Clear The Air News Tobacco Blog Rotating Header Image

Sweden

Swedish anti-cigarette billboard ‘coughs’ when smokers walk by

https://www.rt.com/news/373325-anti-smoking-billboard-sweden/

cough

Nicotine addicts who find themselves mindlessly smoking through the streets of Stockholm are being reminded that the habit isn’t healthy – but not by a doctor. Instead, a billboard equipped with smoke detectors is ‘coughing’ as they pass by.

The electronic sign featuring a black-and-white picture of a man seems usual enough upon first glance and for non-smokers it will continue to appear ordinary. However, smokers will see a different side of the billboard when they walk by, as the man on the sign begins coughing in reaction to their secondhand smoke.

A video that the pharmacy posted online shows the mixed reactions of passersby, ranging from confusion to amusement. One man looks at the sign while continuing to puff on his cigarette, while a woman starts laughing after realizing she was the one who triggered the coughing.

The billboard ends with an advertisement for nicotine gum products from various manufacturers.

The pharmacy said the sign is “just in time for the New Year” and aimed at helping people “live a longer and healthier life.”

Although the billboard has apparently been placed in an area “where people smoke a lot,” Sweden actually has the lowest smoking rate of all European Member states, just 13 percent, according to a 2012 report by the European Council

Smokeless Tobacco: Research Putting Another Nail in That Coffin

http://wabi.tv/2016/11/01/smokeless-tobacco-research-putting-another-nail-in-that-coffin/

By: Dr. William Sturrock

For years many have wondered whether using smokeless tobacco in forms such as dip, chew or E-cigs might somehow be safer because there are no combustion products that are being inhaled. While we already do know that oral, esophageal and GI cancers are more common in those who use smokeless tobacco, users have argued that these types of cancer are not as common, and may not be as life-threatening as diseases associated with smoking such as lung cancer and COPD. Lung cancer in particular remains the leading cause of cancer death for men and women in the US, so many with a nicotine habit have hoped to avoid this known risk of tobacco smoke to themselves, as well as the risks to others with second hand smoke. Unfortunately for smokeless tobacco advocates, we now have evidence of health risks that go beyond what was previously known.

Just this past month researchers from the Harvard School of Public Health published the results of their study done in Sweden, looking at the health of men using smokeless tobacco over a 21 year time-frame. They found was that compared to men that never used these products, smokeless tobacco users suffered a 24% higher chance of prostate cancer as well as a 19% higher of death from any cause. While the involvement of the prostate may be surprising to some, scientists have known for years that smokers of tobacco products can have higher rates of disease in non-respiratory organs compared to non-smokers. Cervical cancer, skin cancer and especially bladder cancer all occur more frequently among smokers.

Toxins from the tobacco combustion can be more concentrated in many different cell types as the body tries to metabolize and excrete these compounds. However this is the first time that a study on non-combusted tobacco had evidence of disease distant from the tissues that have direct contact with the smokeless product. So, if there was no exposure to the combustion products, what is the cause of these distant effects? Consumers of smokeless products do get regular exposure to nicotine, which is absorbed through the oral mucosa and transported by the blood stream to the rest of the body. Now researchers are more convinced that nicotine by itself can promote cancer transformation of many cell types. Already animal studies had suggested that nicotine puts oxidative stress onto cell DNA, and with this study we have the first evidence in humans that this is the likely mechanism for these distant ill effects.

Although it may ‘seem’ safer to use smokeless tobacco, Mother Nature has once more taught us that she cannot be fooled, and there is no such thing as a less dangerous consumption of this product. Unfortunately, children growing up in the US get mixed messages about smokeless tobacco when they see their role-models in many sports (especially baseball) using these products. It turns out that there has been a public health campaign to get baseball to kick the habit that has been gaining momentum.

Smokeless tobacco usage is now prohibited in the minor leagues, but only Boston, Chicago and the California teams have outlawed its use in the majors. Now, if we can just get the rest of the league to step up to the plate and ban smokeless tobacco in all of its forms from our national pastime, then that would be a real reason to cheer!

