New evidence shows that four countries are proving safer nicotine alternatives can cut smoking rates, prevent disease and save lives.
The findings come from The Safer Nicotine Revolution: Global Lessons, Healthier Futures, a new report that tracks how products such as nicotine pouches, vapes and heated tobacco products are helping millions of smokers switch away from deadly cigarettes.
Sweden: smoke-free status in sight
Sweden is on course to be the world’s first “smoke-free” nation, with just 5.3 per cent of adults smoking and only 4.9 per cent of men – the lowest rates in Europe.
- 76.3% of men and 71.6% of women who use snus have quit smoking completely
- Risk of heart disease cut by 45% when switching from smoking to snus
- Around 3,000 lives saved each year
- Lung cancer deaths among men 61% lower than EU average
- Overall cancer deaths 34% lower than EU average
- Smoking down 54% in 12 years, women’s smoking down 49% since 2016
Japan: cigarettes halved in a decade
Japan’s introduction of heated tobacco products (HTPs) in 2014 triggered the fastest drop in smoking in the country’s history.
- Smoking prevalence dropped from 21% in 2015 to 16% in 2023
- 12.4% of adults now use HTPs
- Cigarette sales fell 52% between 2015 and 2023 (182bn to 88bn sticks)
- Modelling shows 12m cases of smoking-related disease could be prevented if half of smokers switched
United Kingdom: vaping built into NHS services
The UK has integrated vaping into its stop-smoking programmes.
- Smoking fell from 20.2% in 2011 to 11.9% in 2023 (41% reduction)
- 5.5m adults now vape, with more than half quitting smoking entirely
- 166,000 premature deaths projected to be prevented by 2052
- Since 2013: cardiovascular deaths down 19%, COPD deaths down 15%, cancer deaths down 13%
- Hospital admissions for smoking-related illness fell from 446,400 in 2019–20 to 408,700 in 2022–23
New Zealand: smoking halved in six years
New Zealand halved smoking between 2018 and 2024 after legalising vaping and heated tobacco.
- Vaping prevalence rose from 2.6% to 11.1%
- 78% of daily vapers are ex-smokers
- COPD hospitalisations down 29% between 2017 and 2022
- Smoking-related cardiovascular deaths down 20% between 2009 and 2021
- Biomarker modelling projects 195,000 extra quality-adjusted life years
Why it matters
The report says these examples prove safer nicotine alternatives deliver measurable benefits: fewer deaths, fewer hospitalisations and better health outcomes.
Low and middle income countries, which account for 80 per cent of smoking-related deaths, stand to gain most. Experts say regulated alternatives such as nicotine pouches could replace dangerous local products like gutka in India and Bangladesh.
