A leading global health expert is urging governments to rethink their approach to safer nicotine products, warning that outdated policies and misconceptions about flavours are costing millions of lives.
Dr. Konstantinos Farsalinos, a cardiologist and tobacco harm reduction researcher from Greece, says the evidence is now overwhelming: combustion – not nicotine – is the primary killer in smoking-related diseases.
“Despite decades of tobacco control, we’re still losing more than eight million people globally each year to smoking-related illness,” Dr. Farsalinos said. “But there is hope. When smokers are supported to switch to safer, smoke-free alternatives like vaping and oral nicotine pouches, the impact is profound.”
Sweden has ‘ transformed its public health landscape’
One country, he says, proves this better than any other: Sweden. Once a nation where nearly half of men smoked, Sweden has now reached a remarkable milestone – just 4.5 per cent of Swedish-born adults smoke, meeting the official definition of a smoke-free society a full 15 years ahead of the European Union’s 2040 target.
While total nicotine use in Sweden is similar to other European countries, the shift away from combustible tobacco has delivered striking public health gains. Sweden now reports 61 per cent fewer male lung cancer deaths and a 34 per cent lower total cancer death rate compared to the EU average.
Speaking on World Vape Day on Friday, he said: “This revolution wasn’t driven by abstinence. It was driven by innovation. Sweden’s success came from embracing accessible, affordable, and socially acceptable alternatives like snus, e-cigarettes, and nicotine pouches. Since 2012 alone, Sweden has cut its smoking rate by 54 per cent – transforming its public health landscape.”
Flavours are a lifeline
Yet he says while Sweden moves forward, many other countries remain stalled, largely because of misinformation and moral panic – particularly around flavoured vapes.
Dr. Farsalino said: “Flavours are not a marketing gimmick; they’re a lifeline,” he said. “International evidence shows that flavours improve satisfaction, reduce cravings, and significantly increase the chances that smokers will quit for good.”
While some regulators fear that flavours appeal to youth, Dr. Farsalinos argues that bans are not the answer. Instead, he recommends strict age verification, adult-focused marketing, and evidence-based regulation.
Banning flavours, he warns, risks pushing adults back to smoking or into dangerous black markets – a pattern already observed in San Francisco after its failed flavour ban.
Dr. Farsalinos points to Sweden as a blueprint, not an outlier, and notes that other countries are already following suit. New Zealand has nearly halved its smoking rate since 2018, coinciding with a major rise in daily vaping.
In Japan, cigarette sales have plunged by 43 per cent as smokers switch to heated tobacco products. And in the UK, nearly three million people have quit smoking using vapes.
“This World Vape Day, I urge policymakers to stop vilifying vaping and start listening to the science,” Dr. Farsalinos said. “Flavours save lives. Vaping saves lives. Let’s make nicotine safer – and support, not sabotage, smokers who want to quit.”