World’s third-largest tobacco producer quits cigarettes

As cigarettes face increasing regulation and a diminished customer base, under Lars Dahlgren’s leadership Swedish Match is looking ahead to a smoke-free tobacco industry

Based in Stockholm, Swedish Match is a company that makes snuff, chewing tobacco, cigars, matches and lighters. However, it is most famous for making snus – a unique Swedish variety of moist snuff, designed to be placed under the upper lip for long periods of time. The company is the third-largest producer of tobacco products in Europe, according to the 2015 Financial Times Global 500 list. The two other largest tobacco firms on the continent, by the same measurement, are British American Tobacco and Imperial Tobacco. Both of these are UK-based.

While the UK is not exactly known as a hotspot of tobacco use in Europe, historically it played a larger role in the development and growth of the tobacco industry, while Sweden – at least within popular perception – has played a much smaller role. It should be seen as no small feat, then, that this Swedish tobacco company has managed to secure itself so lofty a position. A large part of its success is due to the company’s forward-looking approach when it comes to selling tobacco. The firm itself no longer produces cigarettes, having divested from that particular product 11 years ago. Rather, Swedish Match has steered away from smoke-related tobacco products, focusing instead on the safer snus and chewing tobacco alternatives. This strategy has been followed under the overall direction of one man since 2008: CEO Lars Dahlgren.

Dahlgren and Swedish Match have recognised that smoking tobacco is on the way out. Fewer and fewer people want to enjoy nicotine through the traditional method of burning and inhaling tobacco smoke. However, the consumption and enjoyment of nicotine through other means is far from at a dead end. With the health threats of cigarettes universally known, consumers are looking for safer ways to get their fix – and removing the combustible element massively reduces the potential risks. The recent explosion in popularity of electronic vaporiser cigarettes attests to this. Swedish Match, under the leadership of Dahlgren, has accepted this trend and acted according.

Dahlgren’s strategy as CEO has not been to batten down the hatches and defend smoking from the ever-growing regulation of governments around the world, amid a general decline in use. Rather, he has taken the initiative to push Swedish Match to develop its focus away from conventional cigarettes.

Striking the match

Even before its divestment, Swedish Match was always more than just a cigarette producer. The company is over 100 years old; its origins lie in two firms founded in Sweden in the early 20th century, one producing tobacco products and the other matches and lighters. Svenska Tobaksmonopolet, founded in 1915, started to produce tobacco as a monopoly firm, while Svenska Tändsticks was founded in 1917 and produced matches. The two firms joined together in 1992, under the Procordia Group, before merging into the company that exists today – Swedish Match. As of 1996, Swedish Match has been listed on the Nasdaq Stockholm exchange. In 2015, it had total revenue of €1.5bn, and an operating income of over €425m.

With its nearly 5,000-strong workforce, Swedish Match sells its products worldwide, in more than 100 countries. The firm’s snus products have a majority market share in both Sweden and Norway, and its other products also enjoy market dominance further away from home. Swedish Match’s Redman chewing tobacco has a 40 percent market share in the US, while its cigar products hold almost 25 percent. Its matches and lighters are leaders in a wide range of markets, including the UK, various Scandinavian nations, France, Spain, Australia, Brazil, Russia and France.

Dahlgren himself has worked his way up since joining the company shortly after graduating, as an assistant controller. Now aged 46, Dahlgren climbed to the top through first reaching the position of CFO in Swedish Match’s Philippines office, before working for a few years in the firm’s group finance division. Finally, in 2004, he gained an executive role, serving as the head office’s CFO in Stockholm. Four years later, in 2008, he was appointed CEO. Dahlgren hopes to dispel the myth that tobacco companies are led by out-of-touch traditionalists, clinging to what is left of a declining and increasingly unfashionable market.

