Can tobacco harm reduction really work?
The male population of Sweden is living proof that tobacco harm reduction can work. Smokeless tobacco has a long history in Sweden and, though it was largely replaced by cigarettes when they became popular in the early 20th century, it made a comeback. Over the last few decades, men in Sweden have smoked less and used more “snus” (the Swedish word for moist snuff) instead. This was not caused by any public health campaign or government meddling. It was a normal social process of people changing their tastes. But the result was a huge public health triumph. Swedish men have a very low rate of lung cancer and other smoking related diseases, as we would expect from a population that quit smoking. The scientific evidence shows that the widespread use of smokeless tobacco is not causing any substantial disease risk. (Swedish women, unfortunately, continue to smoke at the higher rates typical of other countries, and their rates of smoking-related diseases remain high [1]). Could the Swedish
