Sweden : A Public Health Blueprint for a Smokeless Future by Dr. R.S Maujood (Chest Physician)
The Promise of Progress
Every nation shares the goal of reducing the enormous health burden caused by smoking.
It is a complex challenge that requires an open mind to innovative solutions.
Around the world, a public health strategy known as tobacco harm reduction is gaining traction, centred on a pragmatic principle: help adult smokers who cannot or will not quit to switch to smokeless alternatives.
The data shows this works.
Nowhere is this success more evident than in Sweden.
By embracing smokeless nicotine products, it has achieved the lowest smoking rate in the European Union - now below 5% - well below WHO’s benchmark for a smoke-free nation – defined as having less than 5% smoking prevalence.
This remarkable progress has resulted in Sweden having Europe's lowest rates of tobacco-related mortality.
It is a powerful testament to what is possible when policy is guided by evidence.
In Sri Lanka, tobacco consumption amongst air pollution, diet and high BP sits among the top ten risks underpinning death, disease and disability.
Smoking is also one of the largest causes of chronic obstructive pulmonary disease (‘COPD’), ischaemic heart disease (‘IHD’) and stroke.
A Path Obscured
For Sri Lanka, the current policy landscape fails to distinguish between the vastly different risk profiles of nicotine products.
By conflating innovative, tobacco-free products like nicotine pouches - which involve no combustion - with traditional cigarettes, we inadvertently create a barrier that prevents adult smokers from accessing better alternatives.
This approach, while well-intentioned, is counterproductive.
It denies smokers viable off-ramps from the most dangerous form of nicotine consumption and stifles a critical public health opportunity.
When we fail to provide and encourage access to scientifically substantiated, reduced-risk products, we let down millions of adult smokers who deserve access to different choices.
The Solution : A Call for Evidence-Based Dialogue
Smokers, vapers, and all nicotine users deserve evidence-based dialogue on the role of nicotine pouches in reducing the use of combustible, tobacco-based products.
We must ask: are current regulations truly serving the goal of public health, or do they risk preventing progress?
A modern regulatory framework should be built on the principle of relative risk.
It should encourage adult smokers to switch to smokeless products while ensuring strict quality standards.
This includes clear rules that prevent underage access and provide accurate information to adult consumers.
It is not a choice between regulation and no regulation; it is a choice between smart regulation that accelerates progress and outdated rules that stall it.
By looking to the success of Sweden, Sri Lanka can begin its journey to design a framework that is fit for purpose.
One that provides adult smokers with the confidence to switch, knowing they are choosing a regulated, quality-controlled, and potentially less harmful product.
It is time for a policy discussion that reflects this progress.
It requires shared responsibility from industry, regulators, and public health advocates alike.
By working together to create an evidence-based regulatory environment, we can unlock the transformative potential of these products to improve public health in Sri Lanka.