“I think many people perceive the tobacco industry as conservative and middle-aged”, he said in an interview with the Swedish Match website. “At Swedish Match, it is the complete opposite; we constantly strive to think in a youthful and innovative manner in everything we do.”

Adapt and improve

As the result of a merger between a firm producing lighters and matches, and another producing tobacco products, Swedish Match has a wider product base than most tobacco companies. At the same time, its production of the uniquely Swedish snus means its tobacco-producing arm is also more varied.

In a world of reduced smoking levels and increased tobacco control – with policies regulating and discouraging smoking from local government councils all the way up to national governments and beyond – Swedish Match’s diverse product base gives it an edge. Rather than fighting the tide of anti-smoking campaigns, it has even embraced it, seeing it as an opportunity to gain market share for its non-smoke tobacco products.

In 1996, when the company first became publically listed, its “smokeless tobacco business consisted of chewing tobacco and moist snuff in the US, and snus in Scandinavia”, said Dahlgren. Now, however, snus products have seen growing sales, particularly in the US. This has been part of a drive to focus on non-cigarette tobacco products. “Today, Swedish Match is truly a different company with a truly different vision.”

According to Dahlgren: “Swedish Match adapts and thrives.” And, in a world of smoking cessation, it is doing both. As he has noted: “In line with our strategic focus and vision, we are working diligently and enthusiastically to facilitate the trend and goal of a world without cigarettes.” And the adaptation seems to be working: snus products now account for more than 50 percent of Swedish Match’s operating profits.

Dahlgren said that now, “in line with our strategic focus and vision, we are working diligently and enthusiastically to facilitate the trend and goal of a world without cigarettes”. The company has taken clear steps towards this, gradually divesting from smoking products. It has already wound up its cigarette operations and, in January 2015, the company took the decision to reduce its shareholding in Scandinavian Tobacco Group, a cigar-producing firm. The company was founded in 2010, and Swedish Match previously owned 49 percent of it, which has now been cut to 31.2 percent.

Snus is, of course, still a tobacco product, meaning it still has some associated health risks. However, it remains much safer than cigarette smoking. In spite of this, many anti-smoking campaigns and local authorities have attempted to clamp down on non-smoking tobacco products. As Dahlgren has noted: “We face challenges through product taxation, regulation, and even the efforts of anti-tobacco organisations.” However, Swedish Match has taken steps to work towards remedying this through the relevant authorities. In the US, for instance, the firm has made an application to the US Food and Drug Administration (FDA) for its snus products to be classified as a Modified Risk Tobacco Product, allowing them to potentially escape certain punitive anti-smoking regulations.

Across the Atlantic

This attempt at a US reclassification is also part of Dahlgren’s forward-looking strategy. The US is seen as a key market for Swedish Match to expand into with its snus products; already a key market for chewing tobacco, Swedish Match has identified it as having a strong potential to become a large destination for snus.

The US is one of the few places in the world where the use of chewing tobacco has gained widespread use and cultural status. However, Americans are increasingly turning away from the product; Swedish Match estimated that in 2014 the company had a 40 percent market share for chewing tobacco in the US, representing an eight percent decline from 2012. Likewise, 2015 saw further a decline in sales volumes. Although Swedish Match owns Red Man, the market-leading premium brand in the US, it recognises use of the product is in decline. For this reason, alongside the decline of smoking, Swedish Match is gearing a lot of its efforts towards expanding its snus market in the US.

Swedish Match’s various snus products saw good growth in the US market last year. “For snus and moist snuff in the US, the General snus brand had good growth in both consumption volumes and market share, and the overall snus market experienced more rapid growth”, said Dahlgren. Dahlgren put the increased popularity of the product down to “its taste, its quality, and its benefits versus smoking”.

