Smoke Free Sweden: Sweden Urged to Defend the Innovation Driving Women’s Quit-Smoking Success

On International Women’s Day (March 8), Swedish policymakers are being urged to defend the innovation that has delivered one of the world’s fastest declines in female smoking, as Brussels considers EU-wide restrictions on oral nicotine pouches.

The appeal accompanies the release of Empowerment in a Pouch, a report showing how tobacco-free nicotine pouches have transformed women’s ability to quit smoking in Sweden, placing the country on the brink of smoke-free status.

“Sweden’s progress shows what happens when women are given alternatives that fit real lives,” said Professor Marewa Glover, behavioural scientist and co-author. “Nicotine pouches have allowed women to quit successfully and on their own terms. Rolling back access would hit women first, and hardest.”

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.

These gains have contributed to falling rates of smoking-related cancers and cardiovascular disease among Swedish women and helped narrow long-standing health gaps.

Despite this progress, the European Commission is considering revisions to the Tobacco Products Directive that could impose uniform restrictions on nicotine pouches across the EU, regardless of their role in reducing smoking. Such an approach risks limiting access to the smoke-free products women are most likely to adopt.

Participants in the research rated nicotine pouches as the most effective quitting aid, outperforming vapes and traditional nicotine replacement therapies. Women ranked pouches almost three times higher than vapes and 56% higher than nicotine gum. Sixty percent of female users cited flavour variety as a key reason for choosing pouches.

“Women have led Sweden’s smoke-free transition, and policy must protect what made it possible,” said Dr Delon Human, co-author and former secretary-general of the World Medical Association. “Defending proportionate, risk-based regulation is essential, not just for Sweden, but for women across Europe who still need a realistic way out of smoking.”

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