Sweden has become the world’s first “smoke-free” country, with an astonishingly low daily smoking rate of just 3.7 percent—well below the internationally accepted threshold of 5 percent. That’s according to the country’s leading public health research institute, the Swedish Council for Information on Alcohol and Other Drugs (CAN), which issued data for 2025 in a report released on April 1.
“I am happy and proud to be a Swede!” Dr. Karl Fagerström told Filter of the landmark news.
Fagerström, a professor and clinical psychologist who created the Fagerström Test to assess nicotine dependence, added that he was “grateful” to the Swedish government for its evidence-based health policies.
The country has a long history with snus, the oral safer nicotine product—use of which has now overwhelmingly replaced smoking, having overtaken it back in the 1990s.
“It has saved people from unnecessary suffering and death.”
The public health benefits have long been apparent. Sweden has for years had the European Union’s lowest rate of lung cancer. A 2024 report indicated overall cancer incidence 41 percent lower than the EU average, and tobacco-related deaths 44 percent lower.
Snus consumers place a tobacco-filled pouch under the lip that slowly releases nicotine. This avoids combustion and inhalation of the many toxic chemicals in cigarette smoke. In more recent years, modern nicotine pouches, which similarly reduce harm but don’t contain tobacco, have also become increasingly popular—especially among women, whose snus uptake has lagged behind men’s.
In January 2025, Sweden’s government raised tax on cigarettes by 10 percent while reducing the taxation on snus by 20 percent. Fagerström credits this move with helping to accelerate the decline in smoking.
“It has saved people from unnecessary suffering and death,” he said.
The new report shows that Sweden’s smoking rate has slumped since 2013 while use of safer nicotine products has risen, indicating large-scale migration. And the availability of attractive safer alternatives, in a range of flavors, means that many people who might have smoked never start in the first place. Daily smoking in the 18-29 age group is now just 2.9 percent—with snus and pouch use 10 times higher, at 29 percent.
“Sweden’s 67 percent drop in smoking since 2012 should be the gold standard. It’s a clear example of putting people and science first.”
CAN’s report should come as no surprise, according to Suely Castro, founder of the harm reduction advocacy group Quit Like Sweden. “It’s exactly what happens when policy follows evidence instead of politics,” she told Filter.
“Sweden’s 67 percent drop in smoking since 2012 should be the gold standard,” she added. “It’s a clear example of putting people and science first.”
Castro contrasted Sweden’s success with the failures of the EU as a whole, in which smoking prevalence fell just 14.2 percent within the same time frame.
Snus is banned throughout the EU—Sweden obtained a permanent exemption when it joined the block in 1995—and as Castro noted, there are many more recent examples of European politicians pushing anti-tobacco harm reduction policies.
In 2025, for instance, the Irish government imposed high taxes on vaping e-liquids, while Germany is among countries currently considering banning flavored vapes.
“That’s not just disappointing,” Castro said, “it suggests it’s ignoring what actually works.”
The lesson couldn’t be more obvious. But will other countries now replicate Sweden’s success? Or did it really come down to Sweden’s unique relationship with snus?
“Other countries may lack that history [with snus], but the principle is simple: When smokers have access to lower-risk options, many switch.”
“I don’t think Sweden’s success is unique, but is shaped by its longstanding acceptance of snus and a model that makes alternatives to smoking accessible, acceptable and affordable,” Castro said. “Other countries may lack that history, but the principle is simple: When smokers have access to lower-risk options, many switch.”
Fagerström noted that Sweden’s success is already being replicated elsewhere if you consider the whole category of safer nicotine products.
He pointed to the United Kingdom, where millions have quit cigarettes thanks to vapes, which have been involved in the majority of successful quit attempts in recent years. Meanwhile snus itself has caught on in a big way in Norway (not an EU member), helping to drive that country’s smoking rate down to 7 percent.
Outside Europe, New Zealand is verging on “smoke-free” status because of vaping, while public acceptance of heated tobacco products has enabled Japan to halve cigarette sales.
“Nicotine is not a health product, but as [with] other cultural drugs, such as caffeine and alcohol, it’s difficult to ban or extinguish all use,” Fagerström said. “Therefore, we have to reduce the risks as much as possible.”
Photograph by Tom Swinnen via Pexels