While Swedish Match’s application for Modified Risk Tobacco Product status is still awaiting approval, Dahlgren appears confident that it will be achieved. “While we are still awaiting an FDA decision, we were very pleased to see that Swedish Match this past year was the first and so far only tobacco company to have received product approvals under the pre-market approval process of the FDA”, he said. With its pre-existing brand dominance and its acceptance of changing market conditions, Swedish Match is well positioned to grow its snus sales in the US market. It has recognised which tobacco products are on the decline, and has focused its energies accordingly, as well as working with regulators in order to ensure lighter regulation of its products.

‘Ban smoking at outdoor restaurants in Sweden’

http://www.thelocal.se/20160607/ban-smoking-at-outdoor-restaurants-in-sweden

All outdoor restaurants, cafés and bars in Sweden could become non-smoking. A government inquiry reviewing tobacco legislation to reduce the use of tobacco is currently being looked at by a long line of organizations and government agencies. Their deadline to put forward their views is July 1st. The proposal that will be put to parliament has yet to be outlined, but such a smoking ban could very well go through.

Public opinion is for a smoke-free society, according to a major survey on behalf of Cancerfonden.

People want to breathe fresh air at restaurants, both inside and outside. Staff at restaurants welcomed the decision to ban smoking in the pub, when that law came into force 11 years ago. The decision was preceded by heated debates where worried commentators predicted the death of all pubs and unemployment, but just the opposite happened. Fresh air is appreciated.

It is time to ban smoking in outdoor seating areas and some other public outdoor areas as well.

Forced smoke, so-called passive smoking, is unhealthy. There are no levels of smoke low enough to be harmless, according to the World Health Organization (WHO), which has therefore proposed legislation as the only option of getting rid of the smoke. The WHO Framework Convention of Tobacco Control, of which Sweden is a signatory, recommends zero tolerance.

A week ago it was the day of the WHO’s international tobacco-free day. We don’t think that there should be a blanket ban on smoking, but everyone should be able to breathe fresh air. Not having to be exposed to second-hand smoke is especially important to people with asthma or allergies and to children. The lessons learned when smoking was banned at indoor resturants and bars show that not even smokers themselves appreciate cigarette smoke when there is good food to be enjoyed.

We need legislation for some non-smoking outdoor environments, such as at entrances to public buildings, on train station platforms and bus stops, at restaurant outdoor seating areas and in outdoor stadiums.

There is strong popular support for a more restrictive tobacco legislation. Demoskop polled more than 5,300 people on behalf of Cancerfonden this spring, suggesting that three out of four people wanted measures banning smoking in public places such as playgrounds, bus stops and outdoor cafes and so on.

If more people stop smoking and more places become non-smoking, children will not find smoking role models and will not be attracted to smoking. Smoking will then be seen as unusual behaviour. It would also help those who want to quite smoking. More non-smoking places also means a smaller risk of accidents because children are in various ways harmed or injured by cigarette butts.

Those who suffer from asthma, allergies or other kinds of hyper-sensitivity enjoy the same right as everyone else to be able to hang out at outdoor bars, platforms or bus stops. Accessibility is a right. Allergy symptoms when exposed to second-hand smoke is very common. In Sweden, around ten percent of all children and adults have hay fever, which is most cases mean that you are extra sensitive to tobacco smoke.

As early as 2003, parliament set a target that from 2014 nobody would be exposed to forced second-hand smoke. This target is far from met. But there is a possibility now of making good progess in terms of a smoke-free society, accessible to all.

It is our hope that the Swedish parliament this year votes to ban smoking in those public outdoor places recommended by the government tobacco inquiry.

E-cigarettes no longer considered medicinal products in Sweden

http://www.lexology.com/library/detail.aspx?g=9258ca21-ab20-4384-bcad-2a8d64044143

The Supreme Administrative Court has ruled that e-cigarettes not marketed for smoking cessation purposes should not be classified as medicinal products. This is contrary to the Medical Product Agency’s long-standing position and rulings of the first and second-instance courts. As a result, the EU Tobacco Product Directive (2014/40/EU) rules for e-cigarettes will apply to e-cigarettes in Sweden from May 20 2016, when the directive must be implemented in national legislation.

