SWEDEN’s achievement of having one of the world’s lowest smoking rates offers lessons for Filipino policymakers seeking to reduce the health risks associated with traditional cigarettes, a tobacco harm reduction expert said.
Dr. Lorenzo Mata, president of Quit for Good and an occupational health physician and tobacco harm reduction advocate with more than 40 years of medical experience, shared his insights at the 2nd National Summit on Nicotine and Harm Reduction, held under the theme “Choice, Evidence, and Access.” Mata said that about 5.4 percent of Swedes aged 16 to 84 reported smoking daily in 2024, one of the lowest rates worldwide.
He attributed this partly to the widespread use of snus, a smokeless tobacco product used daily by 22 percent of men and 10 percent of women in the same age group.
The expert said the figures challenge policymakers to move beyond arguments framed around “safe versus unsafe” and consider how strong tobacco control measures can coexist with the availability of non-combustible nicotine products.
“The Philippines is not Sweden,” Mata said, pointing to differences in culture, smoking prevalence, the healthcare system and the regulatory environment.
He said the key lesson is the willingness to use the best available evidence to determine how to reduce harm for the greatest number of people.
This includes preventing tobacco use initiation, protecting young people, helping smokers quit, reducing exposure to combustion, ensuring product quality, providing consumers with accurate information and measuring public health outcomes, he said.
The World Health Organization maintains that tobacco use remains a major global public health threat and advocates comprehensive tobacco control measures, including taxation, smoke-free policies, advertising restrictions, health warnings and access to cessation services.
In the Philippines, Republic Act 11900, or the Vaporized Nicotine and Non-Nicotine Products Regulation Act, establishes a regulatory framework for vaporized nicotine and non-nicotine products, including their manufacture, sale, distribution and use. The law includes provisions intended to regulate the industry and protect minors.
Mumbai-based cardiologist Dr. Rohan Sequeira warned that annual tobacco-related deaths are projected to exceed 10 million by 2030 if governments fail to act.
“That means we are adding two million people every year who are going to die because of harm reduction not being implemented by regional and national governments,” he said.
Sequeira described cigarettes as the most dangerous form of nicotine delivery.
Mata, meanwhile, said adult smokers need access to credible alternatives if they cannot or are unwilling to quit immediately.
He said these alternatives should be scientifically evaluated and realistically accessible.
“Harm reduction cannot mean ignoring young people, unrestricted promotion, poor quality products, or unsupported health claims,” he said.
Professor Eric Castillo of CAPS and Partners Inc. said about 90 countries allow and regulate the sale of alternative nicotine products, including e-cigarettes, heated tobacco products and Swedish snus.
He said the Philippines, through Republic Act 11900, has adopted a harm reduction framework in law, while the United Kingdom, New Zealand and Canada have also pursued public health approaches that encourage smokers to switch to alternatives.
Anton Israel of the Nicotine Consumers Union of the Philippines said smoking rates have declined in Sweden, Britain, New Zealand and Japan alongside the availability of alternatives to conventional cigarettes.
“All we ask is this: that policy be based on evidence and on the level of risk. The choice belongs to the Filipino consumer. Our duty is to make sure it is not lost, that they keep their access, their choice and their hope,” Israel said.
Mata also addressed common misconceptions about nicotine and alternative products.
He acknowledged that nicotine is addictive and biologically active but emphasized the distinction between nicotine dependence and the toxic effects of cigarette smoke, which contains thousands of chemicals, including numerous carcinogens.
Mata also rejected the notion that all nicotine products carry the same level of risk, citing differences in their composition, delivery methods and exposure to toxic substances.
“Harm reduction does not mean zero risk. It means reducing risk compared with a more harmful behavior,” he said.