As world governments continue to debate how best to reduce smoking, some pursue punitive measures such as sweeping bans, and extreme taxation, despite decades of evidence showing that these approaches often fail. Others, like several Nordic countries, have chosen a more pragmatic and science-based approach, by allowing adult smokers access to safer nicotine alternatives. Yet while the latter has produced the most dramatic and sustained declines in smoking ever recorded in Europe, it has also been the subject of constant controversy and scrutiny, as many seem to view it a way of indulging addiction.
Unlike countries adopting prohibitionist strategies, some Nordics have embraced the continuum of risk, supporting a transition away from combustible cigarettes. Across Sweden, Norway, Finland, Denmark and Iceland, smoking has been driven to historic lows—not because nicotine has been eradicated, but because consumers have shifted toward significantly less harmful forms such as snus, nicotine pouches, vaping and heated tobacco.
Alternatives outperform bans and taxes
Sweden remains the clearest case study of what happens when adult consumers have broad access to safer alternatives. With smoking now at approximately 4.5 percent among Swedish-born adults, the country has achieved the EU’s smoke-free target sixteen years ahead of schedule. This milestone was not reached through harsh penalties, but through the continued availability and affordability of snus and, later, nicotine pouches. Naturally, as smoking declined, Sweden also recorded some of the lowest rates of lung cancer, oral cancer and COPD in Europe, underscoring the effectiveness of harm reduction in real-world health outcomes.
Norway shows a parallel pattern, particularly among younger adults, who overwhelmingly choose snus and nicotine pouches instead of cigarettes. This shift has produced some of the steepest declines in youth smoking across the region. Finland, despite stricter controls on snus, has nonetheless experienced sustained drops in smoking as nicotine pouch use has grown. Even in Iceland—where snus remains banned and the nicotine market has evolved through pouches, vapes and heated products—daily smoking has fallen to just 5.6 percent.
For more than half a century, Iceland—like its Nordic neighbours—built one of Europe’s strongest tobacco-control environments through advertising bans, prominent health warnings, prevention campaigns and restrictive norms around smoking. Yet what ultimately accelerated its decline in cigarette use was not prohibition, but the rise of practical, appealing and affordable lower-risk products. The real turning point came after 2010, when modern smoke-free products—including nicotine pouches, vapes and later heated tobacco—became widely available.
Denmark’s irony as it fights its own success
New evidence from Denmark reinforces this regional trend. Over the past eight years, Denmark has seen a significant increase in the use of nicotine pouches and vaping products, particularly among adults who previously smoked. Danish health surveys and cessation studies have documented a clear shift from combustible tobacco to non-combustible products, with former smokers reporting that they switched because pouches and vapes were affordable, accessible and less harmful. Several Danish cessation researchers have noted that the rise of nicotine pouches has coincided with the country’s first sustained decline in daily smoking in more than a decade, making Denmark one more example of harm reduction succeeding where traditional policies plateaued.
Given these outcomes, it is striking—if not outright ironic—that the Danish Presidency is now pushing for a dramatic tax increase on safer alternatives through the EU’s Tobacco Excise Directive. Denmark’s proposal more than doubles the minimum tax on heated tobacco from €155 to €360 per kilogram and introduces a mandatory minimum of 55 percent of the retail price. The draft also places nicotine pouches on a steep tax-increase trajectory and maintains heavy taxation on e-liquids, despite clear evidence that these products help adult smokers quit. These sudden shifts mirror the demands of certain anti-tobacco NGOs far more closely than the stated positions of Member States. Several governments have already criticised the proposal as lacking transparency, proper consultation and scientific justification.
Safer nicotine alternatives don’t create smokers—they replace them
The World Vapers’ Alliance warns that eliminating the price difference between cigarettes and safer alternatives will undermine smoking cessation. When low-risk products become more expensive or less accessible, smokers lose key incentives to switch. Michael Landl, director of the WVA, argues that raising taxes on harm-reduction products amounts to “prohibition by price” and risks forcing former smokers back to cigarettes. This concern is echoed by 83 independent public-health experts who submitted evidence to the EU warning that disproportionate taxation on safer products would reverse progress and contradict decades of scientific consensus.
This tension highlights a central truth in the Nordic experience: harm reduction works when consumers have practical, affordable choices. It fails when governments impose policies that ignore relative risk. The declining smoking prevalence in Sweden, Norway, Finland, Iceland and Denmark demonstrates that people move down the risk continuum when alternatives are available. They shift from cigarettes to snus, from snus to pouches, and from combustible products to vapes and heated tobacco. This behavioural pattern has repeated across multiple markets, multiple product categories and multiple generations. In each of these countries, the pattern is consistent: as smoking falls, use of low-risk alternatives rises.
These trends align with international findings. A 2024 U.S. study showed a historic collapse in teen smoking despite increases in experimentation with low-risk nicotine products. Research from Public Health England, the Royal College of Physicians and the U.S. National Academies of Sciences has long affirmed that nicotine itself is not the danger; combustion is. When policymakers respect this distinction, progress follows. When they ignore it, smokers remain trapped in the most harmful form of nicotine delivery.
Will Europe follow the evidence or repeat past mistakes?
As Europe debates the future of tobacco taxation, the Nordic countries offer a clear blueprint based not on ideology but on lived evidence. They show that the fastest path to a smoke-free society is not prohibition, but the proliferation of safer, appealing and accessible alternatives. They demonstrate that consumers willingly abandon cigarettes when given risk-reduced choices. And, perhaps most importantly, they prove that public health improves when harm-reduction principles guide policy rather than punitive instincts.
The question now facing the EU is not whether harm reduction works. The Nordic region has already answered that. The question is whether governments will follow the data—or undermine their own success by making safer alternatives harder to obtain. Denmark’s recent tax proposal, when own health data shows that these products are helping smokers quit, sadly suggests the latter.
Snus vs Nicotine Pouches: Comparing the Safety and Science Behind The Products