Facts

The Medical Product Agency had ordered a company to stop selling e-cigarettes with nicotine-containing liquids. The agency argued that the products had a high nicotine content, which is a pharmacologically active substance with an established medical use, primarily for smoking cessation.

The distributor argued that the e-cigarettes in question did not have a sufficiently strong pharmacological effect on the body’s functions to be classified as a medicinal product. Even if the e-cigarettes did have such an effect, they had no health benefits. The distributor claimed that it sold the e-cigarettes purely as a recreational product, with no claims that they were beneficial to health.

Both the first and second-instance courts dismissed the distributor’s arguments and held that e-cigarettes and nicotine-containing liquids should be classified as medicinal products. The appeal court stated that the manufacturers’ and distributors’ perceptions of the products’ use could not be considered decisive. The products were held to have scientifically documented pharmacological characteristics insofar as the active substance nicotine can be used to treat tobacco addiction, which results in nicotine cravings and withdrawal symptoms. This qualified as a beneficial health effect. The fact that the e-cigarettes were not used exclusively as medicinal products did not change this assessment and they were thus classified as medicinal products. The appeal court held that the Tobacco Product Directive does not prevent a member state from classifying e-cigarettes as medicinal products.

Decision

The Supreme Administrative Court held that all characteristics of a product must be considered when deciding on that product’s classification, including:
• the way it is used;
• how it is distributed;
• how well known it is among consumers; and
• the risks which may be involved with use.

It is not sufficient that a product has a pharmacological effect on the body’s functions. Referring to EU case law, the court stated that in order to be classified as a medicinal product, the product, if used as intended, must be capable of appreciably restoring, correcting or modifying physiological functions in human beings. The mere fact that the active substance affects the body’s functions is insufficient for it to be defined as a medicinal product.

The court did not consider that the Medical Product Agency’s scientific reports conclusively highlighted the effects that e-cigarettes had on smoking cessation and therefore did not demonstrate any e-cigarette health benefits (one of the prerequisites for medicinal product classification). Further, in its assessment of how e-cigarettes are distributed and used, the court referred to a report from the European Commission which showed that only 2% of Swedish respondents used e-cigarettes to stop smoking and that they did not consider the product to have any long-term effects on their smoking.

The court also noted that the e-cigarette distributor in this case had stated that the e-cigarettes were developed as a healthier, recreational alternative to normal tobacco cigarettes. They were designed to mimic traditional cigarettes and simulated cigarette smoke through their vapour. The addition of various aromas made product use pleasant. The products were not sold with any particular instructions on how the user should cut down on smoking or nicotine addiction.

The court therefore found that e-cigarettes were not medicinal products.

Comment

The Swedish market for e-cigarettes has until now been almost non-existent. However, this is likely to change following this decision. The judgment focused on the actual use of the products on the market and how they are marketed. Considering that no e-cigarettes are currently registered as medicinal products in Sweden, and that sales of non-registered e-cigarettes were virtually non-existent pending this decision, the Swedish respondents’ answers in the commission’s report to which the court referred should be reasonably affected. The court considered that because the way that these products are used and distributed will likely change following this decision, that classification of the product could also change.

The Supreme Administrative Court decision is something of a surprise in light of the lower-court decisions and agency case law. While the legislature in the ongoing implementation of the Tobacco Product Directive had mentioned that it would await the outcome of the judgment, it is likely that this particular outcome was not anticipated. This means that the directive’s rules for e-cigarettes will have to be put quickly into place in Swedish national law.

The judgment may also open up the possibility of introducing other smokeless nicotine products that would have been previously classified as medicinal products. It is uncertain whether the fact that e-cigarettes imitate tobacco cigarettes in terms of shape and vapour was decisive for the decision, and whether such anti-smoking products as lozenges or sprays could be considered general products. These questions remain unanswered.

