Nicotine Pouches, Snus, and the Remarkably Low Smoking Rates in Sweden


Sweden is a unique case study in public health, especially when considering the prevalence of smoking in the country. Despite its geographic location in Europe, where many countries exhibit high rates of smoking, Sweden has consistently reported one of the lowest rates of smoking in the world. A key factor influencing this scenario is the widespread use of alternatives to cigarettes, such as nicotine pouches and snus.

What Are Nicotine Pouches and Snus?

Before delving into the implications of their use, it’s essential to understand what nicotine pouches and snus are.

Nicotine pouches are smokeless, spitless, and tobacco-free products that are often used as substitutes for cigarettes. They contain nicotine, which is encapsulated in small, white pouches. Users place these pouches under their upper lip, where the nicotine is absorbed through the mucous membrane and into the bloodstream.

Snus, on the other hand, is a moist tobacco product popular in Sweden and Norway. It’s similar to American chewing tobacco but differs in key ways. Unlike chewing tobacco, snus doesn’t require spitting. It’s also steam-pasteurized, which results in fewer harmful byproducts compared to other smokeless tobacco products that are fermented. Like nicotine pouches, snus is used by placing a pouch under the upper lip.

The Historical Context of Snus in Sweden

Sweden’s relationship with snus dates back to the early 19th century. This smokeless tobacco product became popular as a cheaper and more accessible alternative to cigars and pipe tobacco. Over time, snus use became ingrained in Swedish culture, and it’s now the most commonly used tobacco product in the country.

The Rise of Nicotine Pouches

In recent years, nicotine pouches have also gained popularity in Sweden. They’re viewed as a healthier alternative to cigarettes and other tobacco products because they don’t contain tobacco and don’t require combustion. Instead, they deliver nicotine in a cleaner, smokeless, and odorless manner.

The Link Between Snus, Nicotine Pouches, and Low Smoking Rates

The widespread use of snus and nicotine pouches in Sweden has resulted in a unique public health outcome: lower smoking rates. According to the World Health Organization, Sweden has the lowest rate of daily smokers among adults in Europe.

Nicotine pouches and snus provide nicotine—the addictive component of cigarettes—without the combustion and smoke, which are responsible for the majority of health risks associated with smoking. These alternatives allow users to satisfy their nicotine cravings without resorting to cigarettes, which may help explain the low prevalence of smoking in Sweden.

However, it’s important to note that nicotine pouches and snus are not risk-free. They still contain nicotine, a highly addictive substance, and long-term use can lead to dependency. While they may be safer than cigarettes, the best course of action for health is to avoid all forms of tobacco and nicotine products.


Sweden’s low smoking rates highlight the potential impact of harm reduction strategies in tobacco control. By providing alternatives to smoking that still satisfy nicotine cravings, it may be possible to lower smoking rates and associated health risks. However, the best course of action is always complete abstinence from nicotine and tobacco products.

While nicotine pouches and snus have played a part in shaping Sweden’s tobacco landscape, their use should not be promoted without acknowledging the potential risks associated with nicotine addiction. As such, they should form part of a broader strategy, one that emphasizes education, regulation, and support for those seeking to quit nicotine entirely.

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