A comprehensive new report titled “Saving Lives Like Sweden” compares the radically different public health outcomes between France and Sweden in tobacco use and harm reduction. Released by the Second Focused Study (SFS-2N) network, this study makes a powerful case for how adopting or rejecting safer nicotine alternatives directly impacts national health.
A Tale of Two Strategies
Sweden is on track to become the first country in the EU to achieve “smoke-free” status—defined as having less than 5% of the population smoking daily. In 2023, Sweden’s daily smoking rate stood at just 5.6%, the lowest in the EU. The key? A pragmatic and inclusive public health approach that accepts and promotes safer nicotine alternatives, particularly snus and nicotine pouches.
Meanwhile in France, daily smoking rates hover around 25%, among the highest in Europe. France, unlike Sweden, restricts access to and communication about reduced-risk products. E-cigarettes, snus, and nicotine pouches are either heavily regulated or outright banned. The result: millions remain addicted to combustible cigarettes, with little state support for switching to safer options.
The Swedish Model: Pragmatic Harm Reduction in Action
Sweden’s success is built on decades of integrating harm reduction into public policy:
- Snus is legal and culturally accepted, with over 20% of adult men using it daily.
- Nicotine pouches are widely available and seen as viable alternatives to smoking.
- Sweden has low tobacco-related disease and cancer mortality rates, among the lowest in the EU.
- Smoking-related deaths have fallen by over 40% in the past two decades.
Importantly, the Swedish model does not ignore youth protection or downplay nicotine risks—it balances these concerns with a broader goal of saving adult lives.
France’s Policy Paralysis
In stark contrast, France’s approach remains ideologically opposed to nicotine use of any form. The SFS-2N report identifies several key failings:
- Snus is banned, despite overwhelming evidence of its harm reduction potential.
- Nicotine pouches and vaping products face legal, financial, and social barriers that limit adult access.
- Doctors and healthcare providers receive little training on tobacco harm reduction and are often misinformed.
- French public health campaigns continue to frame all nicotine use as equally dangerous, regardless of delivery method.
As a result, France sees higher rates of smoking-related diseases, increased healthcare costs, and stagnant progress in helping smokers quit.
A Shared European Goal—Different Paths
Both countries are EU members and nominally committed to the EU Beating Cancer Plan, which includes a target to create a smoke-free Europe by 2040. Yet Sweden’s trajectory suggests this goal is realistic—while France’s current policies make it unlikely to succeed.
The report urges France to:
- Legalize and regulate snus and nicotine pouches.
- Promote accurate information about the relative risks of different nicotine products.
- Support research and medical education on harm reduction.
- Learn from Sweden’s success to help millions of French smokers transition away from cigarettes.
Why It Matters
This isn’t just a national issue—it’s a European one. If more EU countries adopted evidence-based harm reduction, over 700,000 lives could be saved across the continent. The report frames it clearly: this is not about promoting nicotine use, but about reducing harm where it’s most dangerous—combustible smoking.
As the evidence grows, so does the responsibility of policymakers, regulators, and health professionals to act.
Read the full report: France vs. Sweden – SFS-2N 2025
