Tobacco use remains a significant public health challenge in Pakistan, with over 25.4 million users and a high prevalence of smoking-related diseases.

Despite various tobacco control measures, the smoking rate remains stubbornly high. To address this, Pakistan can look to Sweden's successful tobacco harm reduction (THR) strategies as a model for reducing smoking rates and improving public health outcomes.

Sweden has become a global leader in tobacco harm reduction, achieving remarkable results through the widespread adoption of better alternatives of nicotine products like snus, nicotine pouches and e-cigarettes into a broader tobacco control strategy.

This approach has led to Sweden having one of the lowest smoking rates in the world, with only 5.6% of adults smoking. The country's focus on harm reduction has resulted in significantly lower rates of tobacco-related diseases, including a 41% lower cancer rate compared to the European average.

This success has resulted due to the legalization and promotion of safer alternatives to smoking. The country also invested in creating advocacy amongst the public about the benefits of harm reduction products, leading to greater acceptance and use of these alternatives.

The Swedish government also played their due role in implementing policies that supported the use of harm reduction products, making them accessible and affordable for everyone.
Federico N. Fernández, CEO of We Are Innovation, a global network of 40+ think tanks and NGOs and visionary leader dedicated to driving innovation and change states that while many European countries have followed the World Health Organization’s guidelines for reducing smoking, Sweden went further and combined proven tobacco control with forward-looking innovation strategies.

The results have been astonishing. Since the mid-2000s, the proportion of smokers in Sweden has dropped dramatically from over 15% to just 5.6% by 2023—the lowest proportion in the European Union (EU).

Sweden implemented evidence-based policies, including advertising bans, smoking bans in public places and tax increases on traditional cigarettes, but many also argue that Sweden’s biggest innovation was to reduce tobacco harm through alternative nicotine products.

In contrast, Pakistan's approach to tobacco control has primarily focused on traditional measures such as taxation, advertising restrictions, and public smoking bans.

While these efforts are important, they have not been sufficient to significantly reduce smoking rates. To achieve better results, Pakistan can adopt a more comprehensive THR strategy.

Following the Swedish example, the government of Pakistan should promote and commercialize these alternatives and implement tax reductions on these products.

This will not only create advocacy for the general public about the benefits of THR products and dispel myths and misconceptions, but also it will also assist in making them more affordable for the consumers.

By adopting a comprehensive tobacco harm reduction strategy inspired by Sweden's success, Pakistan can significantly reduce smoking rates and improve public health outcomes.

Legalizing and promoting safer alternatives, coupled with public education and supportive policies, can pave the way for a healthier future for Pakistan.