For further information on this topic please contact Jonas Löfgren or Annie Kabala at Advokatfirman Lindahl KB by telephone (+46 8 527 70 800) or email (jonas.lofgren@lindahl.se or annie.kabala@lindahl.se). The Advokatfirman Lindahl KB website can be accessed at www.lindahl.se.

Plain Packaging – International Overview

Download (PDF, 852KB)

Sweden puffs up outdoor smoking ban proposals

Plans for an outdoor smoking plan in Sweden are hotting up with reports that a majority of politicians in the Swedish parliament will back plans to stop people lighting up on terraces and in beer gardens.

http://www.thelocal.se/20150527/swedens-outdoor-smoking-ban-plan-puffs-up

Sweden was one of the first countries in Europe to ban smoking in restaurants, bars and cafes around the country, almost exactly ten years ago.

The idea of extending the ban to include places such as outdoor terraces has been repeatedly discussed in the Nordic nation and in October 2014 Sweden’s Public Health Agency (Folkhälsomyndigheten) revealed its full proposals for new limits, to be considered by the government.

Now, top Swedish lawyer Göran Lundahl has been tasked with checking out how such a law might be worded and how this would fit in with the latest EU Tobacco Products Directive, which was approved by the European Parliament in February 2014 and aims to further limit smoking across member states.

Lundahl’s research is set to be completed by March 1st 2016 but he told Swedish broadcaster SVT on Wednesday that he was hopeful that a ban on smoking in outdoor restaurant areas could work.

“It won’t be so difficult technically to extend the smoking ban to outdoor dining. However, it is a little more difficult when it comes to things such as sidewalks outside entrances. But we pondering on this and hope that we can come up with a scheme that works,” he said.

Meanwhile the broadcaster says it has information which suggests that a majority of politicians from across the political spectrum will support a ban on smoking in outdoor eating areas.

YOUR VIEWS: Should outdoor smoking be banned in Sweden?

Repeated polls suggest that most Swedes back the idea of an extended smoking ban, with young people especially in favour of the plan.

“It’s about time to make public places free of cigarette smoke,” the head of Sweden’s Public Health Agency Johan Carlson said last year when announcing its push for a ban.

“Many people are uncomfortable with cigarette smoke and it can even trigger breathing difficulties for asthmatics.”

Lung cancer groups in Sweden made headlines in 2013 after proposing that the country should have a total smoking ban by 2025.

Evaluation of a tobacco prevention programme among teenagers in Sweden

http://bmjopen.bmj.com/content/5/5/e007673.full?g=w_tc_open_tab

Abstract

Objective

To study the prevalence of tobacco use among teenagers, to evaluate a tobacco prevention programme and to study factors related to participation in the prevention programme.

Design and setting

Population-based prospective cohort study.

Method

Within the Obstructive Lung disease in Northern Sweden (OLIN) studies, a cohort study about asthma in schoolchildren started in 2006. All children aged 7–8 years in three municipalities were invited to a questionnaire survey and 2585 (96%) participated. The cohort was followed up at age 11–12 years (n=2612, 95% of invited) and 14–15 years (n=2345, 88% of invited). In 2010, some of the children in the OLIN cohort (n=447) were invited to a local tobacco prevention programme and 224 (50%) chose to participate.

Results

At the age of 14–15 years, the prevalence of daily smoking was 3.5%. Factors related to smoking were female sex, having a smoking mother, participation in sports and lower parental socioeconomic status (SES). The prevalence of using snus was 3.3% and risk factors were male sex, having a smoking mother, having a snus-using father and non-participation in the prevention programme. In the prevention programme, the prevalence of tobacco use was significantly lower among the participants compared with the controls in the cohort. Factors related to non-participation were male sex, having a smoking mother, lower parental SES and participation in sports.

Conclusions

The prevalence of tobacco use was lower among the participants in the tobacco prevention programme compared with the non-participants as well as with the controls in the cohort. However, the observed benefit of the intervention may be overestimated as participation was biased by selection.