High nicotine use does not lead to high rates of health issues: report

A new report by international health experts reveals that Sweden's innovative approach to nicotine consumption has resulted in significantly lower rates of tobacco-related diseases compared to other European countries, despite similar levels of nicotine usage.

The report, ‘No Smoke, Less Harm’ released earlier this month in Stockholm at an event organised by the global health advocacy group Smoke Free Sweden, presents a comprehensive analysis of nicotine usage and its health impacts in Sweden and several comparable countries. It found that nicotine use itself is not the primary factor in tobacco-related diseases. Instead, the method of nicotine consumption plays a crucial role.

While Sweden’s nicotine consumption aligns with the European average, the country has a 41 per cent lower incidence of lung cancer and reports fewer than half the tobacco-related deaths seen in its European peers. This remarkable health outcome is attributed to the widespread adoption of smoke-free nicotine products such as snus, nicotine pouches, and electronic cigarettes, which pose significantly lower risks than traditional smoking.

“This distinction between smoking and the use of smokeless products is crucial,” said Dr. Karl Fagerström, a public health expert and contributor to the report.

“While nicotine is addictive, it does not cause the serious diseases associated with smoking. Our findings support a shift in focus from cessation to substitution with less harmful alternatives for those unable to stop completely.”

The report credits Sweden's proactive public health education and regulatory frameworks for encouraging the transition to these safer alternatives, thereby significantly improving public health outcomes. The Swedish experience, as outlined in the report, underscores the potential benefits of harm reduction strategies that other nations could adopt to mitigate the health impacts of tobacco use.

Dr. Fagerström added, “The Swedish experience demonstrates that understanding and addressing public misperceptions about nicotine can lead to health policies that better protect and inform consumers.”

Misconceptions about nicotine's harm are prevalent among physicians and the public alike, the report notes, highlighting the example of the UK. Despite clear guidance from the NHS stating that “nicotine itself does not cause cancer, lung disease, heart disease, or stroke,” 40 per cent of the UK public mistakenly believes that nicotine is a leading cause of smoking-related cancers.