Once again, news site EU Reporter appears to be an outpost of the tobacco lobby, with a story that praises the Swedish model of harm reduction. But snus is not the cause of the low smoking prevalence in Sweden, and the Swedish Cancer Institute mainly sees disadvantages.

By the web editors

‘How the Swedish model can power a smoke-free EU’, was the headline on the news site EU Reporter last week. The site presents itself with the slogan ‘Independent media for better debate’, but once again reveals itself as an undisguised lobby vehicle. The article attempts to convince European policymakers that excise duty on nicotine pouches would be the wrong way to achieve a smoke-free society. The low smoking prevalence in Sweden is said to be entirely attributable to the popularity of snus (mouth tobacco, also known as brown snus) and nicotine pouches (white snus) in Sweden.

The former British TV journalist Colin Stevens, the owner of EU Reporter, describes in a sunny article a visit to the cozy Snus and Match Museum in Stockholm, to elaborate on the history of snus and how it would have ensured one of the lowest smoking prevalences in Europe. Stevens quotes the well-known Swedish harm reduction propagandist Karl-Olov Fagerström, who claims that “smoke-free nicotine is at the heart of Sweden’s smoking decline”. The 79-year-old scientist argues that the total elimination of nicotine poses the risk that millions of smokers will remain trapped in the use of cigarettes, instead of leading them to alternatives that would be less harmful.

‘355,000 fewer deaths in EU’

To convince his readers in Brussels, Steven cites an unspecified study by the World Health Organization that would show that if the Swedish model were projected on Belgium, it would save 11,000 deaths per year in Belgium. Across Europe, 355,000 fewer deaths per year would have to be regretted. After all, it is not the nicotine that harms people, but the smoke from burnt tobacco, is the fixed argument from the harm reduction camp.

In his piece, Stevens also lets a spokesperson for snus producer Swedish Match, part of Philip Morris International since 2022, and the chairman of the National Association of Snus Users in Sweden have a word. He then describes how unwise it would be to levy excise duty on nicotine pouches, which is exactly what the European Commission has proposed. Stevens writes: “Excessive taxation or blanket regulation could make pouches as expensive as cigarettes, stripping away the incentive to switch. These kinds of policies could hurt innovators developing alternative nicotine products, leaving the field to illicit suppliers with no quality control at all.”

Stage for political influence

It is the well-known arguments that betray that Stevens is acting as a spokesman for the nicotine lobby. In 2021, Politico already described how EU Reporter is paid by various companies to lobby in Brussels, where Stevens was also president of the press club from 2020 to 2022. Politico wrote: “With reporters accredited at European institutions like the Commission, and a ‘press club’ where Stevens is president just a stone’s throw away from the Berlaymont building, EU Reporter is the most prominent example of a network of EU-focused websites portraying themselves as independent media organizations — while secretly facilitating political influence campaigns.”

Strong growth in snus use among girls

European policymakers who read EU Reporter would do well to also look at the website of the Swedish Cancer Institute, Karolinska Institutet, where the downside of the snus epidemic comes to light. A news item from 2024, ‘Nicotine in a new guise’, mentions how the use of snus and nicotine pouches has increased enormously, especially among girls, based on various studies. In 2010, 6 percent of girls in the second grade of high school had used snus. In 2023, after the rise of nicotine pouches, it was 22 percent. An increase can also be seen among boys, but it is slightly less strong. The number of second-grade boys who had used snus in the last month in 2023 was 27 percent.

Meanwhile, the steady decline in the number of smokers is a long-term trend that cannot be explained by the rise of snus in recent years, says Professor of Public Health Rosaria Galanti of the Karolinska Institutet. The number of smoking men in Sweden has been declining since 1970, the number of smoking women since 1990. Sweden has a coherent anti-smoking policy for a long time.

Glitter boxes and candy flavors

A school principal saw the use of snus increase enormously. “Snus is normalised”, she says. “We’re back in the 70s, where we were then with smoking.” She denounces the aggressive marketing via websites and social media where the boxes of nicotine pouches with glitter and colours look like make-up. The companies call themselves ‘fashion-conscious’ and focus specifically on women. “Obviously, very strong market forces want our young people to do this. It pisses me off, to be honest. The adult world has a responsibility to ensure the next generation has the best conditions and we don’t know how their bodies are affected by these products. Yet we allow these companies to get young girls to take up snus by offering glitter boxes and candy flavours.”

Risks of nicotine pouches

The growing number of girls who use nicotine pouches also means that their use during pregnancy is becoming more common. In that case, the nicotine reaches the unborn child via the placenta. This increases the risk of miscarriage, premature birth and disturbances in the baby’s breathing. Children of mothers who used brown snus during pregnancy appear to have higher blood pressure than children of mothers who did not use snus.

In 2011, research by the Uppsala University and the Karolinska Institute into the risks of using brown snus showed that snus users are more likely to suffer from heart failure and need hospital treatment more often than non-snus users.

Dentist and researcher Karin Garming-Legert sees that users of nicotine pouches are more likely to have gum damage . “Some of them have more extensive lesions that cover larger portions of the mucosa, not just where the snus lies”, she says. “The lesions can extend across the entire side above the dental arch, sometimes affecting both sides. Symptoms may include pronounced redness with signs of inflammation, occasionally accompanied by sores and blisters. Interestingly, patients seek dental care for these issues, which is not typically the case with snus lesions caused by brown snus.”

Industry knows how to seduce 30-year-old woman

A year ago, the Karolinska Institutet also published a story in which a 34-year-old woman shares her experiences with nicotine pouches. In the spring of 2020, when she was 30 years old, she tried her first nicotine pouch, which was offered to her. After getting it from others a number of times, she bought her first box of her own because she no longer wanted to scrounge. Before she tried that first nicotine pouch, she had never used nicotine. The woman, Fanna Ndow Norrby, had always been warned as a child not to smoke because of her asthma and she thought brown snus was disgusting.

After a while, she wondered how the industry had managed to get her addicted. She got the stuff from friends, but how did they get it? The answer is shocking and worrying at the same time. “These products crept into our lives in a very clever way”, Ndow Norrby said. “When we were sitting in a bar, friends would come over with lots of cans and share them with us. They had got them for free at some event. These events were like parties where big artists performed, everything was very credulous.”

I Lyft or I Velo

The friends also didn’t feel like they were using snus, she says, but were talking about ‘I Lyft’ or ‘I Velo’, referring to the brand names. After two years, Ndow Norrby managed to get rid of the nicotine pouches. But as a communications and PR professional, she saw how skilfully the industry has managed to reverse a health trend with a new product. “I’ve felt annoyed with the tobacco companies that managed to lure me into this, but I was still 30 years old and made my own choice. I think it's absolutely terrible that children start using snus. Children shouldn’t get addicted just because someone else wants to make money.”