s Day (March 8), health experts are warning EU policymakers not to jeopardise women’s health by restricting or banning nicotine pouches that have helped drive one of the world’s most dramatic declines in female smoking.

The warning accompanies the release of Empowerment in a Pouch, a report showing how access to oral, tobacco-free nicotine pouches has accelerated Sweden’s progress towards smoke-free status, particularly among women.

European Commission proposals under consideration in the Tobacco Products Directive could reverse this progress if applied across the EU, where more than one in five women still smokes.

“Sweden’s experience shows what happens when women are given realistic alternatives to smoking,” said Professor Marewa Glover, behavioural scientist and co-author. “Remove those options and you remove momentum. The danger now is that European policy ignores success and repeats past mistakes.”

The report shows that since nicotine pouches became available in Sweden in 2016:

• Women’s smoking rates have fallen by nearly 50%, now among the lowest globally.
• Women’s quit-smoking rates increased around threefold, putting Sweden on track to become the first smoke-free country (adult daily smoking below 5%).
• Female smoking is declining six times faster in Sweden than elsewhere in Europe, according to WHO statistics.

Nicotine pouches have proved particularly effective for women, who often face greater barriers to quitting. Unlike cigarettes, they contain no tobacco and involve no combustion. Used under the lip, they deliver pharmaceutical-grade nicotine without smoke, vapour or odour.

Survey and focus group findings show women value their practicality, discretion and compatibility with daily life. Many cited the ability to quit without disrupting work, social interactions or caregiving responsibilities.

“As the European Commission weighs changes to the Directive, it must follow the evidence,” said Dr Delon Human, co-author and former secretary-general of the World Medical Association. “Treating low-risk nicotine products as cigarettes risks pushing women back to smoking, with predictable and deadly consequences.”

Research participants rated nicotine pouches as the most effective quitting aid, outperforming vapes and traditional nicotine replacement therapies.

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