As Zambia contemplates the future of smoking cessation and tobacco control with the proposed bill, the Swedish model serves as a powerful example of how harm reduction can be leveraged to achieve lasting health benefits.

Sweden is set to become the first country in the world to achieve ‘smoke-free’ status when its tobacco smoking prevalence rate falls below 5% in the next few months.

The Swedish Model has made tobacco harm reduction products as accessible, acceptable, and affordable as possible to adult smokers, effectively wiping out smoking in a country where 50 years ago, 49% of men were smoking regularly.

The county has slashed its smoking rates from 15% in 2008 to 5.6% today, and its cancer incidence is 41% lower than the rest of the EU. Sweden also has a 39.6% lower rate of death of all tobacco-related diseases compared to the EU average and is one of the three countries with the lowest number of deaths attributed to lung cancer.

This success did not occur spontaneously; it resulted from concerted public health campaigns, regulatory reforms, and the widespread adoption of safer nicotine alternatives, such as nicotine vapes, snus, and oral nicotine pouches. These products have become an acceptable alternative for Swedish smokers seeking to quit or reduce their cigarette consumption.

In addition to encouraging safer alternatives, Sweden has implemented comprehensive public health campaigns, introduced age limits for tobacco purchases, and established smoke-free zones in public areas. Importantly, the Swedish approach has been collaborative, involving regulators, health practitioners, and the broader society to drive this success. As a result, smoking-related diseases have drastically decreased, saving lives and reducing the burden on Sweden’s healthcare system.

There are approximately 1.1 million current smokers in Zambia today, with 7947 people dying every year from smoking-related diseases each year. Despite the importance given to cessation programs, there are no comprehensive cessation services offered in most public care facilities in the country, leaving smokers with little to no help.

If Swedish tobacco-related mortality rates were replicated in other countries, more than 3.5 million lives could be saved. This experience offers a roadmap that Zambia can adapt to suit its unique socio-economic and public health landscape. Given the country’s growing population and the prevalence of smoking, adopting a harm reduction strategy like Sweden’s could have a transformative impact.

To beat smoking like Sweden, policymakers in Zambia must support harm reduction strategies and make smoke-free alternatives more affordable than cigarettes.